Heilman D K, Jones R T, Swanson M C, Yunginger J W
Mayo Graduate School of Medicine, Rochester, MN 55905, USA.
J Allergy Clin Immunol. 1996 Aug;98(2):325-30. doi: 10.1016/s0091-6749(96)70157-4.
Although protocols have been published for reducing natural rubber latex exposure in medical environments, there are no objective data documenting their effectiveness.
We prospectively studied the impact of a single intervention, substitution of low-allergen-containing latex gloves for high-allergen-containing latex gloves, on latex aeroallergen levels in a single operating room (OR).
We sampled OR air on 52 consecutive days, including 33 surgery days and 19 nonsurgery days. On each surgery day all personnel wore either high-allergen gloves (n = 18 days) or low-allergen gloves (n = 15 days). Latex aeroallergen levels (in nanograms per cubic meter) and extractable latex glove allergen contents (in allergen units per milliliter) were measured by inhibition immunoassays. An on-site study monitor recorded the number of gloves used, the total time spent by all patients in the OR each day (OR time), and the total time of all procedures for each day (operating procedure time).
Latex aeroallergen levels during low-allergen glove use days (mean, 1.1 ng/m3; median, 0.9 ng/m3; range, 0.1 to 3.5 ng/m3) were significantly lower than on high-allergen glove use days (mean, 13.7 ng/m3; median, 7.7 ng/m3; range, 2.2 to 56.4 ng/m3) (p < 0.001) but not significantly different from that on nonsurgery days (mean, 0.6 ng/m3; median, 0.3 ng/m3; range, 0.1 to 3.6 ng/m3). Latex aeroallergen levels were strongly correlated with the total number of gloves used on designated high-allergen glove days (r = 0.66, p = 0.003). There was no appreciable day-to-day carryover of latex aeroallergen.
The substitution of low-allergen-containing latex gloves for high-allergen-containing latex gloves can reduce levels of latex aeroallergen by more than 10-fold in an OR environment.
尽管已经发布了在医疗环境中减少天然橡胶乳胶暴露的方案，但尚无客观数据证明其有效性。
我们前瞻性地研究了一项单一干预措施，即用低过敏原乳胶手套替代高过敏原乳胶手套，对单个手术室（OR）中乳胶气传过敏原水平的影响。
我们连续52天对手术室空气进行采样，包括33个手术日和19个非手术日。在每个手术日，所有人员要么佩戴高过敏原手套（n = 18天），要么佩戴低过敏原手套（n = 15天）。通过抑制免疫测定法测量乳胶气传过敏原水平（以每立方米纳克为单位）和可提取乳胶手套过敏原含量（以每毫升过敏原单位为单位）。一名现场研究监测员记录了使用的手套数量、每天所有患者在手术室的总时间（手术室时间）以及每天所有手术的总时间（手术操作时间）。
在使用低过敏原手套的日子里，乳胶气传过敏原水平（平均值为1.1 ng/m³；中位数为0.9 ng/m³；范围为0.1至3.5 ng/m³）显著低于使用高过敏原手套的日子（平均值为13.7 ng/m³；中位数为7.7 ng/m³；范围为2.2至56.4 ng/m³）（p < 0.001），但与非手术日的水平无显著差异（平均值为0.6 ng/m³；中位数为0.3 ng/m³；范围为0.1至3.6 ng/m³）。在指定的高过敏原手套日，乳胶气传过敏原水平与使用的手套总数密切相关（r = 0.66，p = 0.003）。乳胶气传过敏原没有明显的每日残留。
在手术室环境中，用低过敏原乳胶手套替代高过敏原乳胶手套可使乳胶气传过敏原水平降低10倍以上。
