T Kibby1, M Akl. 1. Mallinckrodt, Inc., St Louis, Missouri, USA.
Abstract
BACKGROUND: Immediate-type allergic reactions to latex products have become increasingly recognized in hospital workers. OBJECTIVE: This study was designed to assess the prevalence of latex sensitization by skin testing and specific IgE testing in a group of hospital employees and compare these with each subject's self-reported allergic history. METHODS: Volunteers were recruited from selected departments. Each was tested with epicutaneous skin test with latex glove extract and commercial environmental allergens, had blood drawn for latex-specific IgE testing (AlaSTAT brand of ELISA), and was given a questionnaire for general and latex allergy history. RESULTS: There were 135 participants. Eleven (8.2% of sample, 95% confidence interval 3.4% to 13.0%) were skin test positive for latex reagent, and seven of these (5.2% of sample) reported allergic symptoms to latex contact. Testing for latex-specific IgE (ELISA) showed 6.7% with class II or higher reaction. There was high correlation of the two tests, with ELISA showing a sensitivity of 63.6% and a specificity of 98.4% with reference to skin testing. In this sample, 16% reported some upper respiratory symptoms in association with latex contact, although only one-third of this group was skin test positive. Past history of allergic or atopic disease was poorly predictive of skin or blood test reactivity. A reaction to a greater number of environmental allergens was associated with positive latex skin test reactivity. CONCLUSION: Testing for latex sensitivity in this hospital sample revealed more than 5% of workers developed clinical allergies to latex and continued to remain occupationally in contact with latex. In vitro testing is a potential substitute for the more technically difficult skin testing.
BACKGROUND: Immediate-type allergic reactions to latex products have become increasingly recognized in hospital workers. OBJECTIVE: This study was designed to assess the prevalence of latex sensitization by skin testing and specific IgE testing in a group of hospital employees and compare these with each subject's self-reported allergic history. METHODS: Volunteers were recruited from selected departments. Each was tested with epicutaneous skin test with latex glove extract and commercial environmental allergens, had blood drawn for latex-specific IgE testing (AlaSTAT brand of ELISA), and was given a questionnaire for general and latexallergy history. RESULTS: There were 135 participants. Eleven (8.2% of sample, 95% confidence interval 3.4% to 13.0%) were skin test positive for latex reagent, and seven of these (5.2% of sample) reported allergic symptoms to latex contact. Testing for latex-specific IgE (ELISA) showed 6.7% with class II or higher reaction. There was high correlation of the two tests, with ELISA showing a sensitivity of 63.6% and a specificity of 98.4% with reference to skin testing. In this sample, 16% reported some upper respiratory symptoms in association with latex contact, although only one-third of this group was skin test positive. Past history of allergic or atopic disease was poorly predictive of skin or blood test reactivity. A reaction to a greater number of environmental allergens was associated with positive latex skin test reactivity. CONCLUSION: Testing for latex sensitivity in this hospital sample revealed more than 5% of workers developed clinical allergies to latex and continued to remain occupationally in contact with latex. In vitro testing is a potential substitute for the more technically difficult skin testing.