Latex allergies are a reaction to the flexible, elastic material used in many rubber products. Healthcare workers are among those most susceptible to the allergy, which is often triggered by exposure to the latex gloves and instruments that they use frequently in the workplace. Children with spina bifida (a birth defect of the bones covering the spinal cord) also have high incidences of the reaction, because they frequently are exposed to latex-based products during surgeries and treatments. When very high levels of latex are present, asthma symptoms can be triggered.

Most latex allergies are caused by exposure to dipped latex, a common material found in “stretchy” products such as rubber gloves, balloons, rubber bands and condoms. These products are especially powerful triggers because they usually come into direct contact with the skin. However, latex particles also can be inhaled once they become airborne.

Hardened rubber – found in products such as shoe soles, tires and rubber balls – rarely causes allergies in most people. Synthetic rubbers, such as those that are butyl- or petroleum-based, do not cause people to react. This includes products such as latex house paints.

There is no cure for latex allergies. However, symptoms can be reduced by avoiding latex and seeking out products which use nonallergenic substitutes in place of latex.

Latex allergies trigger symptoms in millions of sensitive people who encounter these allergens at home, on the job or during medical procedures. Symptoms are often similar to those caused by hay fever but can also include skin reactions. In rare instances, they can be life-threatening.

Latex is a milky sap produced by rubber trees in Africa and Southeast Asia. It is used in many products because it is flexible and relatively inexpensive. In addition, latex is used in most surgical and examination gloves because it provides an effective barrier against infectious organisms found in diseases such as AIDS and hepatitis B.

Most latex allergies are caused by products (e.g., gloves, balloons and condoms) that have been dipped in the material. During the manufacture of these products, a form is dipped into a vat of latex. After it dries, the product is washed and stripped from the form. If it is not washed thoroughly, a good deal of “free” latex remains. This can later trigger latex allergies or, in some cases, asthma symptoms. In some cases, reactions may be caused by additives added during the manufacturing process rather than to the latex protein itself.

Products made from molded latex – such as rubber stoppers and erasers – trigger fewer reactions. Synthetic rubbers, such as those that are butyl- or petroleum-based, do not cause people to react. These include products such as latex house paints and latex caulking.

Exposure to latex particles can occur through several routes, including:

• Standard skin contact
  
  
• Thin-skin contact (such as mouth, vagina, rectum)
  
  
• Mucous membrane contact (such as eyes, mouth, vagina and rectum)
  
  
• Inhalation
  
  
• Blood (such as when medical devices containing rubber are used in surgery)

Cornstarch is sometimes added to the inside of latex gloves to make them easier to slip on and off. This cornstarch can absorb latex proteins. When individuals slip their hands into or out of these gloves, they are snapped and the proteins can become airborne. The amount of latex that can become airborne varies greatly among different brands of glove.

There are several types of latex reactions:

• Immediate allergic reaction. Also known as latex hypersensitivity, this is the most serious reaction to latex and can result from any form of contact. Symptoms are similar to those of allergic rhinitis (hay fever), which in rare instances can progress to life-threatening anaphylactic shock.
  
  
• Contact urticaria. The most commonly occurring allergic reaction to rubber. It particularly affects healthcare workers sensitized to latex. Symptoms include itching and hives, which often appear within 15 minutes of donning latex gloves.
  
  
• Allergic contact dermatitis. A skin reaction to additives used in latex processing. Symptoms often appear one to two days after contact with the allergen. This delayed reaction can affect several areas of the body.
  
  
• Irritant contact dermatitis. A skin reaction to a chemical or other substance not caused by an allergic reaction. This is the least threatening type of latex reaction. Repeated exposures to chemicals in latex gloves cause irritant contact dermatitis.

Latex allergies are rooted in previous exposures to latex. During an initial encounter with latex, the body’s immune system overreacts to a perceived threat and begins to produce antibodies. 

Each antibody is designed to recognize a particular antigen. The antibody is attached to a mast cell, which contains granules of histamines and other chemicals. The next time the body is exposed to the allergen, the antibody binds to it and the mast cell releases histamines and other chemicals that cause the symptoms of an allergic reaction.

Repeated exposure to an allergen increases the risk of developing an allergy. Therefore, healthcare workers and people who spend long periods in healthcare settings have a greater likelihood of developing latex allergies. People with other occupations that involve frequent glove use (e.g., hairdressers, housekeepers) and individuals who work in industries that manufacture latex products are also at risk.

In addition, repeated exposures to an allergen can result in greater numbers of antibodies, which can cause more frequent and severe reactions to the allergen. In recent years, latex has been increasingly used to produce certain products, especially medical gloves and tools. As more individuals have been exposed to latex, the incidence of allergies has soared.

More than 40,000 products use some form of latex. Common latex products include:

• Rubber bands
• Balloons
• Condoms
• Latex gloves used in healthcare, food service and other settings
• Motorcycle and bicycle handgrips
• Automobile and bicycle tires
• Carpeting
• Swim goggles
• Bath mats and floor rugs with rubber backing
• Sink stoppers
• Elastic waistbands in undergarments, bathing suits and other clothing
• Bathing caps
• Bowling balls
• Dishwashing gloves (reusable)
• Rubber or rubber-grip utensils
• Toothbrushes with rubber grips or handles
• Sports mouthpieces
• Racquet handles

Additional latex products include:

• Helmets
• Rubber toys, including some dolls
• Hot water bottles
• Nipples on baby bottles and pacifiers
• Some disposable diapers, sanitary pads and adult incontinence products
• Some adhesive bandages
• Waterproof bed pads that contain rubber
• Pencil erasers
• Grocery store checkout belts
• ATM buttons made of rubber
• Computer mouse cords and pads
• Keyboards, calculators and remote controls with rubber buttons and switches
• Adhesives such as glue, paste and art supplies
• Ventilation tubes
• Diaphragms

Medical and dental facilities use many latex products. Latex gloves are especially effective in protecting healthcare workers from contracting infectious diseases such as AIDS and hepatitis B. Between 5 percent and 10 percent of healthcare workers are estimated to have a sensitivity to latex, according to the American Academy of Allergy, Asthma and Immunology. Healthcare and dental products that contain latex or rubber include:

• Blood pressure cuffs
• Stethoscopes
• Intravenous tubing
• Syringes
• Respirators
• Electrode pads
• Surgical masks
• Oral and nasal airways
• Tourniquets
• Injection ports
• Catheters
• Dental dams
• Endotracheal tubes
• Enema tips

For reasons not yet clearly understood, some health conditions can make a person more susceptible to developing latex allergies. Conditions which increase an individual’s risk for latex allergies include:

• Defect in bone marrow cells
  
  
• Deformed bladder or urinary tract
  
  
• Use of urinary catheter with a rubber tip
  
  
• Allergies, asthma or eczema
  
  
• Food allergies, many of which spring from contact with allergens that are also contained in latex (a condition known as cross-reactivity). The foods most likely to trigger cross-reactivity include bananas, avocados, kiwis and chestnuts. Other potential cross reactive allergens include:
  
  

  Almonds Apples Blackberries  Brazil Nuts Carrots Cashews Celery Cherries Crab Dates Dill  Figs Ginger Hazelnuts Lobster Mango Melons Oregano Papaya

  Passion fruit Peaches Peanuts Pears Pecans Pineapples Pistachios Plums Potatoes Sage Shrimp Snails Squash Strawberries Sunflower seeds Tomatoes Walnuts Water chestnuts

Among the many conditions related to latex allergies are:

• Asthma. Individuals with latex allergies may develop asthma following continued exposure to the allergen.
  
  
• Contact dermatitis. Any inflammation that occurs on the skin’s surface after coming into contact with a substance originating outside of the body. Contact dermatitis is the most common source of work-related diseases. There are two types of contact dermatitis:
  
• • Allergic contact dermatitis. Caused by an allergic reaction. Additives used in latex processing can trigger allergic contact dermatitis.
    

    

  • Irritant contact dermatitis. A nonallergic reaction caused by a chemical or substance that is naturally irritating to the human skin. Repeated skin contact with latex – such as wearing latex-based surgical or examination gloves – can trigger irritant contact dermatitis.
    
    
• Food allergies. An adverse response by a person’s immune system to a food or food component. After a sensitive person ingests a problem food, the immune system reacts with the release of histamines and other hormones that trigger symptoms that can range from mild to life-threatening (anaphylactic shock). Many food allergies share the same allergens as latex allergies, a condition known as cross-reactivity. The most common triggers of cross-reactivity in people with latex allergies are bananas, chestnuts, avocados and kiwis. Patients experiencing allergy symptoms (e.g., hives, shortness of breath, itching around the mouth) after consuming a food should avoid that particular food in the future.  
  
  
• Allergic rhinitis. Commonly called hay fever, allergic rhinitis is an inflammation of the inner lining of the nose that occurs when an allergic individual encounters an airborne allergen such as pollen, mold, dust mites or animal dander. Usually inhaled, these triggers generate allergy symptoms such as sneezing, coughing, runny nose, sore throat and itchy and runny eyes. Oftentimes, the symptoms of latex allergy mimic those of allergic rhinitis.
  

  

• Spina bifida. Birth defect in which part of one or more vertebrae fails to fully develop. This leaves part of the spinal cord unprotected. Children with spina bifida are much more susceptible to latex allergies than their peers because they are frequently exposed to latex-based medical gloves and equipment. Nearly 50 percent of children with spina bifida are likely to react to latex, according to the American Academy of Allergy, Asthma and Immunology.
  
  
• Poinsettia allergies. Poinsettia plants – the popular holiday season decoration – are part of the same plant family as the Brazilian rubber tree that produces latex. So those with latex allergies may have a similar reaction when exposed to this plant. Ficus benjamina, tobacco plants and Hevea brasiliensis may also trigger a reaction.

Symptoms associated with latex allergies differ depending on the nature of the allergen that triggers the reaction. Though some people react to latex itself, others react to chemical additives used to make latex-based products. 

Allergies to the chemical additives used in manufacturing rubber latex typically manifest as contact dermatitis. This is a rash that resembles poison ivy. It is caused by close contact with latex, usually in the form of latex gloves. As a result, healthcare workers are particularly susceptible to this form of latex allergy. Symptoms appear within 24 hours of exposure and include:

• Red, cracked and blistered skin
• Skin burning, itching and dryness
• Scaling or skin lesions

Latex allergies to the latex protein itself produce more serious symptoms similar to those of allergic rhinitis or asthma. This type of reaction may be triggered by skin contact with latex protein or the inhalation of airborne latex particles. Symptoms can appear within minutes of exposure and may include:

• Stuffy or runny nose
• Coughing
• Sneezing
• Hives or rash
• Itchy skin
• Itchy or watery eyes
• Chest tightness
• Breathing problems (e.g., wheezing)
• Shortness of breath

In rare cases, allergies to the latex protein can trigger life-threatening anaphylactic shock. In highly sensitive individuals, anaphylactic reactions typically develop immediately after latex exposure. They may cause the bronchi to constrict, making it difficult to breathe. Blood pressure may also drop to dangerous levels. Signs and symptoms of anaphylaxis include:

• Swelling of the throat, tongue or nose
• Wheezing
• Confusion
• Slurred speech
• Low blood pressure
• Rapid or weak pulse
• Bluish tint in the skin, lips and nail beds (cyanosis)
• Diarrhea
• Nausea and vomiting
• Faintness
• Loss of consciousness

Immediate medical treatment should be sought for anyone having an anaphylactic reaction.

A physician will compile a complete medical history and a list of symptoms as the first step in diagnosing latex allergies. A history of certain conditions such as food allergies and eczema makes latex allergies more likely.

An allergy skin test might occasionally be recommended if an allergy to latex is suspected. Skin testing for allergies is not approved by the U.S. Food and Drug Administration because of the small but significant risk of anaphylaxis. Skin testing for latex allergies is also considered less accurate than other types of skin testing. During this procedure, a tiny dose of latex is introduced to the skin. A wheal (raised red bump) indicates an allergic response to the latex. In some cases, an allergy blood test – such as a RAST (radioallergosorbent test) – may be used to diagnose an allergy.

Treatment begins with avoidance, which is difficult because so many products are made of or use latex. For prevention strategies, see Prevention methods.

Medications that are often prescribed to treat symptoms include:

• Antihistamines. Medications that block the actions of histamine, a chemical that triggers many of the symptoms of an allergic reaction. In the treatment of latex allergies, they are generally taken before exposure to the allergen to reduce the risk of an allergic reaction occurring and/or lessen the severity of symptoms.
  
  

  

• Corticosteroids. Powerful anti-inflammatory medications that must be used with caution, as they sometimes produce serious side effects. They may be used to treat more severe latex allergies and are taken after an allergic reaction has occurred to relieve symptoms.
  
  
• Epinephrine. Those with a history of anaphylaxis may receive a prescription for an allergy kit. This kit contains an emergency dose of the drug epinephrine, which reverses the potentially life-threatening reactions of an anaphylaxis attack. A patient injects the drug into the thigh during an emergency.

There is no cure for latex allergies, and preventing symptoms from appearing can be difficult. It has been estimated that latex is found in more than 40,000 commonly used everyday products, so those with allergies will find it difficult to completely avoid. However, several steps can be taken to reduce exposure or the threat of serious illness. These include:

• Try to limit exposure to latex products. Check labels to determine which products contain latex. Patients who work in an atmosphere with a lot of latex should talk to employers about ways to reduce latex use. In some cases, a career change may be necessary to prevent symptoms related to latex allergies.
  
  
• Patients should wear a medical alert bracelet that reveals their allergy. This way, healthcare professionals will be aware of the allergy in the event that a person is unconscious and needs emergency medical care.
  
  
• Inform healthcare professionals such as physicians and dentists about latex allergies, so they are aware and can avoid using latex-based gloves and equipment.
  
  
• Choose alternatives to latex gloves when practical. Vinyl gloves work well for many tasks, but do not match latex’s ability to protect against disease. Some synthetic alternatives do work as well as latex, but can be more expensive. Try to use “powder–free” gloves which do not contain the cornstarch that makes them easier to use, but also more likely to spread protein allergens.
  
  
• When wearing gloves, do not use oil–based hand creams or lotions, which contribute to glove deterioration. After using gloves, wash hands with a mild soap.
  
  
• Keep shoes, boots and tennis shoes in covered containers to minimize exposure to latex in these products.
  
  
• Ask if latex-based gloves are used during food preparation in restaurants or other food preparation settings.
  
  
• Parents of children with spina bifida and latex allergies should inform school or child care officials about the condition. Identify areas of potential latex exposure in the school and work with school officials to put a plan into place that allows them to properly respond should an emergency arise.  
  
  
• Avoid inhaling latex when possible. Try to avoid areas where people work with latex gloves or ask that they not use gloves powered with cornstarch. Plan in advance to avoid latex exposure at social functions. Scheduling early physician appointments to be the first patient of the day can also help minimize exposure to airborne latex particles.
  
  
• Be careful around holiday poinsettias. These share several proteins with latex, and an individual allergic to latex may exhibit symptoms after exposure to poinsettia plants.
  
  
• Use products that substitute nonallergenic substances in place of latex. Examples of such alternatives include:

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  Latex product	Alternative
  Balloons	Mylar balloons
  Baby toys	Plastic or cloth toys
  Bottle nipples	Silicone nipples
  Condoms	Polyurethane condoms
  Elastic bands	Paper clips, string, twine
  Disposable gloves	Vinyl gloves
  Household gloves	Synthetic, cotton gloves
  Raincoat	Nylon or synthetic waterproof coats
  Shoes with rubber	Leather or synthetic shoes
  Telephone cords	Clear cords

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctors the following questions about latex allergies:

1. Do my symptoms indicate a latex allergy?
   
   
2. What methods will you use to determine if I am allergic to latex?
   
   
3. What may have caused me to develop this allergy?
   
   
4. What are my treatment options? How effective are they?
   
   
5. Does this allergy pose a danger to my overall health?
   
   
6. How can I avoid coming into contact with latex? What types of products commonly have latex in them?
   
   
7. What should I do if I accidentally come into contact with latex?
   
   
8. Are medical procedures dangerous to me if I have a latex allergy? What precautions do I need to take?
   
   
9. I have heard about cross reactivity. Should I be avoiding certain foods?
   
   
10. Are my children likely to develop latex allergies as well?
    
    
11. I work in the healthcare field. What steps can I take to prevent latex allergies?