The allergy to natural latex

Diagnosis

 

Not every suspected "latex allergy" is an allergy to natural latex. The body often only reacts to other (production) additives, e.g.:

  • plasticizer
  • anti-aging agents
  • fillers
  • crosslinker residues
  • vulcanization accelerator
  • Reactions to special additives can also occur, especially with condoms, e.g

Polyisoprene, which is contained in natural latex at up to 96%, is considered non-allergenic.

Back to the condoms: Anyone who suspects a natural latex allergy should therefore test different condoms using the elimination process.

  • A reaction to nonoxynol-9 or benzocaine is likely to be noticed fairly quickly, as the symptoms do not occur in strains without these substances. With other ingredients it is difficult because the composition is very complex and often not listed in detail.
  • Anyone who suspects a reaction to lube could use dry condoms, for example.
  • An allergy to the vulcanization accelerator (1,3-diphenylguanidine) can be ruled out with 1,3-diphenylguanidine-free condoms (e.g. from RFSU). The production of these condoms takes more time, so they are a bit more expensive compared to other "normal" condoms.
  • A slight contact allergy to latex can be ruled out with special hypoallergenic condoms. These are often cheaper than the latex-free types and more comfortable to wear. In this material, the allergy-triggering proteins have been largely removed.
  • In the case of an "adult" latex allergy, i.e. a high degree of sensitization, only completely latex-free condoms can be used. These are made of plastic.

If you want to be absolutely sure, you can (and should!) have your doctor or allergist carry out an allergy test - ideally, of course, with a doctor who is familiar with the symptoms. There are several ways to do this.

  • Skin test (e.g. prick test)
  • Blood test (specific immunological antibody search, e.g. using RAST)
  • provocation test

 

Symptoms

 

As with any allergy, the symptoms of a natural latex allergy vary greatly from person to person. With increasing sensitization, more severe symptoms usually appear. The allergy can develop insidiously and is sometimes only noticed when the symptoms become more severe. In the case of strong sensitization, the most severe symptoms occur even with mere skin contact! How quickly this point is reached varies from person to person.

The range of symptoms often presents in this order (in decreasing frequency):

  • Itching, redness, wheal formation at direct contact points
  • hives (urticaria)
  • Reaction of the mucous membranes (conjunctivitis, pharyngitis, pharyngitis, allergic runny nose)
  • allergic diarrhea
  • Inflammation of the mucous membranes of the larynx (laryngitis), vocal cord edema, allergic asthma
  • cardiac arrhythmias
  • severe fatigue, pronounced physical weakness
  • Anaphylaxis (allergic shock)

Attention! Pronounced swelling of the mucous membranes in the back of the throat and in the bronchi can also be life-threatening!

 

Treatment

 

The best way to treat natural latex allergy is to avoid exposure. This can be done in different ways:

  • through skin contact
  • through mucosal contact, e.g. in the genital area or in the intestine
  • inhalative

Since latex is a component of approx. 40,000 everyday objects, this is of course not possible without restrictions and means a great loss of quality of life. Those who do not have a severe allergy can reduce exposure by lowering the protein content. Laundry containing latex should be washed and ironed before wearing it for the first time; Items should be soaked in detergent solution for a long time. It is not enough to simply wash the objects with washing-up liquid!

Since sensitization occurs through contact, avoidance of exposure should nevertheless be as consistent as possible. Particular difficulties arise in this context in the professional area; In some cases, the previous profession can no longer be practiced or can only be practiced to a very limited extent. However, recognition of an occupational disease/incapacity by the professional associations is very difficult.

One hope in this case would be immunotherapy. This is already being developed and is being clinically tested. However, it is not yet on the market.

There are medications for acute cases. Here, too, the range is large. Starting with over-the-counter tablets, nasal sprays and eye drops through to a complete emergency kit. Every highly sensitized allergy sufferer should always have such an emergency kit with them! It can prevent anaphylactic shock. In this case, you should still consult your doctor. It is important to know how to use the medication and, if possible, to tell other people about the allergy and where the kit is kept. This is especially true for children! The set is prescribed by the family doctor or allergist and consists of:

  • Adrenaline as a metered dose inhaler
  • Antihistamines in drops
  • Cortisone drops

It is also recommended to carry an emergency bracelet, an emergency card or an SOS capsule and to have latex-free gloves in the car first aid kit.

The greatest danger for a person allergic to natural latex is medical intervention, especially in an emergency. Depending on the severity of the allergy, it can lead to inflammation, delayed healing and even death. For this reason, the allergy should always be pointed out during planned interventions or examinations and possible alternatives should be discussed. During operations, care must be taken to ensure that all medical devices do not contain latex, especially ventilation masks, catheters and infusion sets. During examinations, e.g. at the gynecologist or dentist, the allergy should be pointed out every time, because doctors are only human and often the first grip automatically goes to the latex gloves...

 

Trigger

 

The first cases of natural latex allergy were described in 1929. Since then, the number of allergy sufferers has increased significantly, especially in the last 10-15 years. An increase in cases was observed as early as the early 1980s. This is due to the increased use of (powdered) gloves to protect against AIDS. However, only an estimated 1% of all serious cases in connection with natural latex allergy are recognized as such, but interpreted as "unexplained anesthetic incident".

The trigger for a natural latex allergy are certain protein components in latex. Powdered latex gloves are particularly dangerous because the powder disperses allergenic proteins in the air. Highly sensitized allergy sufferers already show symptoms when they are in a room where such gloves have been used! For this reason, powdered gloves can no longer be used professionally. In addition, latex is listed in the TRGS (Technical Rules for Hazardous Substances) 540 and 907 as sensitizing to the respiratory tract and skin.

The following groups of people have a particularly high risk of a natural latex allergy:

  • medical staff (5 - 17% depending on the branch)
  • Patients with spina bifida (spina bifida) (40 - 60%)
  • Patients with urogenital anomalies
  • Patients with frequent surgeries
  • Patients with hand eczema
  • Workers in the rubber processing industry
  • workers in the cleaning industry
  • hairdressers
  • Atopics (people prone to allergies) (1%, well above average compared to other allergies)

Women are more likely to be allergic to latex than men. This is probably due to the fact that there are more women in the vulnerable professions.