Ten myths about latex allergy
Even as the numbers of latex-allergic ED nurses continue to rise, ignorance is rampant about latex allergy. "Often, even very experienced nurses really don't know the basics," says Gail Pisarcik Lenehan, RN, EdD, CS, a Boston-based emergency nurse and editor of the Journal of Emergency Nursing. Here are some misconceptions about latex allergy commonly heard in the ED:
1. "Synthetic gloves aren't as safe." "People equate latex with protection, but many synthetics are said to offer equal or superior barrier protection against viruses," says Lenehan. "If latex is used, most experts agree that it should be low allergen, powder-free latex." Use synthetic gloves with the appropriate barrier protection for a particular task, she advises.
2. "You won't become allergic if you stop wearing latex gloves." Latex proteins can be aerosolized and breathed in, which causes sensitization as well as reactions, Lenehan says. "Too many nurses think avoiding latex gloves will make them safe," she warns. "Very few people know there is a danger if you become sensitized when other people around you wear them."
3. "If you've worn gloves for years with no problem, you don't have to worry." "Many nurses think, 'I've been wearing gloves for 10 years, and they haven't bothered me yet, so I'm sure they're not going to.' But it's a cumulative process," says Lenehan. "In reality, the longer you've worn latex gloves, the more likely it is that you may develop a problem."
Reactions to latex can become more severe with repeated exposures. "With bee stings, symptoms become more severe as your body mounts a defense against the allergen. First, you get a red mark. With the second sting, your arm swells up, and with the third sting, you may go into anaphylactic shock," says Lenehan. "It can be the same way with latex. It can set into motion histamines, which in the end, make your vasculature flaccid and permeable so you 'bottom out,' which can affect your airway."
4. "If you have only slight itchiness from wearing latex gloves, it means you're not seriously allergic." The majority of people will not progress beyond a hand rash, but the most insidious aspect of latex allergy is its progressive nature. "And once someone has a severe reaction to latex-either latex-induced severe asthma or anaphylaxis-each systemic reaction will come with less provocation, and each will be worse, which is exactly the case with an allergy to a substance like penicillin," says Lenehan.
5. "Wearing synthetic gloves over latex gloves will protect you." Realize that the aerosolized latex can be dangerous. "Nurses will put latex gloves over the synthetic gloves, thinking they're protected, but they're still breathing in latex," Lenehan explains.
6. "You can become allergic to synthetic gloves." While an allergy might be theoretically possible, it's usually the chemicals that cause contact dermatitis, and there have been no reports of serious reactions, says Lenehan. "Synthetic gloves can irritate you, but don't seem to cause systemic serious anaphylaxis or asthmatic reactions like the proteins in latex do, " she explains.
7. "If a reaction occurs, you should treat the symptoms." It's dangerous to conceal symptoms of latex allergy while the condition is progressing. "Even experienced ED nurses have put steroid cream around their eyes or hands, which is an unwise practice and only masks symptoms while sensitization could be progressing or even hastened by the creams," says Lenehan.
8. "Latex allergy affects certain populations." Typically, ED nurses want to believe that somehow latex allergy happens to "other" people. "While some things might make someone more likely to become allergic, the literature reveals that it's often a case of how much someone has been exposed to latex and how invasive the contact was," says Lenehan.
You're more at risk if you have a history of other allergies or eczema, but exposure is key. "There are high-risk populations, such as spina bifida patients, but what makes them high risk is the fact that they've been exposed to latex during multiple operative procedures, with latex catheters coming in contact with mucosal tissue," says Lenehan.
9. "It's too expensive to switch to non-latex gloves." Administrators may balk at switching to non-latex gloves, but there are ways to reduce the cost. "The hospital may be buying over 100 different kinds of gloves, and if you consolidate with one synthetic, universal exam glove, you can save money because of the economy of scale," says Lenehan.
There are a plethora of new latex-free supplies being offered by manufacturers in response to increasing demand. "Almost every product made out of latex is either already being made out of a synthetic, or an alternative is being explored," says Lenehan.
10. "Latex allergy isn't as serious as other allergies." "People instantly appreciate how dangerous a penicillin allergy can be, but they don't realize there is the same potential for a lethal anaphylaxis with latex," notes Lenehan.
As a result, facilities continue to put nurses at risk. "Having a latex-free cart is important, but it won't make a difference if there is powdered latex being breathed," says Lenehan. "We wouldn't dream of treating someone with an allergic reaction to penicillin where aerosolized penicillin is being breathed."