Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers

Background: The development of allergy to natural rubber latex (NRL) is a risk for health care workers. A regulation banning powdered NRL gloves was implemented in Germany in 1998. Objective: This study assesses the effects of this regulation on the development of occupational skin disease caused by NRL in health care personnel working in facilities insured by the German statutory accident insurance company, covering some 1.8 million insured health care workers. Methods: We reviewed the annual numbers of reported suspected cases of NRL-induced occupational allergies (mainly contact urticaria) from 1996 through 2002, as well as the number and type of gloves purchased in acute-care hospitals from 1986 through 2002. Results: The number of purchased nonsterile examination gloves increased by 1387% between 1986 and 2002. The purchase of powder-free NRL examination gloves exceeded that of powdered gloves in 1998. The incidence of suspected cases increased until 1998 and has since decreased by 79.9%. Most suspected cases (67.9%) were identified as occupationally caused. Conclusions: Reducing the purchase of powdered NRL gloves is associated with a decrease in suspected and proved cases of occupational contact urticaria caused by NRL. Development of occupationally caused contact urticaria by NRL can be reduced by banning the use of powdered NRL gloves.