Latex Allergy
Allergic responses to latex (rubber) products are fairly common among children and can range from mild irritation to life-threatening reaction. It is an extremely common compound found in many products, including underwear bands, rubber gloves, toys, elastic bandages, baby bottle nipples, pacifiers, and balloons. Anyone with a latex allergy should avoid exposure to all products that contain latex, but children most at risk are those with birth defects requiring multiple surgeries early in life. Between two and eight percent of the population are allergic to latex.
The first incidents of latex allergy in the United States were reported in 1988. Numbers had increased to at least 500,000 by 1992. Between 1990 and January 1991, nine children at a children’s hospital in Milwaukee had anaphylactic reactions within 30 minutes after general anesthesia was started but before any surgical incisions had been made. The latex connection was the anesthesia equipment and intravenous catheters. Eight of the children required intensive care.
Symptoms
Typical symptoms include watery eyes, wheezing, hives, rash, swelling, and, in severe cases, anaphylaxis. (In anaphylactic shock, a child can develop shortness of breath, swollen lips, and throat, heart, and breathing problems within minutes.) These responses can occur when items containing latex touch the skin, the mucous membranes (the mouth, genitals, bladder, or rectum), open areas, or bloodstream (especially during surgery). Lips and the face may swell after contact with latex balloons.
Cause
A latex allergy occurs when the immune system reacts to proteins found in latex, triggering a defensive reaction that can cause unpleasant and, in some cases, life-threatening symptoms. However, certain children are at greater risk of becoming allergic to latex. Those at higher risk include children who are frequently exposed to latex. As many as 65 percent of children with spina bifida have latex allergy. More than 25 percent of children with spinal injuries are allergic to latex, as are 33 percent of children with multiple congenital defects (especially urinary tract defects) and any child who has had three or more surgeries. It is the repeated exposure to latex (usually through catheterization) that sensitizes children to latex. This progressive allergy worsens with increased exposure.
Children who develop latex allergy also can be sensitive to food allergens. A number of fruits, vegetables, nuts, and cereals contain proteins that are similar to the proteins found in latex. A child’s body can generalize an allergic reaction from one protein to another similar one (cross-reactivity). The following foods cross-react with latex: avocados, bananas, pineapples, apricots, grapes, kiwis, tomatoes, papayas, passion fruit, cherries, figs, peaches, nectarines, plums, celery, raw potatoes, hazelnuts, and chestnuts.
Diagnosis
A sensitivity to latex can be diagnosed from a review of past medical history, a physical exam, and blood tests for latex-specific IgE antibodies. Test results define the presence of sensitivity, but once a sensitivity is present, IgE antibodies cannot be used to predict how severe a reaction will occur.
Treatment
There is no cure for a latex allergy. Children at high risk can prevent the development of latex allergy by avoiding latex products in all areas. If a child has already developed latex allergy, avoidance may lessen the response. In order to protect themselves, students with latex allergies should carry nonlatex gloves at all times for health-care professionals to use during both routine examinations and emergency procedures. School nurses should have a supply of nonlatex gloves available for use. Highly allergic children also should wear a Medic Alert bracelet and carry an emergency epinephrine kit (Epipen) in case they are accidentally exposed to latex and go into anaphylactic shock. The school nurse, playground aides, and classroom teacher should be aware of what to do in case of an allergic reaction. The physical education instructor should also be familiar with the student’s allergy because equipment is often made from rubberbased products. Cafeteria workers may need to adjust their food preparation practices to address the student’s sensitivity.
