ALLERGY TO LATEX
D. VERVLOET
Service de Pneumo-allergologie - Hôpital Sainte-Marguerite - 13009 MARSEILLE
(partial) translation : | Français/French |  :-)

I - PREVALENCE OF LATEX SENSITIZATION IN A GENERAL POPULATION

The rate of latex sensitization in a non selected population has rarely been reported :

- 6.5% among 1000 volunter donors using ALASTAT assay system (1).
- 6.6% among 258 subjects visiting an health care center for a check up examination using skin-prick tests and CAP RAST to latex (2).

II - INCREASED RATE IN HEALTH CARE WORKERS AND WORKERS FROM INDUSTRY

- The prevalence of positive skin tests to latex was 6.2% in subjects working in operating units in contrast to 1.6% in persons working in laboratory units (3).
- The prevalence of latex sensitization was found to be 10.2% in a group of 2680 operating nurses (4).
- The prevalence of latex sensitization was found to be 11% in a population of 81 employees working in a factory manufacturing latex gloves (5).

III - INCREASED RATE IN CHILDREN WITH SPINA BIFIDA (SB) OR MULTIPLE, SURGERIES

- 34% positive RAST to latex in a SB group (6)
- 32% positive skin test to latex in 25 children with SB (7)
- 60% and 72% rate of latex sensitization in two other studies (8, 9)
- 59% and 55% latex sensitization respectively in a SB and in a multiple operated group (10)

IV - ATOPY IS A RISK FACTOR

Atopy increases the risk of sensitization in either general population, health care workers, workers from industry and spina bifida groups (4, 11, 12).

V - MAIN ALLERGENS

Several proteins are identified to be latex allergens (13, 14, 15) :
- Rubber elongation factor 14 kDa
- Hevein C domain 14 kDa
- Prohevein 20 kDa
- A 27 kDa in allergic children with spina bifida
- Profilin 14-15 kDa
- Hevamin and other 29-33 kDa proteins
- A 45 kDa protein
Some of these proteins can be present in the ambiant air (17) in enough concentrations to induce asthma attacks in sensitized patients. These proteins are absorbed on glove powder which is an allergen carrier (18, 19).

REFERENCES

1. Ownby DR, Ownby HE, McCullough JA, Shafer AW. The prevalence of anti-latex IgE antibodies in 1000 volunteer blood donors. J Allergy Clin Immunol 1994; 93 : A717.

2. Porri F, Lemiere C, Birnbaum J, Guilloux L, Lanteaume A, Didelot R, Vervloet D, Charpin D. Prevalence of latex sensitization in a general population. Implications for a preoperative screening. (submitted for publication).

3. Turjanmaa K, Reunala T, Alenius H, Brummer-Korvenkontio H, Palosuo T. Allergens in latex surgical gloves and glove powder. Lancet 1990; 336 : 1588.

4. Lagier F, Vervloet D, Lhermet I, Poyen D, Charpin D. Prevalence of latex allergy in operating room nurses. J Allergy Clin Immunol 1992; 90 : 319-322.

5. Tarlo SM, Wong L, Roos L, Booth N. Occupational asthma caused by latex in a surgical glove manufacturing plant. J Allergy Clin Immunol 1990; 85 : 626-631.

6. Slater JE, Mostello LA, Shaer C. Rubber specific IgE in children with spina bifida. J Urol 1991; 146 : 578-579.

7. Moneret-Vautrin DA, Laxenaire MC, Bavoux F. Allergic shock to latex and EO during surgery for spina bifida. Anesthesiology 1990; 73 : 556-558.

8. Ellsworth PI, Merguerian PA, Klein RB, Rozycki AA. Evaluation and risk factors of latex allergy in spina bifida patients : is it preventable ? J Urol 1993; 150 : 691-693.

9. Konz KR, Cjia JK, Kurup VP, Resnick A, Kelly KJ, Fink JN. Comparison of latex hypersensitivity among patients with neurologic defects. J Allergy Clin Immunol 1995; 95 : 950-954.

10. Rate of latex sensitization in children with spina bifida : genetic predisposition or result of repeated latex exposure ? Porri F, Pradal M, Lemiere C, Birnbaum J, Mege JL, Charpin D, Vervloet D, Camboulives J. (submitted for publication).

11. Moneret-Vautrin DA, Beaudouin E, Widmer S, Mouton C, Kanny G, Prestat F, Kohler C, Feldmann L. Prospective study of risk factors in natural rubber latex hypersensitivity. J Allergy Clin Immunol 1993; 92 : 668-677.

12. Arellano R, Bradley J, Sussman G. Prevalence of latex sensitization among hospital physicians occupationnally exposed to latex gloves. Anesthesiology 1992; 77 : 905-908.

13. Muguerza J, Capo C, Porri F, Jacob JL, Mege JL, Vervloet D. Latex allergy : allergen identification in hevea Braziliensis fractions by immunoblotting. (accepted for publication, Clin Exp Allergy 1996).

14. Czuppon A, Chen Z, Rennert S et al. The rubber elongation factor of rubber tree (Hevea braziliensis) is the major allergen in latex. J Allergy Clin Immunol 1993; 92 : 690-697.

15. Alenius H, Kurup V, Kelly K, Polosuo T, Turjanmaa K, Fink J. Latex allergy : frequent occurrence of IgE antibodies to a cluster of 11 latex proteins in patients with spina bifida and histories of anaphylaxis. J Lab Clin Med 1994; 123 : 712-20.

16. Alenius H, Kalkkinen N, Lukka M, Reunala T, Turjanmaa K, Makinen-Kiljunen S, Yip E, Palosuo T. Prohevein from the rubber tree (Hevea brasiliensis) is a major latex allergen. Clin Exp Allergy 1995; 24 : 659-665.

17. Baur X, Jeager D. Airborne antigens from latex gloves. Lancet 1990; 335 : 912.

18. Tomazic VJ, Shampaine EL, Lamanna A, Withrow TJ, Adkinson NF, Hamilton RG. Cornstasch powder on latex products is an allergen carrier. J Allergy Clin Immunol 1994; 93 : 751-758.

19. Lundberg M, Wrangsjo K, Johansson SGO. Latex allergens in glove powdering slurries. Allergy 1995; 50 : 378-380.

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Date de création: 25 Septembre 1996 - Dernière mise à jour: 21/07/98
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