Latex hypersensitivity in spinal cord injured adult patients

[Wise Young]

• Mertes PM, Mouton C, Fremont S, Brugerolle B, Moneret-Vautrin DA, Lavaud F and Laxenaire MC (2001). Latex hypersensitivity in spinal cord injured adult patients. Anaesth Intensive Care. 29 (4): 393-9. Summary: Latex hypersensitivity is a major cause of anaphylaxis during anaesthesia. Patients with spina bifida, health care or rubber industry workers have been considered at risk for latex sensitization. By analogy, the existence of other at-risk subsets of patients with latex exposure due to frequent surgical procedures has been suggested. The aim of this study was to evaluate the prevalence of latex sensitization in a cohort of adult patients with spinal cord injury and repeated latex exposure. Forty-two adult patients with spinal cord injury were studied and retrospectively compared to a group of 30 children with spina bifida evaluated using a similar protocol. Patients were administered a questionnaire concerning history of latex hypersensitivity, atopy, and surgical procedures. Latex sensitivity was investigated by skin prick-tests and latex-specific IgE assay. The search for atopy was based on in vivo and in vitro tests against a panel of environmental allergens. No chronic spinal cord injured patient had a history of latex allergy. When compared with spina bifida, the number of surgical procedures was not statistically different. Although not significantly different, the prevalence of atopy was higher in spina bifida patients. The high level of latex sensitization in spina bifida patients contrasted sharply with the absence of sensitization observed on both skin and in vitro tests in patients with spinal cord injury (P<0.0001). This study confirms that adult patients with chronic neurologic defects resulting from spinal cord injury exhibit a low risk of latex sensitization. These results suggest that considering adult patients with repeated surgical procedures as a group at risk for latex sensitization because of a high degree of latex exposure should be re-examined. <http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11512651> Institution Departement d 'Anesthesie-Reanimation Chirugicale, Centre Hospitalier et Universitaire de Nancy, France.

[KLD]

While the rate is certainly lower than in people with spina bifida, we still see this not infrequently. We actually have seen MORE in health care professionals who provide care to people with SCI though, and have had cases of actual anaphylaxis at our hospital in both clinic and inpatient settings, so we still are working on becoming a latex-free environment, both for the health of our patients and our staff.

[Scorpion]

I read that continued exposure to latex, especially the dust from the inside of latex gloves, can attribute to someone becoming allergic to latex even if they weren't allergic to begin with. I use latex tubing for leg-bags, but I switched to silicone catheters a few years ago. I switched because I preferred the 'Wide Band' by Rochester, but I later figured that less contact with latex the better. I doubt condoms increase sensitivity in most, but I can see how a condom catheter on 24 hrs/day would. Anyway, eliminating latex, especially the gloves with the dust that can be breathed in, in operating rooms and medical facilities seems like a good thing, moreso for nurses and staff than for patients, as health care pros would be exposed to latex more than most patients will be.

Am I correct in the assumption that latex can cause allergic reaction because it's an organic rubber? Are there any reported cases of allergies or sensitivity to silicone?

~Rus

"Because you're not promised tomorrow." ~ Stuck Mojo