Hunt L W, Fransway A F, Reed C E, Miller L K, Jones R T, Swanson M C, Yunginger J W
Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
J Occup Environ Med. 1995 Oct;37(10):1204-9. doi: 10.1097/00043764-199510000-00011.
IgE-mediated sensitivity to natural rubber latex is being recognized more frequently among health care workers. Between January 1990 and June 1993, we evaluated 342 consecutive Mayo Medical Center employees who reported symptoms suggestive of latex allergy. All were interviewed and underwent puncture skin testing with extracts of rubber gloves. In some cases, latex-specific IgE antibodies were measured by immunoassay. One hundred four of the 342 employees evaluated (30%) were latex-allergic. Risk factors for sensitization included frequent use of disposable gloves, presence of prior atopic disease, and prior or current hand dermatitis. The peak onset of symptoms occurred in late 1989 and early 1990 and did not correlate with a peak in glove usage at our medical center, which continued to rise. Most sensitized employees (78%) reported contact urticaria from rubber gloves, and over two thirds also experienced allergic rhinitis, conjunctivitis, or asthma when working in areas where large numbers of gloves were being used. Sixteen episodes of rubber-induced anaphylaxis were documented in 12 employees; six episodes occurred after latex skin testing and were easily reversed with appropriate therapy. Our findings substantiate a local epidemic of latex allergy among medical center employees. Epidemiologic studies are needed to assess the effects of various interventions to reduce occupational exposure to latex allergens. Although prick skin testing with concentrated latex glove extracts presents some risk of systemic reaction, pending availability of commercial diagnostic extracts, such testing is generally safe when performed by skilled laboratory personnel. Skin testing is warranted to investigate health care workers suspected of being latex-sensitive.
医护人员中因免疫球蛋白E介导而对天然橡胶乳胶敏感的情况日益常见。在1990年1月至1993年6月期间，我们对梅奥医学中心连续342名报告有乳胶过敏症状的员工进行了评估。所有人员均接受了访谈，并使用橡胶手套提取物进行了点刺皮肤试验。在某些情况下，通过免疫测定法检测了乳胶特异性免疫球蛋白E抗体。在接受评估的342名员工中，有104名（30%）对乳胶过敏。致敏的风险因素包括频繁使用一次性手套、既往有特应性疾病以及既往或目前患有手部皮炎。症状的发病高峰出现在1989年末和1990年初，与我们医疗中心手套使用量的高峰不相关，手套使用量持续上升。大多数致敏员工（78%）报告接触橡胶手套后出现接触性荨麻疹，超过三分之二的员工在大量使用手套的区域工作时还出现了过敏性鼻炎、结膜炎或哮喘。12名员工记录了16次橡胶诱发的过敏反应发作；6次发作发生在乳胶皮肤试验后，通过适当治疗很容易逆转。我们的研究结果证实了医疗中心员工中乳胶过敏的局部流行情况。需要进行流行病学研究来评估各种干预措施对减少职业接触乳胶过敏原的效果。尽管用浓缩乳胶手套提取物进行点刺皮肤试验存在一些发生全身反应的风险，但在商用诊断提取物可用之前，由熟练实验室人员进行这种试验通常是安全的。对于怀疑对乳胶敏感的医护人员，有必要进行皮肤试验以进行调查。
