Vangveeravong Mukda, Sirikul Jintana, Daengsuwan Tassalapa
Allergy & Immunology Unit, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Aug;94 Suppl 3:S1-8.
Latex allergy is a major occupational health problem in health care workers who regularly use latex gloves. Dentists are one of the high risk groups for latex allergy and sensitization as it is generally found that healthcare workers (HCW) have 3 times greater prevalence of latex allergy. There are very few studies of latex allergy in HCW in Thailand.
To study the prevalence of latex-related symptoms, latex-sensitization and possible risk factors in dental students.
A cross-sectional study was performed on all dental students of the Faculty of Dentistry, Chulalongkorn University, during Dec 2007 to May 2008, using questionnaires and skin prick tests (SPT), using 3 latex extracts prepared from Proglove, Doctor Plus gloves and a commercial latex allergen (Stallergenes, France). SPT was done only in those who were willing and signed informed consents.
There were 617 completed questionnaires (87.3%). The mean age of the volunteers was 20.9 +/- 1.7 years with 29.3% male and 70.7% female. The prevalence of latex glove-related symptoms was 5.0%. These symptoms were all local, cutaneous symptoms, ranging from hand pruritus (64.5%), hand eczema (19.4%) and contact urticaria (16.1%). Eight subjects (1.3%) reported pruritus or urticaria on exposure to other rubber products while 12 subjects (1.9%) reported reactions to some fruits. The risk factors for latex-glove allergy were personal history of allergic diseases (atopic dermatitis, urticaria, pruritus and rubber allergy), duration of using gloves more than 18 hours per week, more than 3 pairs of gloves used per day and timing of glove exposure. The 4th to 6th year students were observed significantly more prevalence of symptoms than the 1st to 3rd year students (OR, 3.69; 95% CI, 1.73-7.87; p = 0.0003). SPT for 3 extracts of latex was done in 247 cases (40.0%); overall latex sensitization rate was 14.2%. The commercial extract had higher incidence of latex sensitization compared to the 2 gloves extract. The 1st year students had the lowest percentage of latex sensitization (3.2%) and positive skin test was significantly found in the 2nd year students (20.8%; OR, 6.46; 95% CI, 1.87-47.98; p = 0.04).
The prevalence of latex allergy in dental students is 5% and the signs and symptoms were local cutaneous reaction; pruritus, eczema and contact urticaria. The latex sensitization rate in dental students was14.2%, which is higher than the general population. The possible risk factors included personal history of allergic diseases, duration and frequency of exposure. Therefore, primary prevention of the occupational latex allergy should be carefully considered especially concerning high risk factors.
乳胶过敏是经常使用乳胶手套的医护人员面临的一个主要职业健康问题。牙医是乳胶过敏和致敏的高危群体之一，因为一般发现医护人员（HCW）乳胶过敏的患病率要高3倍。泰国针对医护人员乳胶过敏的研究非常少。
研究牙科学生中乳胶相关症状、乳胶致敏情况及可能的危险因素。
2007年12月至2008年5月期间，对朱拉隆功大学牙科学院的所有牙科学生进行了一项横断面研究，采用问卷调查和皮肤点刺试验（SPT），使用从Proglove、Doctor Plus手套以及一种商用乳胶变应原（法国Stallergenes公司）制备的3种乳胶提取物。仅对那些愿意并签署知情同意书的学生进行SPT。
共完成617份问卷（87.3%）。志愿者的平均年龄为20.9±1.7岁，其中男性占29.3%，女性占70.7%。乳胶手套相关症状的患病率为5.0%。这些症状均为局部皮肤症状，包括手部瘙痒（64.5%）、手部湿疹（19.4%）和接触性荨麻疹（16.1%）。8名受试者（1.3%）报告在接触其他橡胶制品时出现瘙痒或荨麻疹，12名受试者（1.9%）报告对某些水果有反应。乳胶手套过敏的危险因素包括过敏性疾病个人史（特应性皮炎、荨麻疹、瘙痒和橡胶过敏）、每周使用手套时间超过18小时、每天使用超过3副手套以及手套接触时间。4至6年级学生的症状患病率明显高于1至3年级学生（比值比，3.69；95%置信区间，1.73 - 7.87；p = 0.0003）。对247例（40.0%）进行了3种乳胶提取物的SPT；总体乳胶致敏率为14.2%。与两种手套提取物相比，商用提取物的乳胶致敏发生率更高。1年级学生的乳胶致敏率最低（3.2%），2年级学生中皮肤试验阳性率显著（20.8%；比值比，6.46；95%置信区间，1.87 - 47.98；p = 0.04）。
牙科学生中乳胶过敏的患病率为5%，体征和症状为局部皮肤反应；瘙痒、湿疹和接触性荨麻疹。牙科学生的乳胶致敏率为14.2%，高于普通人群。可能的危险因素包括过敏性疾病个人史、接触的持续时间和频率。因此，应特别谨慎考虑职业性乳胶过敏的一级预防，尤其是针对高危因素。
