- Q.1 I have had a blood test for allergy and the doctor has told me that I am sensitised to latex, but I don’t have any reaction to rubber products. Why is this and will I react in the future?
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Someone who is sensitized to latex has a positive test for latex (see 'tests for Type I latex allergy'), but does not have any symptoms from contact with natural rubber latex (NRL) products. If symptoms were to occur along with a positive test, then that person would be said to be allergic to latex. (see 'What is latex allergy?')
Sensitized individuals do not yet have allergic symptoms because they are not yet sufficiently sensitized to latex or because they are not exposed to sufficient levels of latex to produce an allergic reaction.
At present, we have limited Information about the natural history of latex allergy, and we do not know what proportion of sensitized individuals without symptoms will progress to allergy. However, people who are sensitized to latex may be at risk of developing allergic reactions in the future if they continue to be regularly exposed to NRL products. It would therefore make sense to limit direct contact with latex products to lessen the chance of this happening to you.
It is particularly important to avoid mucosal exposure in healthcare, as sensitised patients with no prior symptoms of latex allergy may go on to have an anaphylactic reaction when undergoing surgical procedures or even during vaginal or rectal examination. (see 'Is latex allergy serious?')
- Q.2 What is the difference between ‘latex-free’ and ‘latex-safe’?
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‘Latex-free’ is the term used to describe products that are not manufactured from natural rubber latex (NRL).
‘Latex-safe’ is the term used to describe an environment that minimises the risk of a reaction occurring in sensitised or allergic individuals. This is achieved by removing the NRL products that are most likely to cause a reaction.
It is very difficult, and not generally practical or necessary, to create a strict latex-free environment.
- Q.3 How do I find a dentist who can treat me safely?
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Many dentists and their team members have latex allergy themselves, so already practise in an environment that is safe for you. Some others now choose to wear latex free gloves routinely.
Try phoning around and ask if the practice is aware of NRL (latex) allergy, or is used to treating affected patients. Remember that not all dentists accept new NHS patients. If you have difficulty, contact your local Primary Care Trust (Health Board in Scotland) as they are responsible for ensuring provision of NHS dental treatment in their area.
- Q.4 I’ve been a patient for years, but now my dentist refuses to treat me. What should I do?
Not all dentists feel confident that they can properly manage a patient with latex allergy. If you are still registered as a NHS patient (remember that NHS registration only lasts for 15 months since your last check up appointment), your dentist has a duty to refer you elsewhere if s/he feels unable to provide you with appropriate care. In other situations, contact your Primary Care Trust (Health Board in Scotland) as they are responsible for ensuring provision of NHS dental treatment in their area.
- Q.5 Can food that has been touched by latex gloves or by latex in packaging cause allergic reactions?
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Recent research from the UK Food Standards Agency has highlighted the potential for problems with the use of latex gloves for food preparation (1). If latex gloves are used to handle food, the latex proteins may be transferred onto the food. This could be a problem for those who are most highly sensitised to latex because this food then has the potential to cause an allergic reaction.
People who have frequent reactions or who have had previous severe reactions to latex should always ask restaurant and other food outlet staff if they wear latex gloves for food preparation. It is best to avoid places that use latex gloves.
Latex allergens may also be present in some food packaging materials, for instance, the ‘cold seal’ adhesive used for chocolate bars and ice cream wrappers (because ‘heat-seals’ would melt them). It is possible that these may be transferred from the material to the food (2).
Bibliography
- Q.6 What is the best way of finding out whether or not an item I suspect I am reacting to, or may react to, contains latex?
Lists are useful (e.g. latex list on www.lasg.co.uk) but may quickly become outdated as manufacturing processes change all the time. The best way to ascertain whether or not an item (medical or consumer) contains latex is to contact the manufacturer directly. It is important to ask whether or not the item contains natural rubber latex, as synthetic rubbers (e.g. nitrile and neoprene) do not contain the proteins which cause latex allergy and so are safe for those people who have latex allergy.
- Q.7 I have been diagnosed with latex allergy and my employer is unsympathetic. I feel they would rather get rid of me if they could. What should I do?
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Under employment law, employees have a right to fair and reasonable treatment at work. The Disability Discrimination Act (1995) makes it unlawful to discriminate unjustifiably against disabled people. If your latex allergy is a problem at work you should know that your employer has a duty under Health and Safety law to protect your health as far as they reasonably can.
The Health & Safety At Work Act 1974 places a general duty upon employers to keep employees and others (such as patients) healthy & safe at their place of work.
The Control of Substances Hazardous to Health (COSHH) Regulations 2002 asks your employer to undertake an assessment of any substances used at work that are hazardous to health. These include natural rubber latex. (http://www.hse.gov.uk/latex/law.asp)
The employer's duty is to make reasonable accommodation, i.e. an adjustment, to the items you work with or the way that you work.
If you want to continue working, try and work with your employer to create a safe working environment if you can. Generally, a suitable working arrangement can be reached.
However, this is not always possible and you may have to fight for your rights. It is important that you keep a record of every incident. Sometimes it is helpful to call on the assistance of independent third parties to negotiate for you (e.g. Trades Unions) (click here for a list of unions) and sympathetic friends for support.
Very occasionally a case may go to solicitors, and it may be useful to seek advice from solicitors specialising in latex employment litigation. Your union may be able to help or you can contact the Latex Allergy Support Group (www.lasg.co.uk) who can help you find one.
- Q.8 I have been diagnosed with latex allergy and my employer is not sure how to help me. What should they do to help me?
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Your employer can help by providing you with:
- non-latex (synthetic) gloves
- environments that are free from latex dust (e.g. by removing powdered latex gloves from the workplace).
However, since the way in which latex allergy affects daily life varies from person to person, it may be useful to discuss the kind of environment that would be safe for you as an individual with your employer and perhaps even your doctors.
Your employer can contact the local Health and Safety Executive Offices for further advice on health and safety issues.
- Q.9 What benefits may I be entitled to?
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These are some of the benefits that you could be entitled to:
Industrial Injuries Disablement Benefit (IIDB)
If your latex allergy was caused a result of your work, you may be entitled to IIDB. Asthma, rhinitis and anaphylaxis due to latex are now recognised as prescribed diseases, which means they are diseases for which IIDB may be given if it is judged that your disability affects you enough to qualify for a payment. It is paid at different rates depending on how your disability affects you, and is not income-related. For further information visit: http://www.jobcentreplus.gov.uk/cms.asp?Page=/Home/Customers/WorkingAgeBenefits/495
Disability Living Allowance (DLA)
If you have needed help for 3 months because of a severe physical or mental illness or disability, and are you likely to need this for at least another 6 months you may be entitled to Disability Living Allowance. Sensitized individuals who need to be cared for because their allergy is so severe (e.g. it causes them to go into anaphylactic shock) may be able to claim this benefit. It is paid at different rates depending on how your disability affects you and is not income related. More info on http://www.dwp.gov.uk/lifeevent/benefits/disability_liv_allowance.asp#c aniget
NHS Workers Only Injury Benefits Scheme
If you have to take early retirement for health reasons you should not experience too much difficulty obtaining your NHS Early Retirement Pension. You may however feel you are entitled to top it up with the NHS Injury Benefit.
The NHS Injury Benefits Scheme covers all NHS employees and general practitioners, whether or not they are members of the NHS Pension Scheme. There is no qualifying period, everyone is covered from the day they join the NHS. It kicks in if, as a result of an injury, condition or disease caused by NHS employment, you are on sick leave or have your earning ability reduced by 11% or more. For more details see http://www.asu.org.uk/Advisor/advisor/ibs250300.aspl
Incapacity Benefit
You may be entitled to this if you have paid National Insurance contributions and have been incapable of work because of sickness or disability for at least 4 days in a row including weekends and public holidays http://www.jobcentreplus.gov.uk/cms.asp?Page=/Home/Customers/
WorkingAgeBenefits/492
Insurance Claims
Look carefully through any insurance policies you have. Your employer may have corporate insurance cover which applies once you are sick for a period of time, or you may have Mortgage Repayment Insurance and be able to claim if you are off sick. If you lose your job, look for something called Waiver of Premium Cover in any life cover or private pensions you have. It is worth checking all your policies and reading the small (in some cases tiny) print, if you lose your job as a result of latex allergy. You may well have more time on your hands so use it to check these out.
- Q10. Where can I get a latex-free kit of emergency equipment?
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Your local hospital or ambulance service may be able to put one together for you. In addition, your ambulance service and hospital may be able to register your contact details and details of your allergy on a central computer for usein an emergency.
- Q.11 I have been diagnosed with latex allergy and have a red rash from my shoes. Can you tell me where I can get shoes which do not contain latex?
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The best way of doing this is to ask the manufacturers directly.
You need to avoid whatever you are allergic to, i.e. natural rubber latex if you have been diagnosed with Type I latex allergy.
If you have also have been diagnosed with type IV allergy to rubber processing chemicals, which may be present in footwear, you will also need to avoid these. (see 'What is latex allergy?') Your diagnosing doctor will be able to tell you which chemical or chemicals you are allergic to for avoidance purposes.
- Q.12 How can I find latex-free underwear?
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Elastic in underwear may contain latex. Lists are helpful, but you need to contact the manufacturer directly to be sure.
Lycra®, Spandex and Elastane are synthetic polymers and do not themselves contain latex, but this may be added to the finished product. http://www.latexallergylinks.org/lycra.aspl
Be careful: composition labels in garments may exclude elastics and trimmings.
- Q.13 I am having a problem accessing the local shopping centre as their balloon displays cause me to have a reaction to latex. What can I do?
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Write to the centre concerned explaining how the balloons affect your health or restrict your access to their premises, and ask that they consider displaying items that are made from materials which are less hazardous to health than latex (e.g. foil and mylar balloons as an alternative to latex balloons).
Several hospitals have banned latex balloons from their premises in order to protect staff and patients with latex allergy.
http://www.latexallergylinks.org/ball.aspl
- Q.14 My son/daughter has latex allergy. The school seems sympathetic, but is not sure how they can help me. What can I do to help?
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You will need to work with the school to secure a latex-safe environment for your child. The Anaphylaxis Campaign has produced an advisory web site to assist teachers and parents in better managing allergy in schools http://www.allergyinschools.org.uk/
An example of what was done to successfully secure a safe environment for a severely latex allergic child can be found on www.lasg.co.uk (Bryn article)
- Q.15 I need to be vaccinated. Are latex-free vaccines available?
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Your healthcare provider will be able to contact the medical department of the pharmaceutical company concerned to ascertain whether NRL is present in the vaccine or vaccination kit.
If a latex-free presentation of the vaccine that you need does not exist, you and your doctor will need to weigh up the benefits that having the vaccine confers against any risks before deciding whether to have it.
- Q.16 I enjoy sports, but how can I find latex-free sports equipment?
Many items of sports equipment are made from synthetic rubber and it is best to liaise with your gym or sports equipment manufacturers to find suitable latex-free sports equipment that you can safely use.
- Q.17 What should I do about my latex allergy when I go abroad?
The Latex Allergy Support Group has documents written in some European languages that can help explain your allergy abroad. In addition, you can also contact local support organisations, if these exist, for advice. http://www.latexallergylinks.org/supp.aspl
- Q.18 Where can I get latex-free condoms?
Durex manufacturers the Avanti brand of condoms which are polyurethane based and are latex-free (link to www.durex.com)
- Q.19 Our Hospital Trust is reviewing its policy, do you have any information that will help?
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- Q.20 Where can I find a solicitor who specialises in latex litigation?
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Via your union (click here for a list of unions)
The Latex Allergy Support Group have details of solicitors who specialise in latex litigation
- Q.21 My hands become itchy and swell when I wear rubber gloves and I think I might have latex allergy. What should I do?
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In the first instance seek advice from your General Practitioner. If s/he thinks that you may be allergic to latex or rubber chemicals (see 'What is latex allergy?'), you may be referred to a dermatologist or immunologist for further investigation, diagnosis and advice.
In the meantime, stop wearing rubber gloves, and avoid the main dangers for people with latex allergy (see 'How do I prevent – Avoidance')
- Q.22 I have latex allergy and am pregnant. Will I transfer latex allergy to my child?
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IgE (see 'What is latex allergy?') does not cross the placenta, so you will not pass on latex allergy to your child.
What is essential is that you deliver your child in a latex-safe environment – for your safety. You must tell the hospital, obstetrician, midwife, whoever else is involved with your confinement that you are allergic to latex so that they are well-prepared in advance for your delivery. Babies don’t always come when you expect!
- Q.23 I have latex allergy and am worried because I have to go into hospital for an operation. How can I be sure that I won’t be exposed to latex?
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The most important things you can do are to inform the healthcare staff that you are allergic to latex, and to let them know your concerns. Make sure you tell the pre-admission clinic, the ward Charge Nurse, the surgeon and the anaesthetist. The staff will then ensure all your carers are informed of your allergy. You should have a warning bracelet on your wrist along with stickers on your bed and case-notes to serve as an extra reminder.
As long as the staff are aware of your latex allergy, they should have a system in place to deal with this by removing all significant latex risks from your environment.
It is your right to reassure yourself that this is so by asking in advance if the hospital has a Policy for dealing with latex allergy.
- Q.24 My local restaurant uses latex gloves. Are there other gloves that I can ask them to use instead?
The UK Food Standards Agency has never required food handlers to wear latex gloves. If gloves are needed, polythene or vinyl are fine.
- Q.25 Do latex paints contain natural rubber latex?
No, contrary to the impression from the name, "latex paints" do not contain latex proteins. The term "latex" is used loosely here to denote the physical characteristics of these paints.
