The name for pure natural rubber. Found all over the place – foam (mattresses), condoms, balloons, seals, adhesives. In hospitals, BP cuffs, elastic bandages, catheters and ET tubes, pulse oximeters… Not so often in surgical gloves now. Can cause mild and severe (anaphylaxis) reactions, plus delayed (non type 1) allergy. Allergy first described in 1979, became epidemic in 1980s.

The rubber tree Hevea brasiliensis is not the same as “rubber plants” (Ficus) you get as pot plants, although you can be allergic to those too, of course.

About half of latex allergic patients also have fruit allergies, especially avocado, banana, kiwi, melon but also chestnut and tree nuts.

Certain high risk groups:

• Spina bifida
• Health care workers

Atopic or irritant dermatitis may also be caused by rubber chemicals rather then latex itself.

Diagnosis

• Blood IgE test – as with other IgE tests, potential for false positives esp with grass/fruit allergy.
• Skin prick test with standardised latex
• Prick through suspected glove! Needs latex free environment, of course. Potential for reaction to powder, rather than latex…
• Glove test – wet hand! Risk of anaphylaxis.

Risk of Anaphylaxis

As with other allergies, seems to vary between individuals. And previous reactions do not reliably predict future reactions.

With health care, difficult. First on surgical list. Label patient. Latex free environment, as far as possible. Reports of probable reactions from IV fluids and needle puncture of bungs in IV sets.

Need for careful occupational advice.

[Cullinan, Clin Exp Allergy 2003]