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  1. Latex (a natural rubber) is produced from the sap of the Brazilian rubber tree (Hevea Brasiliensis).[1] Latex is used in the manufacture of a wide range of everyday products: medical devices including gloves, intravenous tubes and catheters; clothing including elastic and underwear; children’s products including baby bottle nipples and pacifiers; personal care items including condoms and diaphragms; office and school supplies including rubber bands erasers and paint.[1] When a person is sensitive to a specific protein contained in the raw material (sap) of latex an allergic response may occur.[2] Allergic reactions to other latex components and/or other chemicals used in the manufacturing process are also a risk.[1][3] The amount of exposure necessary to cause an allergic reaction is not quantified, but the more frequent the exposure the greater the risk. The severity of the allergic reaction ranges from a skin rash to shock and in rare cases even to death.[4] The Finnish study showed that among all symptoms contact urticaria (a kind of skin rash) had been observed in 75% of latex allergy patients, conjunctivitis (pink eye) in 22%, rhinitis (inflammation inside the nose) in 15%, asthma or dyspnoea in 3% and severe systemic reactions in 8%.[5]   Determining the prevalence of latex sensitivity is difficult, but it is thought that <1% of the general population is reported to be prone to a reaction.[6] This increases to 12% among health professionals and more than 1,700 cases were reported to the FDA between 1988 and 2014.[7] This increase in latex allergies is thought to be a result of the vast increase in the use of latex gloves, which are now universally used by healthcare workers as a precaution against the spread of HIV and hepatitis B.[8] It is also known that the one of the largest sources of latex aeroallergens is in the surgical setting.[9] However there is also widespread use of latex gloves in all areas of the food and care industries. Their use in supermarkets, for example, may bring an indirect food additive by the transfer of latex proteins to the handled food.[10]  The increase in latex sensitivity presents a challenge in the face of increasing latex use, particularly within the healthcare system. The initial step following the appearance of allergic symptoms is to avoid any further contact with latex until a medical evaluation has been completed. Consideration must be given to both patients and staff but elimination of the risk of bloodborne pathogens is still paramount.[9] There is a correlation between the use of high-allergen and powdered gloves, the number of gloves used, the time spent in a latex-containing environment (such as a surgical suite) and aeroallergen levels.[9] To combat latex allergy, a more than 10-fold reduction of aeroallergens can be achieved by changing to non -powdered, low allergen gloves.[9] The provision of non-latex gloves should also be encouraged and utilised. Whilst the likelihood of a completely latex free surgical environment is unlikely, every effort should be made to reduce exposure for both staff and patients.[9] With respect to those who directly handle food, the use of latex gloves should be totally avoided, replacing them with alternative materials with lower incidence of allergy including nitrile, polyvinyl chloride, neoprene.[11] For individuals who suffered from severe latex allergies in the past there is available medical alert identificator designed as wearable bracelet, necklace or keychain. Patients may also utilize prescribed epinephrine self-injection pen in case of severe reaction occurrence.[6] To lower the frequency of unexpected severe cases of latex allergies FDA has also recommended to avoid labelling products as “latex-free” due to the fact that there are no actual tests available for reliable determination of latex rubber. And still the product labeled as “latex-free” doesn’t mean it has no allergen proteins.[12]   The increasing prevalence of latex sensitivity seen today, particularly amongst healthcare workers, cannot be disputed. The solution is to use a safe alternative whenever possible, however latex gloves are still often preferred due to better sensitivity to touch and lower price. Manufacturers should also assist by changing manufacturing methods so that even latex gloves contain minimum levels of allergenic proteins. [1] Cabañes, N., Igea, J., & de la Hoz, B. (2012). Latex Allergy: Position Paper. J Investig Allergol Clin Immunol, 22(5), 313-330. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23101306  [2] Yeang, H., Cheong, K., Sunderasan, E., Hamzah, S., Chewa, N., & Hamidb, S. et al. (1996). The 14.6 kd rubber elongation factor (Hev b 1) and 24 kd (Hev b 3) rubber particle proteins are recognized by IgE from patients with spina bifida and latex allergy. Journal Of Allergy And Clinical Immunology, 98(3), 628-639. http://dx.doi.org/10.1016/s0091-6749(96)70097-0 [3] Guidance for Industry and FDA Reviewers/Staff: Premarket Notification [510(k)] Submissions for Testing for Skin Sensitization To Chemicals In Natural Rubber Products. (1999). Fda.gov. Retrieved 19 October 2017, from https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm073792.htm [4] Warshaw, E. (2003). Latex Allergy. Skinmed, 2(6), 359-367. http://dx.doi.org/10.1111/j.1540-9740.2003.02177.x [5] Turjanmaa, K., Alenius, H., Mäkinen-Kiljunen, S., Reunala, T., & Palosuo, T. (1996). Natural rubber latex allergy. Allergy, 51(9), 593-602. http://dx.doi.org/10.1111/j.1398-9995.1996.tb04678.x [6] Pollart, S., Warniment, C., & Mori, T. (2009). Latex allergy. Am Fam Physician, 80(12), 1413-8. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20000303 [7] Latex Allergy Information. (2017). Health.ny.gov. Retrieved 19 October 2017, from https://www.health.ny.gov/environmental/indoors/food_safety/latex/ [8] Caballero, M., & Quirce, S. (2015). Identification and practical management of latex allergy in occupational settings. Expert Review Of Clinical Immunology, 11(9), 977-992. http://dx.doi.org/10.1586/1744666x.2015.1059754 [9] Elliott, B. (2002). Latex allergy: The perspective from the surgical suite. Journal Of Allergy And Clinical Immunology, 110(2), S117-S120. http://dx.doi.org/10.1067/mai.2002.125594 [10] Beezhold, D., Reschke, J., Allen, J., Kostyal, D., & Sussman, G. (2000). Latex Protein: A Hidden "Food" Allergen?. Allergy And Asthma Proceedings, 21(5), 301-306. http://dx.doi.org/10.2500/108854100778248214 [11] Taylor, J., & Erkek, E. (2004). Latex allergy: diagnosis and management. Dermatologic Therapy, 17(4), 289-301. http://dx.doi.org/10.1111/j.1396-0296.2004.04024.x [12] Don't be Misled by "Latex Free" Claims. (2015). Fda.gov. Retrieved 19 October 2017, from https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm342641.htm