Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
BMJ Open. 2013 Dec 9;3(12):e002900. doi: 10.1136/bmjopen-2013-002900.
The present study describes latex sensitisation and allergy prevalence and associated factors among healthcare workers using hypoallergenic latex gloves at King Edward VIII Hospital in KwaZulu-Natal, South Africa.
Cross-sectional study.
A tertiary hospital in eThekwini municipality, KwaZulu-Natal, South Africa.
600 healthcare workers were randomly selected and 501 (337 exposed and 164 unexposed) participated. Participants who were pregnant, with less than 1 year of work as a healthcare worker and a history of anaphylactic reaction were excluded from the study.
Latex sensitisation and latex allergy were the outcome of interest and they were successfully measured.
The prevalence of latex sensitisation and allergy was observed among exposed workers (7.1% and 5.9%) and unexposed workers (3.1% and 1.8%). Work-related allergy symptoms were significantly higher in exposed workers (40.9%, p<0.05). Duration of employment was inversely associated with latex allergy (OR 0.9; 95% CI 0.8 to 0.9). The risk of latex sensitisation (OR 4.2; 95% CI 1.2 to 14.1) and allergy (OR 5.1; 95% CI 1.2 to 21.2) increased with the exclusive use of powder-free latex gloves. A dose-response relationship was observed for powdered latex gloves (OR 1.1; 95% CI 1.0 to 1.2). Atopy (OR 1.5; 95% CI 0.7 to 3.3 and OR 1.4; 95% CI 0.6 to 3.2) and fruit allergy (OR 2.3; 95% CI 0.8 to 6.7 and OR 3.1; 95% CI 1.1 to 9.2) also increased the risk of latex sensitisation and allergy.
This study adds to previous findings that healthcare workers exposed to hypoallergenic latex gloves are at risk for developing latex sensitisation highlighting its importance as an occupational hazard in healthcare. More research is needed to identify the most cost effective way of implementing a latex-free environment in resource-limited countries, such as South Africa. In addition more cohort analysis is required to better understand the chronicity of illness and disability associated with latex allergy.
本研究描述了在南非夸祖鲁-纳塔尔省爱德华七世国王医院使用低变应原乳胶手套的医护人员乳胶致敏和过敏的流行情况及其相关因素。
横断面研究。
南非夸祖鲁-纳塔尔省埃滕哈赫市的一家三级医院。
随机选择了 600 名医护人员，其中 501 名（337 名暴露组，164 名未暴露组）参与了研究。排除了妊娠、工作不满 1 年和有过敏反应史的参与者。
乳胶致敏和乳胶过敏是研究的主要结局，并且已经成功地进行了测量。
暴露组（7.1%和 5.9%）和未暴露组（3.1%和 1.8%）的乳胶致敏和过敏发生率存在差异。暴露组的职业性过敏症状明显更高（40.9%，p<0.05）。就业时间与乳胶过敏呈负相关（OR 0.9；95%CI 0.8 至 0.9）。乳胶致敏（OR 4.2；95%CI 1.2 至 14.1）和过敏（OR 5.1；95%CI 1.2 至 21.2）的风险随着纯粉乳胶手套的单独使用而增加。粉末状乳胶手套存在剂量反应关系（OR 1.1；95%CI 1.0 至 1.2）。特应性（OR 1.5；95%CI 0.7 至 3.3 和 OR 1.4；95%CI 0.6 至 3.2）和水果过敏（OR 2.3；95%CI 0.8 至 6.7 和 OR 3.1；95%CI 1.1 至 9.2）也增加了乳胶致敏和过敏的风险。
本研究进一步证实了接触低变应原乳胶手套的医护人员有发生乳胶致敏的风险，强调了其作为职业危害在医疗保健中的重要性。在资源有限的国家，如南非，需要开展更多的研究来确定实施无乳胶环境的最具成本效益的方法。此外，还需要进行更多的队列分析，以更好地了解与乳胶过敏相关的疾病和残疾的慢性病程。
