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Latex (Natural Rubber) Allergy in Spina Bifida

Online Resources 
2011 Latex List
2011 Latex List - Espanol

The first allergic reactions to natural latex rubber in people with Spina Bifida were reported in the late 1980's, one hundred years after latex was first used to make surgical rubber gloves. Since that time, research studies have shown that up to 73% of children and adolescents with Spina Bifida are sensitive to latex as measured by blood test or by a history of an allergic reaction. Synthetic latex (man made, such as latex paint) is not a threat because it is not made of natural rubber.

Although the cause of latex allergy in individuals with Spina Bifida is not known, it is theorized that sensitization has developed because of the early, intense, and constant exposure to rubber products through repeated surgeries, diagnostic tests and examinations, and bladder and bowel programs. People with Spina Bifida who have shunts for hydrocephalus, other allergies, and multiple surgeries may be at highest risk for latex reactions. Latex allergy is also a problem for people who don 't have Spina Bifida but who have had multiple latex exposures because of their occupation (health care workers) or their medical condition (asthma or other allergic disease, congenital bladder anomalies, frequent surgery or surgery in infancy).

Latex, a milky fluid harvested from the Hevea brasiliensis tree, a found in many common items, including medical and surgical gloves, urinary catheters, elastic bandages, bandaids, balloons, pacifiers, and condoms. Allergic reactions to latex proteins in these items can include watery and itchy eyes, sneezing and coughing, rash or hives, swelling of the windpipe, wheezing, difficulty breathing and the life-threatening collapse of circulation called anaphylactic shock.

Exposure to latex can occur when products containing rubber come in contact with a person's skin or mucous membranes such as the mouth, eyes, genitals, bladder or rectum. Serious reactions can also occur when latex enters the bloodstream, injected through the latex ports on intravenous tubing. The powder from balloon or gloves can absorb latex proteins and become airborne, causing reactions when breathed or touched by a latex-sensitive person. Food that has been handled by someone wearing latex gloves may also be contaminated by this glove powder. (People who have allergic reactions to latex may also be allergic to certain foods, including: bananas, tomatoes, potatoes, avocados and kiwi fruit.) The only way to prevent allergic reactions to latex is by avoiding contact with items containing latex and the latex-contaminated powder .

Latex is often a hidden ingredient in medical and consumer products, and it is difficult to know if a product does or does not contain the substance. For this reason, the Food and Drug Administration now requires labeling of natural latex rubber in all medical devices. Consumer products are not yet covered by a labeling mandate, however. Research is currently focused on identifying all the proteins causing the allergy, standardizing reagents for improved testing, developing rubber products that do not cause allergy, and possibly learning how to desensitize people with severe latex allergy.

Latex allergy is not fully understood at this time. Current knowledge and available evidence indicates that people that people with Spina Bifida are at significant risk of becoming allergic to natural latex rubber, with possible life-threatening reactions. Individuals with Spina Bifida and their families are urged to consider the following recommendations and to discuss them with members of their health care team.

  1. All individuals with Spina Bifida should be considered at high risk for having an allergic reaction to natural rubber (not synthetic rubber) and should avoid contact with latex products in all settings from birth. Alternative products usually made of silicone, plastic, nitrile or vinyl can usually be safely substituted.

  2. Individuals who have had an allergic reaction to latex should
    • Wear a medic-alert bracelet or necklace
    • Carry auto-injectable epinephrine
    • Carry sterile non-latex gloves and other necessary non-latex equipment for emergency use

  3. Latex allergy and latex avoidance should be discussed with all health care and community providers including school, day care, camp, and visitors bringing gifts to the child.

  4. Consultation with healthcare providers familiar with the latex allergy is recommended before hospitalization or surgery to prevent inadvertent exposure and plan for latex-safe care.

The following commonly encountered items may contain latex and may pose a risk to the latex sensitive individual:

  • Healthcare items which may contain latex: gloves, catheters, tourniquets, elastic bandages, ace bandages, IV tubing injection ports, medication vial stoppers, adhesive tape, dental dams, bandaids.

  • Home/community item which may contain latex: balloons, pacifiers, rubber bands, elastic in clothing, beach toys, Koosh balls, baby bottle nipples, condoms, diaphragms, diapers, art supplies.

Please note that this is only a partial list and it is strongly recommended that individuals with Spina Bifida and their families ask about the composition of products used in their case. A more complete list is available directly from the Spina Bifida Association of America at 800-621-3142 or http://www.sbaa.org .

Online Resources
2009 Latex List (PDF)
2009 Latex List - Espanol (PDF)

Latex Allergy Links
www.latexallergylinks.org

American Latex Allergy Association/ALERT
www.latexallergyresources.org

Decent Exposures (latex free undergarments)
1-800-524-4949
www.decentexposures.com

OSHA
www.osha.gov/SLTC/latexallergy

American Academy of Allergy, Asthma & Immunology
www.aaaai.org