Long-term outcome of 160 adult patients with natural rubber latex allergy.

Allergy to natural rubber latex is a major occupational problem in the health care sector and a problem even in other occupations in which protective gloves are used. There is little information available about the long-term outcome at work in large patient populations. To study the occupational outcome when all gloves in the working environment were changed either to low-allergen latex or non-latex gloves, in 1995 to 1996 we re-examined 160 of 174 adult subjects who were diagnosed with natural rubber latex allergy between 1982 and 1994 after a median of 3 years (range, 0.5 to 24 years) after the diagnosis. The outcome in daily work or as a patient in health care was investigated with the use of a questionnaire. Special attention was paid to the assessment of the occurrence of hand eczema. Glove selection policy as an intervention in the treatment of natural rubber latex allergy is described. Of 71 health care workers and 89 non-health care workers, 72% and 83% were atopic; 54% and 65% had hand eczema at the time of diagnosis, and 89% and 19% had work-related allergy to natural rubber latex, respectively. On re-examination, none of the health care workers had changed work because of natural rubber latex allergy, and only 38% had hand eczema (significant decrease). Ninety-eight percent of the non-health care workers, of which 58% had hand eczema, continued with their previous jobs. The use of low-allergen latex or non-latex gloves throughout the health care sector seems to be an adequate step for health care workers who have natural rubber latex allergy; nonhealth care workers get along with personal avoidance of latex gloves if they are not working directly with natural rubber latexcontaining materials in production.