Latex allergy and its clinical features among healthcare workers at Mankweng Hospital, Limpopo Province, South Africa.
ABSTRACT Background and objectives. Latex allergy, caused by sensitisation in atopic individuals, is a common occupational disease among healthcare workers who use latex gloves. It may be present in non-atopic individuals as well. The main objective of this study was to document the prevalence and disease spectrum of latex allergy at Mankweng Hospital, Limpopo Province, South Africa. The secondary objective was to determine clinical presentation of the disease. Methods. A cross-sectional descriptive study, with an analytical component, was conducted among healthcare workers who worked in high-risk areas for latex sensitisation. ImmunoCAP testing was performed and followed by a skin-prick test (SPT) in those who tested negative to the blood test. Results. Two hundred screening questionnaires were distributed to healthcare workers at the hospital. Of these 158 (79.0%) were returned, with 59 participants meeting the inclusion criteria (experiencing symptoms due to wearing latex gloves). The mean age of the participants was 39.6 years (standard deviation 9.8 years, range 20 - 60 years). There were more females (98.1%) than males (1.9%). Glove-related symptoms were present in 59 subjects (37.1%), in 7 (11.9%) of whom the ImmunoCAP was positive to latex (95% confidence interval 4.2 - 22.9%). Fourteen participants were lost to follow-up before the SPT was performed. Thirty-eight of the participants with negative ImmunoCAP tests underwent SPT. Positive SPTs were reported in 5 of these 38 workers (13.2%), indicating that the ImmunoCAP test missed 11.1% (5/45) of latex-allergic individuals. The prevalence of latex allergy in this study was 8.3% (12/144). A denominator of 144 was used, as there is a possibility that some of the 14 individuals lost to follow-up could have tested positive to latex sensitisation by SPT. The symptoms experienced by latex-sensitised workers were rhinitis (100.0%), asthma (50.0%), dermatitis (25.0%), severe anaphylaxis (8.3%), abdominal pain (8.3%) and angio-oedema (8.3%). Conclusion. Our findings reveal that latex allergy is a problem at our hospital. The prevalence of 8.3% is comparable to findings in other South African centres. We recommend a latex-free protocol for high-risk areas and healthcare workers.
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ABSTRACT: Allergens are one group of respiratory hazards in the workplace of healthcare workers (HCWs). The purpose of this review is to summarize the recent advances in occupational allergy as well as potential hazardous agents in HCWs. The review covers new developments on the epidemiology, diagnosis and management of occupational allergy in HCWs. This article also provides updated information on the prevalence of work-related respiratory symptoms, as well as on respiratory hazards among healthcare providers. It is established that HCWs are at risk of asthma symptoms. The growing use of cleaning products is one of the causes of occupational airway disease in that group. Among healthcare professionals, the prevalence of asthma varies depending on worksite. Recent findings indicate a need for education among HCWs concerning occupational risks. A lack of knowledge of product components as well as about exposure to cleaning/disinfecting agents has been demonstrated. Further studies are necessary to determine the relative role of individual agents versus complex workplace exposures in the development of work-related asthma in HCWs.Current Opinion in Allergy and Clinical Immunology 01/2014; DOI:10.1097/ACI.0000000000000039 · 3.66 Impact Factor
Article: Anaphylaxis as occupational risk.[Show abstract] [Hide abstract]
ABSTRACT: Anaphylaxis is a severe form of allergic reaction that may cause death. Main triggers of anaphylaxis have been reported to also cause occupational anaphylaxis (OcAn). The purpose of this article was to summarize the current scientific evidence on OcAn and review the specific literature published in 2012 and 2013.Current Opinion in Allergy and Clinical Immunology 05/2014; DOI:10.1097/ACI.0000000000000066 · 3.66 Impact Factor
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ABSTRACT: Anaphylaxis is a systemic allergic reaction, potentially life-threatening that can be due to non-occupational or, less commonly, to occupational triggers. Occupational anaphylaxis could be defined as anaphylaxis arising out of triggers and conditions attributable to a particular work environment. Hymenoptera stings and natural rubber latex are the commonest triggers of occupational anaphylaxis. Other triggers include food, medications, insect/mammal/snake bites and chemicals. The underlying mechanisms of anaphylactic reactions due to occupational exposure are usually IgE-mediated and less frequently non-IgE-mediated allergy or non-allergic. Some aspects of work-related allergen exposure, such as route and frequency of exposure, type of allergens and cofactors may explain the variability of symptoms in contrast to the non-occupational setting. When assessing occupational anaphylaxis both confirmation of the diagnosis of anaphylactic reaction and also identification of the trigger are required. Prevention of further episodes is important and is based on removal from further exposure. Workers with a history of occupational anaphylaxis should immediately be provided with a written emergency management plan, an adrenaline auto-injector and educated to its use. Immunotherapy is recommended only for occupational anaphylaxis due to Hymenoptera stings.This article is protected by copyright. All rights reserved.Allergy 11/2014; 70(2). DOI:10.1111/all.12541 · 6.00 Impact Factor