Outcome of Occupational Latex Allergy—Work Ability and Quality of Life

OBJECTIVE: The quality of life (QOL) and work ability of health care workers allergic to natural rubber latex (NRL) were assessed after implementation of regulations on powder-free NRL gloves in Germany. METHODS: 196 HCW with reported NRL allergy answered a questionnaire (response rate 58%) containing the Work Ability Index (WAI), Mini Asthma Quality of Life Questionnaire (MiniAQLQ), and Dermatology Life Quality Index (DLQI). RESULTS: 63.2% still had NRL-related symptoms during the last 6 month. However on a scale from 0 to 10, the intensity of NRL-related symptoms decreased from 8.5 before to 2.3 after implementation of regulations on powder-free NRL gloves. A higher number of subjects were able to avoid NRL in the private than in the work environment (85% vs. 61%). NRL-related symptoms decreased and WAI increased with successful avoidance of NRL at workplace (b = 0.23, p = 0.003). QOL was only little affected by NRL allergy (mean: MiniAQLQ = 6.0; DLQI = 4.1). CONCLUSIONS: Although there was improvement after implementation of powder-free NRL gloves, there is still a considerable number of HCW with NRL-related symptoms. Further investigations on latex avoidance and the cause of persisiting allergic symptoms in HCW with NRL allergy are therefore needed

Randomized, double-blind, placebo-controled clinical trial of sublingual immunotherapy in natural rubber latex allergic patients

<p>Abstract</p> <p>Background</p> <p>Natural rubber latex allergy is a common and unsolved health problem. Since the avoidance of exposure is very difficult, immunotherapy is strongly recommended, but before its use in patients, it is essential to prove the efficacy and safety of extracts.</p> <p>The aim of the present randomised, double-blind, placebo-controlled clinical trial was to assess the efficacy and tolerability of latex sublingual immunotherapy in adult patients undergoing permanent latex avoidance.</p> <p>Methods</p> <p>Twenty-eight adult latex-allergic patients (5 males and 23 females), with mean age of 39 years (range 24-57) were randomized to receive a commercial latex-sublingual immunotherapy or placebo during one year, followed by another year of open, active therapy. The following outcomes were measured at baseline and at the end of first and second year of follow-up: skin prick test, gloves-use score, conjunctival challenge test, total and specific IgE, basophil activation test, and adverse reactions monitoring.</p> <p>Results</p> <p>No significant difference in any of the efficacy <it>in vivo </it>variables was observed between active and placebo groups at the end of the placebo-controlled phase, nor when each group was compared with their baseline values at the end of the two year-study. An improvement in the average percentage of basophils activated was observed. During the induction phase, 4 reactions in the active group and 5 in the placebo group were recorded. During the maintenance phase, two patients dropped out due to pruritus and to acute dermatitis respectively.</p> <p>Conclusion</p> <p>Further studies are needed to evaluate latex-sublingual immunotherapy, since efficacy could not be demonstrated in adult patients with avoidance of the allergen.</p> <p>Trial registration number</p> <p><a href="http://www.anzctr.org.au/ACTRN12611000543987.aspx">ACTRN12611000543987</a></p

EAACI position paper on occupational rhinitis

The present document is the result of a consensus reached by a panel of experts from European and non-European countries on Occupational Rhinitis (OR), a disease of emerging relevance which has received little attention in comparison to occupational asthma. The document covers the main items of OR including epidemiology, diagnosis, management, socio-economic impact, preventive strategies and medicolegal issues. An operational definition and classification of OR tailored on that of occupational asthma, as well as a diagnostic algorithm based on steps allowing for different levels of diagnostic evidence are proposed. The needs for future research are pointed out. Key messages are issued for each item

Zirkadiane Rhythmik bei der Simulation des D-2-Weltraumfluges

Acht Versuchspersonen waren ber einen Zeitraum von 26 Tagen von der Aussenwelt isoliert. Waehrend dieser Zeit wurden zwei Zeitverschiebungen durchgefuehrt und eine Woche lang durch eine Kopftieflage von 6 Grad Schwerelosigkeit simuliert. Die Versuchsergebnisse zeigen, dass diese Methode der graduellen Zeitverschiebung um eine Stunde pro Tag ueber einen Zeitraum von einerWoche durchaus ein geeignetes Verfahren ist, um bei einigen der Koerperfunktionen, wie Herzfrequenz und Natriumausscheigung, eine Verschiebung der zirkadianen Rhythmik nach Osten von sieben Stunden zu bewirken. Bei anderen Werten, wie Temperatur und 6-Hydroxymelatoninsulfat-Ausscheidung, ist die Anpassung an den Erwartungswert erst waehrend der Schwerelosigkeitssimulation erfolgt.Daraus folgt, dass die von uns angewandte Methode nicht zu einer optimalen Anpassung aller Koerperfunktionen an die angestrebte Schichtarbeitszeit zum Termin des Startes eines Raumfluges fuehrt

Relevance of latex aeroallergen for healthcare workers

The dispersion of latex allergen bound on glove powder has been shown to be of clinical importance to latex-sensitized medical staff and patients. To investigate whether latex aeroallergen is associated with the development of latex allergic reactions in health care workers, air samples were collected in 33 hospital rooms and two physicians' offices. Concentrations of latex allergens in the samples were determined by a competitive inhibition immunoassay and related to reported hypersensitivity reactions and to specific IgE results of 111 staff members engaged in these rooms. Latex aeroallergen (up to 205 ng/m3) could be detected in all rooms where powdered latex gloves were used and ventilation systems were not installed. Conjunctivitis (n=10), rhinitis (n=12) and dyspnea (n=4) were reported exclusively by employees working in such contaminated rooms. Also workers with latex-specific IgE antibodies (n=l 7) were found only in these rooms. Urticaria in personnel (n=26) was reported in rooms with and without detectable allergen load. All symptoms were significantly associated with latex-specific IgE antibodies. Our results demonstrate that immediate-type sensitization and allergic symptoms are associated with detectable latex aeroallergen