Latex allergy at Groote Schuur Hospital--prevalence, clinical features and outcome.

BACKGROUND

The incidence of latex allergy is increasing worldwide but there is very little information available on the clinical outcome for affected individuals.

OBJECTIVE

To determine the prevalence of latex allergy at Groote Schuur Hospital, a large teaching hospital in Cape Town, and to study the outcome for affected individuals.

METHOD

Using a questionnaire, we screened 2,316 hospital workers for the presence of work-related symptoms. Workers who were symptomatic had Immunocap RAST (CAP RAST) or skin-prick tests to confirm latex sensitivity. Latex-avoidance measures were implemented in positive subjects. One hundred symptomatic, sensitised individuals were followed up 3 months after intervention to assess their clinical status. A further cohort of 25 individuals with ongoing nasal symptoms were studied in detail.

RESULTS

Latex sensitisation was confirmed in 182 of 717 symptomatic workers (25.3%). Sensitised symptomatic workers were significantly more likely to have had a previous history of urticaria (P = < 0.001), oral allergy syndrome (P = < 0.001), or allergic conjunctivitis (P = 0.001), but not hay fever, perennial rhinitis, eczema or insect allergies. Latex sensitisation occurred among all classes of health care workers. Ocular and cutaneous symptoms were significantly associated with positive latex sensitisation (P = < 0.001). After latex intervention, ocular symptoms (P = < 0.001), skin rashes (P = < 0.001) and wheezing (P = 0.001) reduced significantly. Nasal symptoms did not improve. Undiagnosed and untreated underlying allergies to common aero-allergens were present in the majority of latex-sensitised patients with ongoing nasal symptomatology.

CONCLUSION

The prevalence of symptomatic sensitisation to latex allergy at Groote Schuur Hospital is between 9.2 and 11.2%. Ocular and cutaneous symptoms are the most prevalent in sensitised workers, and unlike nasal symptoms are significantly reduced when latex-avoidance measures are introduced. Ongoing nasal symptoms after intervention is instituted are probably due to other allergic sensitivities in latex-sensitised health care workers.