Latex allergy; the road ahead

1. Latex Allergy
The Road Ahead

2. What is Latex?
Natural rubber latex is the milky fluid extracted and processed from the rubber tree Heveabrasiliensis.
The fluid is made up of 60% water, 35% rubber and 5% organic substances.
(Bundesen, 2008)
3. The Latex Molecule
The latex molecule is constructed of spherical poly-isoprene droplets coated with a layer of water-soluable proteins.
(Deval, Ramesh, Prasad, & Jain, 2008)
Of the 250 or so different proteins only 11 have been mapped.
(Bundesen, 2008)
4. Production
During production chemicals are added, such as accelerators, antioxidants, emulsifiers, dyes, and stiffeners.
(Bundesen, 2008)
Most are destroyed in the manufacturing process, however the few that remain can cause dermatological problems.
5. Cause of latex allergies
Type I allergic reaction is caused by the latex protein allergen.
Type IV allergic reaction is caused by the chemicals used in the manufacturing process.
6. Known as a true allergy.
The latex protein allergen provokes an immunologic response in the form of antibodies, specifically immunoglobin E.
Ig E binds with the allergen resulting in a cascading action of mast cells and basophil cells releasing chemical mediators such as histamines.
(Bundesen, 2008)
Type I reaction The proteins fault
7. Symptoms may include itching, reddening, hives (anywhere on the body), inflammation of the nasal mucosa, wheezing, coughing, shortness of breath, sneezing, conjuncgtivitis, asthmatic reactions, and hypotension.
In rare cases a severe type I reaction may be life-threatening when blood pressure drops and airways constrict.
Type I reactions have had contact with mucous membranes, the airways or bloodstream.
Rapid onset, effects skin, airways, central nervous system, gastrointestinal tract.
(Bundesen, 2008)
(Deval, Ramesh, Pradsad, & Jain, 2008)
Type I signs and symptoms
8. Type IV reaction caused by the chemicals added to the latex in production and not the latex protein itself.
Type IV reaction involves various cells, including T-cells but do not effect antibody formation significantly.
Onset is delayed from 12 to 48 hours.
Manifests itself most commonly as contact dermatitis.(Bundesen, 2008)
Type IV reaction The chemical's fault
9. Which is which?
Both types are preceded with exposure resulting in a non-allergic contact dermatitis.
Difficult to distinguish IV allergic contact dermatitis with non-allergic contact dermatitis except that IV may spread from site of contact.
Though initially presenting with the signs and symptoms of a type IV reaction, with continued exposure over time, increasing severe symptoms manifest, to evolve into a type I reaction.
10. Cross allergenicity-problems with proteins -
Type I allergy to latex involves sensitization to multiple constituent proteins.
Different proteins means people respond to latex in various ways.
As those latex proteins are found in the rubber tree, so they are also found in other trees.
11. Fruity twist
Either the fruit allergy triggers a previously undiagnosed recognition of latex allergy or after years of exposure to latex or latex sensitivity the person develops a fruit allergy.
Most common groups of proteins that cause cross-allergy reactions have occurred with avocado, banana, celery, chestnut and pear.(Davel, Ramesh, Prasad, & Jain, 2008)
12. Less common are reactions to apricot, buckwheat, cherry, fig, grape, kiwi, mango, melon, nectarine, orange, papaya, passion fruit, peach, peanut, pineapple, plum, potato, tomato and walnut.
13. Population at risk
Those with a history of atopic reactions
Concurrent allergy to certain fruits
Children with neural tube defects like congenital spina bifida
Those who have had repeated exposure either through occupation or multiple procedures.
The most efficient source of sensitization in a medical environment is via aerosolized latex protein form powdered latex gloves.
14. Latex Folder
Aim is to streamline care and management of patients with latex sensitivity.
15. Building the Folder
List a products with latex content indicated for set-ups and products required during the procedure.
This list needed to be easy to use, complete and reliable.
Available Education and Guidelines
16. Some Obstacles to Avoid
A Z listings
Same product, different companies
Does yes mean latex free?
Keeping the documents / statements
Updating
17. Latex Folder- contents
Information Sheet
Theatre Management of Latex Sensitive Patients
Latex Free Zone signs
How to Use Latex Catalogue
Addition to Latex Catalogue
User Survey
Latex Catalogue
18. Information Sheet
Quick reference guide.
Used for education and checking of cross-allergies.
Information Sheet
User Survey
Latex Catalogue
20. Theatre Management of Latex Sensitive Patients
Queensland Health guidelines Latex Guide for Heath Care Facilities.
Specific to theatre management
Information Sheet
User Survey
Latex Catalogue
22. Keeping the Catalogue current & relevant
Addition to latex catalogue form
How to use catalogue guide
Survey form
Information Sheet
User Survey
Latex Catalogue
24. Developing a Latex Catalogue
Contents page to find things quicker
25.

Legend on the top of each page

26. Tick or cross to indicate latex free or not 27. A Z listing within category 28. Reference numbers to distinguish between different companies

Latex allergy; the road ahead

Health & Medicine

Transcript of Latex allergy; the road ahead