Patients need information about sources of exposure

Average home full of products containing latex

For patients with latex sensitivity or allergy, the home can be a minefield full of seemingly harmless items that can cause real damage if touched.

Once patients have been diagnosed with latex sensitivity and are receiving medical care in a latex-safe environment, they must turn to their own households to determine which items can stay, which must go, and which must be used with care.

"There’s an estimate that there are probably 400 medical products that are known to have latex, and there’s an FDA requirement that they be labeled," says Kathy Sater, RN, MSN, director of education at Shriners Hospitals for Children Houston Hospital.

"However, that does nothing for the 40,000 household everyday products that are out there that don’t have to be labeled. That’s the biggest challenge for families," she says.

Home contains possible risks

It’s important to provide patients with comprehensive information about possible risks, to help them navigate this new reality. Their responses likely will depend on the severity of their latex reactions. People with milder, Type IV latex sensitivity may not feel the need to be as vigilant as someone with a more serious, Type I allergy.

"It’s not to frighten people, but to make them aware of the environment they’re working in and of their own home environment," says Julie Seehafer, MSMT, an educator in the human resources development department of Marsh field (WI) Clinic.

The list of items that can create a problem is long, varied, and, in some cases, surprising. There are the easier-to-spot offenders such as rubber gloves, some buckets and pails, many baby bottle nipples and pacifiers, balloons, and rubber bands.

A whole range of toys contains the ingredient, including older-issue collectible Barbie dolls, GI Joes, and other figurines. Newer versions aren’t listed as a hazard, Sater says. "If they’re flexible or have that bend to them, I’d be suspicious," she says.

Elastic in gym clothes, socks, or even disposable diapers can contain latex, although synthetic elastic substitutes also are available. Some forms of chewing gum are suspect. The locking closures on some sandwich bags contain latex, as do the undersides of nonskid throw rugs.

And the most intimate of items, condoms and diaphragms, often contain latex. Latex allergy groups recommend polyurethane condoms as substitutes. Lambskin condoms do not cause the allergy, but the Centers for Disease Control and Prevention in Atlanta does not recommend them for prevention of HIV or other sexually transmitted diseases.

Steps to a latex-proof home

Because of the wide range of products that are possible offenders, Sater says, "first of all, acknowledge that you probably can’t get rid of it completely, so you need to know what products in your house have latex and how you’re going to handle them."

That can mean covering an item when there’s no acceptable substitute for it or vacuuming more often to keep allergens at bay.

She advises that patients with a known severe or increasing sensitivity to latex take the following steps:

1. Prepare for possible accidental exposure. Carry vinyl gloves. This serves two purposes: "First, if I’m ever in an accident, and I have a latex allergy, I want to make sure that whoever handles me or helps me wears this glove instead of the latex version," Sater says. "Second, if I have vinyl gloves, and I’m forced into a situation where I have to remove or move away something with latex, I put them on for my protection."

She says any patient or health professional with a latex allergy should wear a Medic Alert bracelet. And someone with a history of severe or increasing reactions should carry an auto-injector of epinephrine such as an Epi-Pen.

2. Look for alternatives to latex products. In many cases, they’re out there but may be a little harder to find. Latex allergy organizations can steer patients to latex-free substitutes. Among them are: ALERT, (888) 97-ALERT; the Latex Allergy Information Service, (203) 482-6869; and the Spina Bifida Association of America, (800) 621-3141. (For more information and Web site addresses, see Internet Connect, p. 107.)

3. Watch out for cross-reactivity to certain foods. Patients often are diagnosed with a latex allergy in part because they are allergic to foods such as bananas, avocados, or chestnuts. They obviously should stay away from those foods and should be careful of other foods that have shown cross-reactivity in latex-sensitive patients. (See list, p. 116.)

4. Work with outside contacts to minimize exposure. Sater’s work with pediatric spina bifida patients has put her in contact with school nurses to explain the dangers of latex allergy. Students can be kept away from pencil erasers, some glues, latex balloons at parties, and the latex gloves in the nurse’s office.

Eating in a restaurant where workers wear powdered latex gloves can cause a reaction, as can trips to the dentist. "Dentist’s offices are a big challenge for families," Sater says. "They need to educate their dentists that they are at risk and on the precautions that they need when they visit the dentist’s office because [dentists] use a lot of latex products."

Patients should request the first appointment of the day, before dental workers have had an opportunity to snap latex gloves on and off repeatedly, dispersing latex-infused powder into the air. The room should be dusted, if possible, to remove any existing latex dust from the equipment.

"If you truly have a severe allergy, it takes a lot of advanced planning to protect yourself," Sater says.