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医护人员中的天然橡胶乳胶过敏:证据的系统评价

Natural rubber latex allergy among health care workers: a systematic review of the evidence.

作者信息

Bousquet Jean, Flahault Antoine, Vandenplas Olivier, Ameille Jacques, Duron Jean-Jacques, Pecquet Corine, Chevrie Karine, Annesi-Maesano Isabella

机构信息

Service des Maladies Respiratoires, INSERM U454, Hôpital Arnaud de Villeneuve, University Hospital, 34295 Montpellier Cedex 5, France.

出版信息

J Allergy Clin Immunol. 2006 Aug;118(2):447-54. doi: 10.1016/j.jaci.2006.03.048. Epub 2006 Jul 3.

Abstract

BACKGROUND

Natural rubber latex is a recognized allergen, but a recent meta-analysis failed to find any association between latex exposure and allergy in health care workers (HCWs).

OBJECTIVES

A meta-analysis was carried out under the auspices of the French National Regulatory Authority to assess the allergic risk induced by latex gloves in HCWs.

METHODS

The risk of work-related exposure to latex for the development of latex allergy was assessed. Prevalence and incidence rates of latex sensitization or allergy were compared in HCWs and in the general population. Exposure-response relationships were assessed in HCWs.

RESULTS

Latex allergy was found in 4.32% (range, 4.01% to 4.63%) of HCWs and in 1.37% (range, 0.43% to 2.31%) of the general population. Latex-positive skin prick test responses ranged from 2.1% to 3.7% in the general population and from 6.9% to 7.8% for the HCWs. HCWs exposed to latex showed an increased risk of hand dermatitis (odds ratio [OR], 2.46; 95% CI, 2.11-2.86), asthma or wheezing (OR, 1.55; 95% CI, 1.15-2.08), rhinoconjunctivitis (OR, 2.73; 95% CI, 1.97-3.81), and at least one generic symptom (OR, 1.27; 95% CI, 1.09-1.47). Sensitization to latex was significantly associated with asthma and rhinoconjunctivitis. By contrast, exposure to latex was not associated with a significantly increased risk of positive skin prick test responses to latex (OR, 1.47; 95% CI, 0.94-2.30).

CONCLUSION

HCWs have an increased risk of sensitization and allergic symptoms to latex.

CLINICAL IMPLICATIONS

Prevention of latex allergy in HCWs is needed.

摘要

背景

天然橡胶乳胶是一种公认的过敏原,但最近的一项荟萃分析未能发现医护人员接触乳胶与过敏之间存在任何关联。

目的

在法国国家监管机构的支持下进行了一项荟萃分析,以评估乳胶手套对医护人员造成的过敏风险。

方法

评估了因工作接触乳胶而导致乳胶过敏的风险。比较了医护人员和普通人群中乳胶致敏或过敏的患病率和发病率。评估了医护人员中的暴露-反应关系。

结果

4.32%(范围为4.01%至4.63%)的医护人员患有乳胶过敏,普通人群中的这一比例为1.37%(范围为0.43%至2.31%)。普通人群中乳胶阳性皮肤点刺试验反应的范围为2.1%至3.7%,医护人员为6.9%至7.8%。接触乳胶的医护人员患手部皮炎的风险增加(优势比[OR],2.46;95%置信区间[CI],2.11 - 2.86)、哮喘或喘息(OR,1.55;95% CI,1.15 - 2.08)、鼻结膜炎(OR,2.73;95% CI,1.97 - 3.81)以及至少一种一般症状(OR,1.27;95% CI,1.09 - 1.47)。对乳胶的致敏与哮喘和鼻结膜炎显著相关。相比之下,接触乳胶与乳胶阳性皮肤点刺试验反应风险的显著增加无关(OR,1.47;95% CI,0.94 - 2.30)。

结论

医护人员对乳胶致敏和出现过敏症状的风险增加。

临床意义

需要预防医护人员发生乳胶过敏。

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