Brown R H, Schauble J F, Hamilton R G
Department of Anesthesiology and Critical Care Medicine, and Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Anesthesiology. 1998 Aug;89(2):292-9. doi: 10.1097/00000542-199808000-00004.
Occupational exposure to natural rubber latex has led to sensitization of health-care workers. However, the prevalence of latex allergy among occupationally exposed workers in American hospitals has not been reproducibly determined. The objectives of the current study were to determine the prevalence of and risk factors for latex sensitization among a cohort of highly exposed health-care workers.
Participants were 168 of 171 eligible anesthesiologists and nurse anesthetists working in the Department of Anesthesiology and Critical Care Medicine. A clinical questionnaire was administered, and testing was performed using a characterized nonammoniated latex reagent for puncture skin testing, a Food and Drug Administration-approved assay to quantify latex-specific immunoglobulin E antibody in serum, and, when required for clarification, a validated two-stage (contact-inhalation) latex glove provocation procedure.
The prevalence of latex allergy with clinical symptoms and latex sensitization without clinical symptoms was 2.4% and 10.1%, respectively. The prevalence of irritant or contact dermatitis was 24%. The risk factors identified for latex sensitization were atopy (odds ratio, 14.1; 95% CI, 1.8-112.1; P = 0.012); history of allergy to selected fruits, such as bananas, avocados, or kiwis (odds ratio, 9.8; 95% CI, 1.6-61.9; P = 0.015); and history of skin symptoms with latex glove use (odds ratio, 4.6; 95% CI, 1.6-13.4; P = 0.006).
The prevalence of latex sensitization among anesthesiologists is high (12.5%). Of these, 10.1% had occult (asymptomatic) latex allergy. Hospital employees may be sensitized to latex even in the absence of perceived latex allergy symptoms. These data support the need to transform the health-care environment into a latex-safe one that minimizes latex exposure to patients and hospital staff.
职业性接触天然橡胶乳胶已导致医护人员致敏。然而，美国医院中职业暴露工人的乳胶过敏患病率尚未得到重复性确定。本研究的目的是确定一组高暴露医护人员中乳胶致敏的患病率及其危险因素。
参与者为麻醉与重症医学科171名合格麻醉医师和麻醉护士中的168名。进行了临床问卷调查，并使用一种经过鉴定的无氨乳胶试剂进行点刺皮肤试验，采用美国食品药品监督管理局批准的检测方法定量检测血清中乳胶特异性免疫球蛋白E抗体，必要时采用经过验证的两阶段（接触-吸入）乳胶手套激发程序进行检测。
有临床症状的乳胶过敏患病率和无临床症状的乳胶致敏患病率分别为2.4%和10.1%。刺激性或接触性皮炎的患病率为24%。确定的乳胶致敏危险因素包括特应性（比值比，14.1；95%可信区间，1.8-112.1；P = 0.012）；对某些水果（如香蕉、鳄梨或猕猴桃）过敏史（比值比，9.8；95%可信区间，1.6-61.9；P = 0.015）；以及使用乳胶手套时有皮肤症状史（比值比，4.6；95%可信区间，1.6-13.4；P = 0.006）。
麻醉医师中乳胶致敏的患病率很高（12.5%）。其中，10.1%有隐匿性（无症状）乳胶过敏。即使没有察觉到乳胶过敏症状，医院员工也可能对乳胶致敏。这些数据支持有必要将医疗环境转变为乳胶安全环境，以尽量减少患者和医院工作人员接触乳胶。
