This section has been reviewed and updated as needed: April 2012
Latex allergy occurs when the body’s immune system reacts to proteins found in natural rubber latex (NRL). NRL, commonly referred to as latex, is most often associated with disposable gloves but may be found in thousands of other products both within a healthcare setting and in normal daily life. The implementation of Universal Precautions resulted in the increased use of latex gloves, and an increase was also being seen in latex sensitivity in healthcare workers. More recently, the introduction of non-powdered low latex and nitril gloves has resulted in a decrease in latex sensitivity among healthcare workers.
This policy is designed to assist in the management of latex sensitization among UNC-CH Clinical Facilities and UNC Healthcare employees and to protect them from undue latex exposure.
Latex allergy prevention will consist of appropriate glove usage, identification and verification of latex sensitive employees and education.
Glove Usage and Selection
Gloves will be used by employees either to protect themselves from potential exposures to infectious or toxic agents, or to protect items from being contaminated by microbes present on the hands. Different types of gloves will be provided based on the potential exposure. Nitrile gloves do not sensitize employees to natural rubber products. Please refer to the Latex Allergy Policy in the Hospital Policy Manual for information regarding glove with latex sensitive patients (Policy # EHS 0054). Only nitrile gloves will be available through UNC Healthcare Central Distribution. The use of latex gloves will be limited at clinical settings as much as possible. Some latex gloves usch as surgical latex gloves may continue to be purchased in certain areas. Following the removal of latex gloves, hands should be washed immediately to remove any latex proteins, which if not washed away could cause irritation and sensitization.
Identification and Verification of Latex Sensitive Employees
All employees will be screened for latex sensitivity within 10 days of employment. This information will become part of the permanent occupational health record. All current employees will be screened at the time of the employees annual review for immunizations/PPD skin testing.
All employees with evidence of latex sensitivity by questionnaire, medical history, or physical examination will be evaluated by the appropriate occupational health service. (University employees shall be evaluated by University Employee Occupational Health Clinic located at 145 North Medical Drive and UNC Hospitals employees shall be evaluated by Occupational Health Services.) Such an evaluation will include:
- Employees with active skin dermatitis will be evaluated by an occupational health nurse for possible latex allergy or other possible causes of skin dermatitis (i.e. soap use).
- Employees with severe dermatitis or evidence of systemic reactions to latex, i.e. anaphylaxis, asthma, will be evaluated by the occupational health Medical Director. Such an evaluation may include laboratory screening for latex sensitization. Also any employee with breaks in the skin will be evaluated for appropriateness of contact with patients and patient equipment.
- For dermatitis not responsive to conservative measures, the employee may be referred by the occupational health Medical Director to Dermatology or appropriate subspecialist.
- For systemic reactions not responsive to conservative measures, the employee may be referred by the occupational health Medical Director to Allergy and Immunology or appropriate subspecialist.
- The occupational health team managing the employee’s case will also talk with the employee’s supervisor if needed.
- The employee will also receive counseling on how to minimize latex exposures and will be provided with a list of latex products to be avoided if possible. Latex allergic employees should use only non-latex gloves and other products and avoid all latex-containing products.
All new employees will be provided information regarding the health risks associated with latex including the prevalence of latex sensitization, risk factors for sensitization, mechanism to report potential problems with latex, and basic management for latex sensitive employees. Similar education will be provided to all employees on an annual basis through their annual safety training.
It is the responsibility of all employees and department managers to ensure compliance with this policy in conjunction with the appropriate occupational health service.