Vital Signs

by Anita Wolf, BSN, RN

Latex Allergy: Relevant to Us All

By now, all health care professionals should be familiar with latex allergy and its potentially deadly effects. Many of us know someone who has experienced the more common symptoms-- hand dermatitis, hives, rhinoconjunctivitis, and sinusitis--associated with allergy to latex gloves. The uncounted health care workers with latex allergy, including me, are at risk for developing even more severe symptoms: asthma, anaphylaxis, even death. Upon being diagnosed as latex-allergic, I approached my hospital's administration with a letter from my physician warning of the growing occupational health concern associated with powdered latex products, and urging the hospital to cease using them. The hospital decided, despite this, to continue its use of powdered latex gloves. I then began working with the Oregon Nurses Association (ONA) on a legislative solution.

On behalf of the ONA, state Senator Thomas Wilde introduced a bill (S 1186) that would "prohibit use of powdered latex products in health care facilities" and would require the use of low-protein latex products. Unfortunately, this bill died in the Senate Health and Human Services Committee after a very heated hearing to which glove companies sent lobbyists and paid "experts" to defeat this attempt at consumer protection.

The defeat drew national attention to the increasing health care problem of sensitization to natural rubber latex and demonstrated the importance and need for such legislation. The testimony given by some glove manufacturers' representatives made it clear that these companies will only change their products if forced by legal mandate or consumer demands. Much of the companies' rhetoric echoed the arguments given by the tobacco industry during national hearings and court cases--that there is no scientific evidence that latex is harmful.

The greatest reward for me in this was to see some of the faces of those affected by latex allergy. These people came to tell of their tragically frightening experiences due to exposure to natural rubber latex, and their testimonies came straight from the heart. The ONA was not aware of many of these people, nor did we ever expect so many to come forward at the Senate hearing.

Each person gave wonderful testimony, but one in particular made a deep impression on me. She was an attractive, professional woman in her 20s who told of a horrifying incident of anaphylaxis at her dentist's office. After surviving the emergency, she was diagnosed with latex allergy. Since that event, she has been denied medical and dental treatment because "no one wants to take the chance." Ultimately, she has been left with nowhere to turn for medical or dental care. Many of us may take for granted our access to such care, but those who have been diagnosed with an allergy, any allergy, know that the common advice is to avoid the allergen. While it's relatively easy to avoid penicillin or seafood, it's virtually impossible to avoid latex in a health care environment. Nurses need to know that persistence on this issue can really pay off. Latex allergy is not just a health care workers' issue, but a relevant one for all people. We must be prepared to treat safely those already sensitive to latex, and we must prevent the potential harm of sensitization to natural rubber latex. Education remains crucial.

Other states have presented similar legislation regarding latex since Oregon's initial attempt. If there is legislation pending in your state, please offer your support. If there is no legislation in your state, contact your elected representatives to get some written. Although Oregon's Senate bill did not pass, it educated lawmakers and the general public. People who had never heard of latex allergy and initially thought it a joke are now aware of the facts.

Hospitals are also on alert, and many of them are making the transition to powder-free latex or synthetic-rubber environments, if only to avoid litigation. Another benefit for me in this situation has been my hospital's cooperation. After its initial resistance, the hospital administration formed a latex committee for the purpose of moving toward a synthetic replacement and is working hard to address the problem. This effort is to be commended.

The Oregon Nurses Association is not through yet; the groundwork has been set for a revised bill for the 1999 legislative session, and many hospitals and glove companies with progressive leadership will be ready and supportive of such legislation.

Anita Wolf, a member of the Oregon Nurses Association (ONA), is an operating room nurse at Mid-Columbia Medical Center, The Dalles, OR. She serves on the hospital's latex task force and on the ONA's Political Action Committee.

The American Nurses Association issued its Position Statement on Latex Allergy last fall. For more information, see "Foundations of Practice," above. To order a copy of the position statement, call the ANA Customer Care Center, (800) 274-4262.