WORK-RELATED LATE ASTHMATIC RESPONSE INDUCED BY LATEX ALLERGY

Background: The occupational uses of latex gloves may De associated with asthma. Hypersensitivity to latex has been shown to be IgE-mediated. The asthmatic reaction to Inter is usually early; however, the natural history of Enter asthma is still unknown. Objective: The purposes Of this study were to investigate asthmatic responses induced by natural rubber. latex and to assess the long-term respiratory consequences of latex-induced asthma after removal from exposure. Methods: This report describes the clinical and immunologic study of sis nurses with work-related respiratory and skirt disorders induced by the use of latex gloves. To determine whether the symptoms induced by latex gloves were IgE-mediated, we assessed later IgE antibody levels by skin prick tests (SPTs) and RASTs with Inter extracts. To confirm work-related latex reactions, we assessed respiratory symptoms, skin reactions, and FEV(1) respiratory symptoms, skit? reactions, and FEV(1) after a glove exposure test and nt? inhalation provocation test with Inter gloves. All subjects were followed up for 7 months to 7 years after the first observation. Results: All subjects had positive SPT and RAST responses to Inter extracts, positive double prick test responses to Inter gloves, and negative SPT responses to cornstarch and common allergens. Ten atopic and ID nonatopic control subjects had negative SPT responses to latex and cornstarch extracts and,negative double prick test responses to Inter gloves. In three subjects later allergy was associated with allergy to fruit (banana and chestnut). After the glove exposure test, four of six subjects had contact urticaria, all had rhinoconjunctivitis, and two had a late asthmatic response. The inhalation provocation? test was performed on four subjects: all had rhinoconjunctivitis, two had urticaria and late asthmatic response, and one had laryngeal edema. A late asthmatic response was recorded in foul subjects. Three subjects continued to have chronic asthma, and foul subjects had increased nonspecific bronchial responsiveness 7,months to 7 years after being assigned to duties not involving latex gloves. Conclusions: This study of six nurses shows that later is a potential cause of occupational asthma, I rhinoconjunctivitis, and urticaria-angioedema. Latex seems to include antigens that elicit IgE-mediated hypersensitivity and may cause a late asthmatic reaction. Occupational asthma caused by latex may lead to permanent respiratory disability, even after removal from exposure.