Evaluating interventions aimed at reducing occupational exposure to latex and rubber glove allergens. 2012

Susan Turner, and Roseanne McNamee, and Raymond Agius, and Stephen Mark Wilkinson, and Melanie Carder, and Susan J Stocks
Centre for Occupational and Environmental Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. susan.m.turner@manchester.ac.uk

OBJECTIVE Concerns over occupational exposures to blood-borne viruses resulted in increased protective glove use; consequentially latex allergy became a hazard for some occupational groups. Interventions aimed at managing this problem included substitution measures (eg, non-powdered/non-latex gloves), but such changes may not occur simultaneously across occupational sectors. This study evaluated whether the incidence of occupational dermatoses fell after interventions aiming to reduce exposure to 'latex and rubber glove allergens' ('latex') were introduced, and whether these interventions were more effective for healthcare workers (HCWs), compared with non-HCWs. METHODS Incidence rate ratios (IRRs) comparing cases reported to EPIDERM (a UK-wide surveillance scheme) during post versus pre-intervention periods were calculated, both where 'latex' was cited and for cases associated with other exposures ('controls'). RESULTS Among HCWs, cases of contact urticaria and allergic contact dermatitis (ACD) where 'latex' was cited showed significant downward trends post-intervention, with IRRs of 0.72, 95% CI; 0.52 to 1.00 and 0.47, 95% CI; 0.35 to 0.64 respectively. For HCWs, this fall in 'latex' associated ACD was significantly greater (p=0.02) than for other exposures ('controls') IRR=0.85, 95% CI; 0.57 to 1.28, and greater than that among non-HCWs (IRR 0.75, 95% CI; 0.61 to 0.93). Increases over time were seen for irritant contact dermatitis (ICD) reporting for HCWs, both for cases associated with 'latex' (IRR 1.47, 95% CI: 1.02 to 2.13) and for other exposures ('controls') IRR 1.36, 95% CI 1.06 to 1.76, but not for non-HCWs. CONCLUSIONS A reduction in overall ACD, particularly in HCWs, coincided with interventions aimed at managing workplace contact dermatoses associated with 'latex' exposure. A coincidental rise in ICD reporting is also important, both for hand care and for infection control strategies.

UI MeSH Term Description Entries
D007840 Latex A milky, product excreted from the latex canals of a variety of plant species that contain cauotchouc. Latex is composed of 25-35% caoutchouc, 60-75% water, 2% protein, 2% resin, 1.5% sugar & 1% ash. RUBBER is made by the removal of water from latex.(From Concise Encyclopedia Biochemistry and Molecular Biology, 3rd ed). Hevein proteins are responsible for LATEX HYPERSENSITIVITY. Latexes are used as inert vehicles to carry antibodies or antigens in LATEX FIXATION TESTS. Latices,Latice
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009784 Occupational Diseases Diseases caused by factors involved in one's employment. Diseases, Occupational,Occupational Illnesses,Disease, Occupational,Illnesse, Occupational,Illnesses, Occupational,Occupational Disease,Occupational Illnesse
D005260 Female Females
D006282 Health Personnel Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976) Health Care Professionals,Health Care Providers,Healthcare Providers,Healthcare Workers,Health Care Professional,Health Care Provider,Healthcare Provider,Healthcare Worker,Personnel, Health,Professional, Health Care,Provider, Health Care,Provider, Healthcare
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000485 Allergens Antigen-type substances that produce immediate hypersensitivity (HYPERSENSITIVITY, IMMEDIATE). Allergen
D012408 Rubber A high-molecular-weight polymeric elastomer derived from the milk juice (LATEX) of HEVEA brasiliensis and other trees and plants. It is a substance that can be stretched at room temperature to at least twice its original length and after releasing the stress, retract rapidly, and recover its original dimensions fully. Latex Rubber,Elastica,India Rubber,Natural Rubber,Plant Rubber,Vulcanite,Natural Rubbers,Plant Rubbers,Rubber, Natural,Rubber, Plant,Rubbers, Natural,Rubbers, Plant

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