DISCLAIMER 

Mention of any company or product does not constitute endorsement by the National Institute for 

Occupational Safety and Health. 

This document is in the public domain and may be free·ly copied or re.pri,nted. 

Copies of this and other NIOSH documents are available from 

Publications Dissemination, EID 

National Institute for Occupational Safety and Health 

4676 Columbia Parkway 

Cincinnati, OH 45226-1998 

Fax number: (513) 533-8573 

Telephone number: 1-800-35-NIOSH (1-800-356-4674) 

E-mail: pubstaft@cdc.gov 

To receive other information about occupational safety and health 

problems, caii1-800-35-NIOSH (1-800-356-4674), or visit the NIOSH Homepage 

on the World Wide Web at http://www.cdc.gov/niosh 

NOTICE TO THE READER 

In this third printing, minor changes have been made In some wording of the text for 

additional clarity. 

DHHS (NIOSH) Publication No. 97-135 

First Printing -June 1997 

Second Printing -August 1997 

Third Printing -August 1998 
Preventing Allergic Reactions to 

Natural Rubber Latex in the Workplace 

WARNING! 

Workers exposed to latex gloves and other products containing natural rubber latex may 

develop al!lergic reactions such as skin rashes; hives; nasal, eye, or sinus symptoms; 

asthma; and (rarely) shock. 

Workers with ongoing exposure to natural rubber latex* should take the following steps to protect themselves: 

1 . Use non latex gloves for activities that are not likely to 

involve contact with infectious materials (food preparation, routine housekeeping, maintenance, etc.). 

2. Appropriate barrier protection is necessary when handling infectious materials. t If you choose latex gloves, 

use powder-free gloves with reduced protein content.* 

3. When wearing latex gloves, do not use oil-based 

hand creams or lotions (which can cause glove deterioration) unless they have been shown to reduce 

latex-related problems and maintain glove barrier protection. 

4. Frequently clean work areas contaminated with latex 

dust (upholstery, carpets, ventilation ducts, and plenums). 

5. Frequently change the ventilation filters and vacuum 

bags used in latex-contaminated areas. 

"In this warning sheet, the term "latex" refers to natural rubber 

latex and includes products made from dry natural rubber. 

Natural rubber latex is the product manufactured from a milky 

fluid derived mainly from the rubber tree, Hevea brasiliensis. 

tCDC (Centers for Disease Control and Prevention) [1987). 

Recommendations for prevention of HIV transmission in 

health-care settings. MMWR 36(82). 

*The goal of this recommendation is to reduce exposure to 

allergy-causing proteins (antigens). Until well accepted standardized tests are available, total protein serves as a useful indicator of the exposure of concern. 

Please tear out and post. Distribute copies to workers. 

-

6. Learn to recognize the symptoms of latex allergy: 

skin rashes; hives; flushing; itching; nasal, eye, or sinus symptoms; asthma; and shock. 

7. If you develop symptoms of latex allergy, avoid direct 

contact with latex gloves and products until you can 

see a physician experienced in treating latex allergy. 

8. If you have latex allergy, consult your physician regarding the following precautions: 

• Avoid contact with latex gloves and products. 

• Avoid areas where you might inhale the powder 

from the latex gloves worn by others. 

• Tell your employers, physicians, nurses, and dentists that you have latex allergy. 

• Wear a medical alert bracelet. 

9. Take advantage of all latex allergy education and training 

provided by your employer. 

Dust produced by removing a latex glove containing powder. 

See back of sheet to order complete Alert. 
For additional information, see N/OSH Alert: Preventing 

Allergic Reactions to Natural Rubber Latex in the Workplace (DHHS [NIOSH] Publication No. 97 -135). Single copies 

of the Alert are available free from the following: 

Publications Dissemination, EID 

National Institute for Occupational Safety and Health 

4676 Columbia Parkway 

Cincinnati, OH 45226-1998 

Fax number: (513) 533-8573 

Phone number: 1-800-35-NIOSH (1-800-356-4674) 

E-mail: pubstaft@cdc.gov 

U.S. Department of Health and Human Services l"f'!J 

Public Health Service w/OSH 

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health 
Preventing Allergic Reactions to 

Natural Rubber Latex in the Workplace 

WARNING! 

Workers exposed to latex .gloves and other products containing natural rubber 

latex may develap allergic reacUons SL!Ch as s~in rashes; hives; nasal, eye, or 

sinus symptoms; asthma; and (rarely) shock. 

The National Institute for Occupational 

Safety and Health (NIOSH) requests assistance in preventing allergic reactions to 

natural rubber latex· among workers who 

use gloves and other products containing 

latex. Latex gloves have proved effective in 

preventing transmission of many infectious 

diseases to health care workers. But for 

some workers, exposures to latex may result in skin rashes; hives; flushing; itching; 

nasal, eye, or sinus symptoms; asthma; 

and (rarely) shock. Reports of such allergic 

reactions to latex have increased in recent 

years-especially among health care workers. 

At present, scientific data are incomplete 

regarding the natural history of latex allergy. 

Also, improvements are needed in methods 

used to measure proteins causing latex allergy. This Alert presents the existing data 

and describes six case reports of workers 

who developed latex allergy. The document 

·In this document, the term "latex" refers to natural 

rubber latex and includes products made from dry natural rubber. Natural rubber latex is the product manufactured from a milky fluid derived mainly from the 

rubber tree, Hevea brasiliensis. 

also presents NIOSH recommendations for 

minimizing latex-related health problems in 

workers while protecting them from infectious materials. These recommendations 

include reducing exposures, using appropriate work practices, training and educating workers, monitoring symptoms, and 

substituting non latex products when appropriate. 

NIOSH requests that employers, owners, 

editors of trade journals, safety and health 

officials, and labor unions bring the recommendations in this Alert to the attention of 

all workers who may be exposed to latex. 

- ::r't. - - --------- - - =-=-- --

' BACKGROUND I • 

Composition of Latex 

Latex products are manufactured from a milky 

fluid derived from the rubber tree, Hevea 

brasiliensis. Several chemicals are added to 

this fluid during the processing and manufacture of commercial latex. Some proteins in 

latex can cause a range of mild to severe allergic reactions. Currently available methods 

of measurement do not provide easy or 

1 
consistent identification of allergy-causing 

proteins (antigens) and their concentrations. 

Until well accepted standardized tests are 

available, total protein serves as a useful indicator of the exposure of concern. [Beezhold 

et al. 1996a]. The chemicals added during processing may also cause skin rashes. Several 

types of synthetic rubber are also referred to 

as "latex;' but these do not release the proteins 

that cause allergic reactions. 

Products Containing Latex 

A wide variety of products contain latex: medical supplies, personal protective equipment, and 

numerous household objects. Most people who 

encounter latex products only through their 

general use in society have no health problems 

from the use of these products. Workers who 

repeatedly use latex products are the focus of 

this Alert. The following are examples of products that may contain latex: 

Emergency Office Supplies Racquet 

Equipment Rubber bands handles 

Blood pressure Erasers Shoe soles 

cuffs Expandable 

Stethoscopes Hospital Supplies fabrics 

Disposable gloves Anesthesia masks (waistbands) 

Oral and nasal Catheters Dishwashing 

airways Wound drains gloves 

Endotracheal tubes Injection ports Hot water 

Tourniquets Rubber tops of bottles 

Intravenous tubing multidose vials Condoms 

Syringes Dental dams Diaphragms 

Electrode pads Balloons 

Household Pacifiers 

Personal Objects Baby bottle 

Protective Automobile tires nipples 

Equipment Motorcycle and 

Gloves bicycle 

Surgical masks handgrips 

Goggles Carpeting 

Respirators Swimming 

Rubber aprons goggles 

Individuals who already have latex allergy should 

be aware of latex-containing products that may 

trigger an allergic reaction. Some of the listed 

products are available in latex-free forms. 

2 

Latex in the Workplace 

Workers in the health care industry (physicians, 

nurses, dentists, technicians, etc.) are at risk 

for developing latex allergy because they use 

latex gloves frequently. Also at risk are workers with less frequent glove use (hairdressers, 

housekeepers, food service workers, etc.) and 

workers in industries that manufacture latex 

products. 

TYPES OF REACTIONS TO LATEX 

Three types of reactions can occur in persons 

using latex products: 

• Irritant contact dermatitis 

• Allergic contact dermatitis (delayed 

hypersensitivity) 

• Latex allergy 

Irritant Contact Dermatitis 

The most common reaction to latex products 

is irritant contact dermatitis-the development 

of dry, itchy, irritated areas on the skin, usually 

the hands. This reaction is caused by skin 

irritation from using gloves and possibly by exposure to other workplace products and chemicals. The reaction can also result from repeated 

hand washing and drying, incomplete hand 

drying, use of cleaners and sanitizers, and exposure to powders added to the gloves. Irritant contact dermatitis is not a true allergy. 

Allergic Contact Dermatitis 

Allergic contact dermatitis (delayed hypersensitivity, also sometimes called chemical sensitivity dermatitis) results from exposure to 

chemicals added to latex during harvesting, 

processing, or manufacturing. These chemicals 

can cause skin reactions similar to those 

Allergic Reactions to Natural Rubber Latex 
caused by poison ivy. As with poison ivy, the 

rash usually begins 24 to 48 hours after contact 

and may progress to oozing skin blisters or spread 

away from the area of skin touched by the latex. 

Latex Allergy 

Latex allergy (immediate hypersensitivity) can 

be a more serious reaction to latex than irritant 

contact dermatitis or allergic contact dermatitis. Certain proteins in latex may cause sensitization (positive blood or skin test, with or without 

symptoms). Although the amount of exposure 

needed to cause sensitization or symptoms is 

not known, exposures at even very low levels 

can trigger allergic reactions in some sensitized individuals. 

Reactions usually begin within minutes of exposure to latex, but they can occur hours later 

and can produce various symptoms. Mild reactions to latex involve skin redness, hives, or 

itching. More severe reactions may involve respiratory symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma 

(difficult breathing, coughing spells, and 

wheezing). Rarely, shock may occur; but a lifethreatening reaction is seldom the first sign of 

latex allergy. Such reactions are similar to those 

seen in some allergic persons after a bee sting. 

LEVELS AND ROUTES OF EXPOSURE 

Studies of other allergy-causing substances 

provide evidence that the higher the overall 

exposure in a population, the greater the likelihood that more individuals will become sensitized [Venables and Chan-Yeung 1997]. The 

amount of latex exposure needed to produce 

sensitization or an allergic reaction is unknown; 

however, reductions in exposure to latex proteins have been reported to be associated 

with decreased sensitization and symptoms 

[Tarlo et al. 1994; Hunt et al. 1996]. 

Allergic Reactions to Natural Rubber Latex 

Figure 1. Dust produced by removing a latex glove 

containing powder. 

The proteins responsible for latex allergies have 

been shown to fasten to powder that is used 

on some latex gloves. When powdered gloves 

are worn, more latex protein reaches the skin. 

Also, when gloves are changed, latex protein/ 

powder particles get into the air, where they 

can be inhaled and contact body membranes 

(see Figure 1) [Heilman et al. 1996]. In contrast, work areas where only powder-free 

gloves are used show low levels or undetectable amounts of the allergy-causing proteins 

[Tarlo 1994; Swanson et al. 1994]. 

Wearing latex gloves during episodes of hand 

dermatitis may increase skin exposure and the 

risk of developing latex allergy. The risk of progression from skin rash to more serious reactions is unknown. However, a skin rash may 

be the first sign that a worker has become allergic to latex and that more serious reactions 

could occur with continuing exposure [Kelly et 

al. 1996]. 

WHO IS AT RISK? 

Workers with ongoing latex exposure are at risk 

for developing latex allergy. Such workers include health care workers (physicians, nurses, 

3 
aides, dentists, dental hygienists, operating room 

employees, laboratory technicians, and hospital housekeeping personnel) who frequently use 

latex gloves and other latex-containing medical supplies. Workers who use latex gloves less 

frequently (law enforcement personnel, ambulance attendants, funeral-home workers, fire 

fighters, painters, gardeners, food service workers, and housekeeping personnel) may also 

develop latex allergy. Workers in factories where 

latex products are manufactured or used can 

also be affected. 

Atopic individuals (persons with a tendency to 

have multiple allergic conditions) are at increased risk for developing latex allergy. Latex 

allergy is also associated with allergies to certain foods-especially avocado, potato, banana, tomato, chestnuts, kiwi fruit, and papaya. 

[Blanco et al. 1994; Beezhold et al. 1996b]. 

People with spina bifida are also at increased 

risk for latex allergy. 

DIAGNOSING LATEX ALLERGY 

Latex allergy should be suspected in anyone 

who develops certain symptoms after latex exposure, including nasal, eye, or sinus irritation; 

hives; shortness of breath; coughing; wheezing; or unexplained shock. Any exposed worker 

who experiences these symptoms should be 

evaluated by a physician, since further exposure could result in a serious allergic reaction. 

A diagnosis is made by using the results of a 

medical history, physical examination, and tests. 

Taking a complete medical history is the first 

step in diagnosing latex allergy. In addition, 

blood tests approved by the Food and Drug 

Administration (FDA) are available to detect 

latex antibodies. Other diagnostic tools include 

a standardized glove-use test or skin tests that 

involve scratching or pricking the skin through 

4 

a drop of liquid containing latex proteins. A 

positive reaction is shown by itching, swelling 

or redness at the test site. However, no FDAapproved materials are yet available to use in 

skin testing for latex allergy. Skin testing and 

glove-use tests should be performed only at 

medical centers with staff who are experienced 

and equipped to handle severe reactions. 

Testing is also available to diagnose allergic 

contact dermatitis. In this FDA-approved test, 

a special patch containing latex additives is applied to the skin and checked over several 

days. A positive reaction is shown by itching, 

redness, swelling, or blistering where the patch 

covered the skin. 

Occasionally, tests may fail to confirm a worker 

who has a true allergy to latex, or tests may 

suggest latex allergy in a worker with no clinical symptoms. Therefore, test results must be 

evaluated by a knowledgeable physician. 

TREATING LATEX ALLERGY 

Once a worker becomes allergic to latex, special precautions are needed to prevent exposures--during work as well as during medical 

or dental care. Certain medications may reduce 

the allergy symptoms, but complete latex 

avoidance (though quite difficult) is the most 

effective approach. Many facilities maintain 

latex-safe areas for affected patients and 

workers. 

HOW COMMON IS LATEX ALLERGY? 

The prevalence of latex allergy has been studied by several methods: 

• Questionnaires to assess reactions to 

latex gloves 

Allergic Reactions to Natural Rubber Latex 
• Medical histories of reactions to latexcontaining products 

• Skin tests 

• Tests for latex antibodies in a worker's 

blood 

Reports about the prevalence of latex allergy 

vary greatly. This variation is probably due to 

different levels of exposure and methods for 

estimating latex sensitization or allergy. Recent 

reports in the scientific literature indicate that 

from about 1% to 6% of the general population 

and about 8% to 12% of regularly exposed 

health care workers are sensitized to latex 

[Kelly et al. 1996; Katelaris et al. 1996; Liss et 

al. 1997; Ownby et al. 1996; Sussman and 

Beezhold 1995]. Among sensitized workers, a 

variable proportion have symptoms or signs of 

latex allergy. For example, one study of exposed hospital workers found that 54% of 

those sensitized had latex asthma, with an 

overall prevalence of latex asthma of 2.5% 

[Vandenplas et al. 1995]. Prevalence rates up 

to 11% are reported for non-health care workers exposed to latex at work [van derWalle and 

Brunsveld 1995; Nasuruddin et al. 1993; Orfan 

et al. 1994; Tarle et al. 1990]. 

Several reasons may exist for the large numbers of latex allergies recently reported in workers [Truscott 1995]: 

1 . Workers rely increasingly on latex gloves to 

prevent the transmission of human immunodeficiency virus (HIV), hepatitis B virus, 

and other infectious agents-as outlined in 

Recommendations for Prevention of HIV 

Transmission in Health-Care Settings [CDC 

1987] and in Guidelines for Prevention of 

Transmission of Human Immunodeficiency 

Virus and Hepatitis 8 Virus to Health-Care 

and Public-Safety Workers [CDC 1989]. 

2. Since 1992, the Occupational Safety and 

Health Administration (OSHA) has required 

Allergic Reactions to Natural Rubber Latex 

employers to provide gloves and other 

protective measures for their employees 

[29 CFRt191 0.1030, Bloodborne pathogens]. 

3. Some manufacturers may have produced 

more allergenic gloves because of changes 

in raw materials, processing, or manufacturing procedures to meet the increased 

demand for latex gloves [Hunt et al. 1995]. 

These production changes may account 

partly for the varied concentrations of extractable latex proteins reported for latex 

gloves (up to a 3,000-fold difference in 

gloves from various manufacturers) 

[Yunginger et al. 1994; Beezhold 1992]. 

Variations may also exist between lots produced by the same manufacturer. 

4. Physicians are more familiar with latex allergy and have improved methods for diagnosing it. 

CASE REPORTS 

The following case reports briefly describe the 

experiences of six workers who developed latex allergy after occupational exposures. These 

cases are not representative of all reactions to 

latex but are examples of the most serious 

types of reactions. They illustrate what has occurred in some individuals. 

Case No.1 

A laboratory technician developed asthma 

symptoms after wearing latex gloves while performing blood tests. Initially, the symptoms occurred only on contact with the gloves; but 

later, symptoms occurred when the technician 

was exposed only to latex particles in the air 

[Seaton et al. 1988]. 

tCode of Federal Regulations. See CFR in references. 

5 
Case No.2 

A 33-year-old woman sought medical treatment 

for occupational asthma after 6 months of 

periodic cough, shortness of breath, chest tightness, and occasional wheezing. She had 

worked for 7 years as an inspector at a medical supply company, where her job included inflating latex gloves coated with cornstarch. Her 

symptoms began within 1 0 minutes of starting work and worsened later in the day (90 minutes after leaving work). Symptoms disappeared 

completely while she was on a 12-day vacation, 

but they returned on her first day back at work 

[Tarlo et al. 1990]. 

Case No.3 

A nurse developed hives in 1987, nasal congestion in 1989, and asthma in 1992. Eventually she developed severe respiratory 

symptoms in the health care environment even 

when she had no direct contact with latex. The 

nurse was forced to leave her occupation because of these health effects [Bauer et al. 1993]. 

Case No.4 

A midwife initially suffered hives, nasal congestion, and conjunctivitis. Within a year, she developed asthma, and 2 years later she went 

into shock after a routine gynecological examination during which latex gloves were used. 

The midwife also suffered respiratory distress 

in latex-containing environments when she 

had no direct contact with latex products. She 

was unable to continue working [Bauer et al. 

1993]. 

Case No.5 

A physician with a history of seasonal allergies, runny nose, and eczema on his hands 

suffered severe runny nose, shortness of 

breath, and collapse minutes after putting on 

6 

a pair of latex gloves. He was successfully 

resuscitated by a cardiac arrest team [Rosen 

et al. 1993]. 

Case No.6 

An intensive care nurse with a history of runny 

nose, itchy eyes, asthma, eczema, and contact 

dermatitis experienced four severe allergic 

reactions to latex. The first reaction began with 

asthma severe enough to require treatment in 

an emergency room. The second and third reactions were similar to the first. The fourth and 

most severe reaction occurred when she put 

on latex gloves at work. She went into severe 

shock and was successfully treated in an emergency room [Rosen et al. 1993]. 

CONCLUSIONS 

Latex allergy in the workplace can result in potentially serious health problems for workers, 

who are often unaware of the risk of latex exposure. Such health problems can be minimized or prevented by following the recommendations outlined in this Alert. 

RECOMMENDATIONS 

The following recommendations for preventing 

latex allergy in the workplace are based on 

current knowledge and a common-sense 

approach to minimizing latex-related health 

problems. Evolving manufacturing technology 

and improvements in measurement methods . 

may lead to changes in these recommendations 

in the future. For now, adoption of the recommendations wherever feasible will contribute 

to the reduction of exposure and risk for the development of latex allergy. 

Allergic Reactions to Natural Rubber Latex 
-Frequently change ventilation filters 

and vacuum bags used in latex-contaminated areas. 

4. Take advantage of all latex allergy education 

and training provided by your employer: 

• Become familiar with procedures for preventing latex allergy. 

• Learn to recognize the symptoms of latex 

allergy: skin rashes; hives; flushing; itching; nasal, eye, or sinus symptoms; 

asthma; and shock. 

5. If you develop symptoms of latex allergy, 

avoid direct contact with latex gloves and 

other latex-containing products until you 

can see a physician experienced in treating 

latex allergy. 

6. If you have latex allergy, consult your physician regarding the following precautions: 

• Avoid contact with latex gloves and other 

latex-containing products. 

• Avoid areas where you might inhale the 

powder from latex gloves worn by other 

workers. 

• Tell your employer and your health care 

providers (physicians, nurses, dentists, 

etc.) that you have latex allergy. 

• Wear a medical alert bracelet. 

7. Carefully follow your physician's instructions 

for dealing with allergic reactions to latex. 

ADDITIONAL INFORMATION 

For additional information about latex allergy, 

caii1-800-35-NIOSH (1-800-356-4674); or 

8 

visit the NIOSH Homepage on the World 

Wide Web at 

http://www.cdc.gov/niosh 

You may access the following latex allergy 

websites directly or by selecting Latex Allergy 

through the NIOSH Homepage: 

• http://mediswww.cwru.edu/dept/anesth/ 

lair/lair.htm 

• http://www. fam ilyvi llage. wisc.ed u/ 

lib_latx.htm 

ACKNOWLEDGMENTS 

Principal contributors to this Alert were 

R.E. Biagini, S. Deitchman, E.J. Esswein, J. 

Fedan, J.P. Flesch, P.K. Hodgins, T.K. Hodous, 

R.D. Hull, W.R. Jarvis, D.M. Lewis, J.A. 

Lipscomb, B.D. Lushniak, M.L. Pearson, E.L. 

Petsonk, L. Pinkerton, PD. Siegal, W.G. Wippel, 

and K.A. Worthington. 

Please direct comments, questions, or requests 

for additional information to the following: 

Director 

Division of Surveillance, Hazard Evaluations, 

and Field Studies 

National Institute for Occupational 

Safety and Health 

4676 Columbia Parkway 

Cincinnati, OH 45226-1998 

Telephone: 513-841-4366 or 

1-800-35-N IOSH ( 1-800-356-467 4). 

Allergic Reactions to Natural Rubber Latex 
Employers 

Latex allergy can be prevented only if employers adopt policies to protect workers from undue latex exposures. NIOSH recommends that 

employers take the following steps to protect 

workers from latex exposure and allergy in the 

workplace: 

1. Provide workers with non latex gloves to use 

when there is little potential for contact with 

infectious materials (for example, in the food 

service industry). 

2. Appropriate barrier protection is necessary 

when handling infectious materials [CDC 

1987]. If latex gloves are chosen, provide reduced protein, powder-free gloves to protect 

workers from infectious materials.* 

3. Ensure that workers use good housekeeping practices to remove latex-containing dust 

from the workplace: 

• Identify areas contaminated with latex 

dust for frequent cleaning (upholstery, 

carpets, ventilation ducts, and plenums). 

• Make sure that workers change ventilation filters and vacuum bags frequently 

in latex-contaminated areas. 

4. Provide workers with education programs 

and training materials about latex allergy. 

5. Periodically screen high-risk workers for latex allergy symptoms. Detecting symptoms 

early and removing symptomatic workers 

from latex exposure are essential for preventing long-term health effects. 

6. Evaluate current prevention strategies whenever a worker is diagnosed with latex allergy. 

*The goal of this recommendation is to reduce exposure to 

allergy-causing proteins (antigens). Until well accepted standardized tests are available, total protein serves as a useful indicator of the exposure of concern. 

Allergic Reactions to Natural Rubber Latex 

Workers 

Workers should take the following steps to 

protect themselves from latex exposure and allergy in the workplace: 

1. Use nonlatex gloves for activities that are 

not likely to involve contact with infectious 

materials (food preparation, routine housekeeping, maintenance, etc.). 

2. Appropriate barrier protection is necessary 

when handling infectious materials [CDC 

1987]. If you choose latex gloves, use powder-free gloves with reduced protein content:* 

• Such gloves reduce exposures to latex 

protein and thus reduce the risk of latex 

allergy (though symptoms may still occur in some workers). 

• So-called hypoallergenic latex gloves do 

not reduce the risk of latex allergy. However, they may reduce reactions to 

chemical additives in the latex (allergic 

contact dermatitis). 

3. Use appropriate work practices to reduce 

the chance of reactions to latex: 

• When wearing latex gloves, do not use 

oil-based hand creams or lotions (which 

can cause glove deterioration) unless 

they have been shown to reduce latexrelated problems and maintain glove 

barrier protection. 

• After removing latex gloves, wash hands 

with a mild soap and dry thoroughly. 

• Use good housekeeping practices to 

remove latex-containing dust from the 

workplace: 

-Frequently clean areas contaminated 

with latex dust (upholstery, carpets, 

ventilation ducts, and plenums). 

7 
We greatly appreciate your assistance in protecting the health of U.S. workers. 

Linda Rosenstock, M.D., M.P.H. 

Director, National Institute for 

Occupational Safety and Health 

Centers for Disease Control and Prevention 

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Czuppon AB [1993]. Health risk in hospitals 

through airborne allergens for patients pre-sensitized to latex. Lancet 342:1148-1149. 

Beezhold D [1992]. LEAP: Latex ELISA for 

antigenic protein. Guthrie J 61:77-81. 

Beezhold D, Pugh B, Liss G, Sussman G. 

[1996a] Correlation of protein levels with skin 

prick test reactions in patients allergic to latex. 

J Allergy and Clin lmmunol98(6):1097-1102. 

Beezhold DH, Sussman GL, Liss GM, Chang 

NS [1996b]. Latex allergy can induce clinical 

reactions to specific foods. Clin Exp Allergy 

26:416-422. 

Blanco C, Carrillo T, Castillo R, Quiralte J, 

Cuevas M [1994]. Latex allergy: clinical features 

and cross-reactivity with fruits. Ann Allergy 

73:309-314. 

CDC (Centers for Disease Control and Prevention) [1987]. Recommendations for prevention 

of HIV transmission in health-care settings. 

MMWR 36(S2). 

CDC (Centers for Disease Control and Prevention) [1989]. Guidelines for prevention of 

Allergic Reactions to Natural Rubber Latex 

transmission of human immunodeficiency virus and hepatitis B virus to health-care and 

public-safety workers. MMWR 38(S-B):1-37. 

CFR. Code of Federal regulations. Washington, DC: U.S. Government Printing Office, Office of the Federal Register. 

Heilman DK, Jones AT, Swanson MC, 

Yunginger JW [1996]. A prospective, controlled 

study showing that rubber gloves are the major contributor to latex aeroallergen levels in 

the operating room. J Allergy Clin lmmunol 

98(2) :325-330. 

Hunt LW, Fransway AF, Reed CE, Miller LK, 

Jones AT, Swanson MC, et al. [1995]. An epidemic of occupational allergy to latex involving 

health care workers. JOEM 37(10):1204-1209. 

Hunt LW, Boone-Orke JL, Fransway AF, 

Fremstad CE, Jones AT, Swanson MC, et al. 

[1996]. A medical-center-wide, multidisciplinary 

approach to the problem of natural rubber latex allergy. JOEM 38(8):765-770. 

Katelaris CH, Widmer RP, Lazarus AM [1996]. 

Prevalence of latex allergy in a dental school. 

Med J Australia 164:711-714. 

Kelly KJ, Sussman G, Fink JN [1996]. Stop the 

sensitization. J Allergy Clin lmmunol 98(5): 

857-858. 

Liss GM, Sussman GL, Deal K, Brown S, 

Cividino M, Siu S, et al. [1997]. Latex allergy: 

epidemiological study of hospital workers. 

Occup Environ Med 54:335-342. 

Nasuruddin BA, Shahnaz M, Azizah MR, 

Hasma H, Mok KL, Esah Y, et al. [1993]. Prevalence study of type I latex hypersensitivity 

among high risk groups in the Malaysian population-a preliminary report. Unpublished paper presented at the Latex Allergy Workshop, 

International Rubber Technology Conference, 

Kuala Lumpur, Malaysia, June. 

9 
Orfan NA, Reed R, Dykewicz MS, Ganz M, 

Kolski GB [1994]. Occupational asthma in a 

latex doll manufacturing plant. J Allergy Clin 

lmmunol 94(5):826-830. 

Ownby DR, Ownby HE, McCullough J, Shafer, 

AW [1996]. The prevalence of anti-latex lgE 

antibodies in 1 000 volunteer blood donors. J 

Allergy Clin lmmunol97(6):1188-1192. 

Rosen A, Isaacson D, Brady M, Corey JP 

[1993]. Hypersensitivity to latex in health care 

workers: report of five cases. Otolaryngol Head 

Neck Surg 109(4):731-734. 

Seaton A, Cherrie B, Turnbull J [1988]. Rubber 

glove asthma. Br Med J 296:531-532. 

Sussman GL, Beezhold DH [1995]. Allergy to 

latex rubber. Ann Intern Med 122:43-46. 

Swanson MC, Bubak ME, Hunt LW, Yunginger 

JW, Warner MA, Reed CE [1994]. Quantification of occupational latex aeroallergens in a 

medical center. J Allergy Clin lmmunol 94(3): 

445-551. 

Tarlo SM, Wong L, Roos J, Booth N [1990]. 

Occupational asthma caused by latex in a surgical glove manufacturing plant. J Allergy Clin 

lmmunol 85(3):626-631. 

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