Latex allergy. A position paper of the british society of allergy and clinical immunology

1. The apparent increase in Type I latex allergy probably reflects a true increase in incidence, beginning in the late 1980s. The cause(s) of this remain unexplained but plausible explanations include the increasing use of latex goods in several settings. 2. Although the condition is probably rare in the general community, it may be much commoner among certain high-risk groups: in particular those with congenital urinary dysfunction and those who wear (powdered) latex gloves of high-protein content at work. There is a paucity of evidence, but latex allergy appears to be less common in the UK than in otherwise similar countries. 3. NR latex contains a large number of allergenic proteins. These may be of differing importance depending on the route of exposure. 4. A diagnosis of immediate-type latex allergy should only be made in the presence of a clear and characteristic history together with immunological evidence of specific IgE production from either skin prick testing (preferable) or immunoassay. 5. The diagnostic accuracy of both skin testing and immunoassay remain a matter for further study. 6. Skin prick testing and immunoassay should be conducted only by persons experienced both in the techniques and in their interpretation. Skin prick testing should be avoided in patients with a history of latex anaphylaxis. 7. Patients with a diagnosis of Type I latex allergy should have the condition carefully explained to them and be advised to follow appropriate avoidance measures. During all health-care procedures they should be treated in a 'latex-free' environment. 8. In the majority of cases where there is workplace exposure to latex, allergic patients can be managed without a change in occupation. 9. A high index of suspicion should be maintained by all those caring for persons at high risk of developing latex allergy; this applies particularly to those who undergo regular, invasive treatment(s) such as patients with congenital urinary dysfunction. 10. There is sufficient knowledge of the broad aetiology of latex allergy for primary preventive programmes to be widely adopted.