What is the best way for the nurse to assess a pre operative patient for possible latex allergy?

• Many products are made from latex, including dummies for babies, rubber bands, balloons, shoe soles, condoms, gloves, catheters and stethoscopes.
• Repeated exposure to latex can increase the immune system response, so avoidance is the best way to manage latex allergy.

Latex is derived from the sap of the rubber tree, Hevea brasiliensis. The substance is then processed to increase elasticity, durability and strength.

Many products are made from latex, including dummies for babies, rubber bands, balloons, shoe soles, condoms, gloves, catheters and stethoscopes.

People with latex allergy are allergic to the proteins found naturally in the substance, or to the industrial chemicals (such as mercaptobenzothiazole) added during manufacturing.

Latex allergy is more prevalent in the health care industry, with around 10% of health professionals affected. Synthetic rubber products made from petrochemicals usually don’t provoke allergic reactions in people who are allergic to latex.

Symptoms of latex allergy

The symptoms of latex allergy range in severity depending on the individual, but can include:

• dermatitis
• itchy skin
• crusty skin lesions
• lesions that are irritated by sweat and friction
• hay fever symptoms, such as running nose and itchy eyes when latex is inhaled
• sneezing
• coughing
• wheezing and breathing difficulties
• drop in blood pressure
• anaphylaxis – severe symptoms include airways swelling and difficulty breathing. Anaphylaxis is an emergency and can be fatal. In an emergency call triple zero (000) for an ambulance.

Types of reactions to latex

There are 3 different kinds of adverse reactions to latex, although they do overlap to a certain degree. These include:

• Irritant dermatitis – characterised by crusty skin lesions. Irritant dermatitis isn’t the same as latex allergy, because it can be caused by a wide range of other factors, including washing with harsh soap or the action of sweat inside rubber gloves. However, irritant dermatitis is often a starting point for the development of latex allergy. Broken skin allows the absorption of latex. Without intervention, people with genetic susceptibility will progress from irritant dermatitis to latex allergy.
• Allergic contact dermatitis – this skin problem is caused by a reaction to the chemicals added to latex during manufacture, not to the latex proteins themselves. Typically, symptoms (including rough skin patches and a weeping rash) tend to develop after exposure. This is not true latex allergy. However, the absorption of latex through broken skin can increase the risk of latex allergy in susceptible people.
• Immediate-type latex allergy – in some people, initial exposure to latex prompts the immune system to create antibodies. On subsequent exposure to latex, the body mounts an immune system response, which includes the release of histamine. This can cause a wide range of sudden reactions including hives, swollen lips and, in severe cases, anaphylaxis. Anaphylaxis is an emergency and can be fatal. In an emergency call triple zero (000) for an ambulance.

People at increased risk of latex allergy

Certain people are at increased risk of developing latex allergy including:

• health care workers (such as doctors, nurses and dentists) who are frequently exposed to latex through medical equipment like gloves
• people who have had many operations, particularly from a young age, such as those with spina bifida
• people who work in latex manufacturing
• people with pre-existing allergies, hay fever, asthma and eczema
• people with allergies to particular foods, including avocado and banana.

Latex allergy and food

Some people with latex allergy have allergic reactions when eating particular foods, including avocado, banana, chestnut, kiwifruit, passionfruit, plum, strawberry and tomato. This is because some of the proteins in latex that cause latex allergy are also present in these fruits.

Common symptoms include tingling in the mouth, stuffy nose, itchy eyes and wheezing.

A person who is allergic to the manufacturing chemicals in latex will not usually have allergic reactions to these foods.