Liss G M, Sussman G L
Ontario Ministry of Labour, Toronto, Canada.
Am J Ind Med. 1999 Feb;35(2):196-200. doi: 10.1002/(sici)1097-0274(199902)35:2<196::aid-ajim12>3.0.co;2-y.
Natural rubber latex (NRL) has become an important occupational health concern in recent years, particularly among health care workers. It has been suggested in some reports that the prevalence of latex sensitization among occupationally exposed groups is not different from that in the general population.
The findings of prevalence studies conducted among occupationally-exposed and general population groups were reviewed to determine whether there is evidence to support this suggestion.
Numerous surveys of HCWs have demonstrated that the prevalence of sensitization to latex ranged in most studies from 5 to 12%; sensitization of HCWs may produce clinical effects including urticaria, rhinoconjunctivitis, occupational asthma, and potentially life-threatening anaphylactic shock. More than a decade ago, data from Finland indicated that the prevalence of latex allergy in the general population was less than 1%. Recent reports from Finland have confirmed this, with observations that 0.7-1.1% of large series of patients were NRL-allergic, while among 804 unselected patients, the prevalence of latex skin prick test (SPT) positivity was 0.12%. In contrast, other studies have suggested that from 4 to 6.4% of individuals tested were positive for serum latex-specific IgE antibodies. However, the specificity of these assays has been reported to be low. In three recent studies based on SPTs, published in 1997, the prevalence of positive reactions to latex was about 1% or less. The prevalence was 0.7% (95% CI 0.3-1.4) among 758 apprentices in Quebec, Canada; and 1.1% among more than 3,000 children tested in Finland (1.0% confirmed on latex use test). There were no first- and second-year dental students with positive latex SPTs in Ontario, Canada.
These recent investigations provide further evidence consistent with earlier studies based on skin testing that the prevalence of latex sensitization in occupationally-unexposed groups is quite low (< 1%). The marked differences in the findings based on serological assays may relate to the nonspecificity of these assays and deserve further investigation.
近年来，天然橡胶乳胶（NRL）已成为一个重要的职业健康问题，尤其是在医护人员中。一些报告表明，职业暴露人群中乳胶致敏的患病率与普通人群并无差异。
回顾了在职业暴露人群和普通人群中进行的患病率研究结果，以确定是否有证据支持这一说法。
众多针对医护人员的调查表明，在大多数研究中，乳胶致敏的患病率在5%至12%之间；医护人员的致敏可能会产生临床症状，包括荨麻疹、鼻结膜炎、职业性哮喘以及可能危及生命的过敏性休克。十多年前，芬兰的数据表明普通人群中乳胶过敏的患病率低于1%。芬兰最近的报告证实了这一点，观察发现大量患者中有0.7 - 1.1%对NRL过敏，而在804名未经挑选的患者中，乳胶皮肤点刺试验（SPT）阳性的患病率为0.12%。相比之下，其他研究表明，4%至6.4%的受测个体血清乳胶特异性IgE抗体呈阳性。然而，据报道这些检测方法的特异性较低。在1997年发表的三项基于SPT的近期研究中，对乳胶阳性反应的患病率约为1%或更低。在加拿大魁北克的758名学徒中，患病率为0.7%（95%可信区间0.3 - 1.4）；在芬兰接受检测的3000多名儿童中，患病率为1.1%（在乳胶使用试验中确认患病率为1.0%）。在加拿大安大略省，没有一年级和二年级牙科学生的乳胶SPT呈阳性。
这些近期的调查提供了进一步的证据，与早期基于皮肤试验的研究一致，即职业未暴露人群中乳胶致敏的患病率相当低（<1%）。基于血清学检测结果的显著差异可能与这些检测方法的非特异性有关，值得进一步研究。
