A Review of Latex Allergy Presentations at the American Academy of Allergy, Asthma & Immunology Annual Meeting

Russell Thompson, Editor

Much progress appears to have been made in numerous medical centers around the world into understanding the underling causes of Type I NRL allergy. This has been achieved through research and education of the healthcare community. Of significant importance is the ability of the most severely latex allergic healthcare workers to return to their work place.

The March 3-7, 2000 Annual Meeting of the American Academy of Allergy, Asthma & Immunology was convened in San Diego, California. This year's attendance exceeded 7,700 researchers, Allergists, Immunologists, allied healthcare workers and exhibitors representing most major countries in the world.

The focus on Type I NRL allergy was greater than in past years with a total of 69 abstracts, papers and seminars representing 6% of all topics covered at the meeting. The diversity of academics, institutional and private facilities input on NRL allergy ranged from Russia, Italy, Spain and Finland to Malaysia, Japan and Australia testifying to the global recognition of this allergy.

Research topics ranged from identification and classification of two new major protein allergens Hev b 9 and Hev b 10, to increasingly heated demands that the FDA approve a standardized Skin Prick Test reagent. This lack of approval by the FDA leaves the US as the only major country without a commercially available skin test while FDA has approved three enzyme immunoassay (EIA), which are available for IgE diagnosis. These EIA assays are reported to have a fairly diverse range of sensitivity and specificity.

Researchers in Finland (Palosuo et al) and Spain (Blanco et al) reported on anti-microbial proteins that play an important role in the defense responses of plants, chitinases. They speculate that these may in some way be responsible for the cross reactivity of certain fruits (bananas, avocados) and vegetables (turnips) to NRL. "Latex fruit syndrome" may be relevant to an individual's sensitization to NRL from these associated food allergens.

A number of institutional researchers (Yunginger, Tarlow and Owenby) reported on the reduction of the number of new cases of NRL allergy amongst healthcare workers. This has been attributed in part to education and testing in the allergy community. The primary reason for the decrease in new cases was attributed to the significant industry improvement in quality of NRL gloves through reduction in allergenicity, powder content and the additional leachings and chlorination of gloves.

Several institutions, including Johns Hopkins, are moving towards the total conversion to synthetic gloves from NRL with cost increases being justified by reduction of work days lost and increased productivity due to associated NRL allergy.

Dr. Levy of France presented the success in a small study of sensitized healthcare workers utilizing "deproteinized" NRL condoms. This study is discussed in more detail inside this issue.

By far the most positive new presentations were made on the success of putting the most severely affected latex allergic healthcare workers back to work in NRL controlled healthcare environments, through switching to lower allergen, low powdered or synthetic gloves.

Reproduced with permission of Editors of Source to Surgery, AnsellCares