Circular Letter # DHCQ-12-97-373 

T0:	Administrators of Licensed Health Care Facilities	
FROM:	Alfred DeMaria, Jr., M.D., Assistant Commissioner, State Epidemiologist
Paul Dreyer, Ph.D., Director, Division of Health Care Quality	
DATE:	December 1997	
RE:	NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace	

The Department of Public Health is issuing this circular letter to alert health care facilities to the increase in allergic reactions to latex produces, especially among healthcare workers. 
Latex rubber has unique properties that make it ideal for barrier protection. The prevention of transmission of infectious agents often requires use of barrier protection. Latex gloves have proved effective in preventing transmission of infectious diseases in health care setting.
Over the past ten years, with increased use of latex gloves and other products, and perhaps related to changes in methods used in the production of latex rubber, allergic and other reactions to latex-associated proteins and chemicals have increased in health care workers and in some groups of patients. These reactions include contact dermatitis, chemical sensitivity dermatitis and immediate hypersensitivity immediate hypersensitivity to latex products can present as itching, rash, hives, respiratory tract irritation., asthma and anaphylaxis. Anaphylactic shock related to latex exposure can be life threatening.
The enclosed alert from the National Institute for Occupational Safety and Health (NIOSH) provides a comprehensive approach to the diagnosis, clinical management and prevention of latex allergy. The Department of Public Health encourages health care facilities to implement the applicable recommendations of NIOSH. Effort especially should be made to decrease the amount of latex in the environment by avoiding the use of latex products in situations where other materials would be effective (e.g., in food service operations, routine housekeeping, and other non-direct patient contact settings). The powder in powdered latex gloves appears to increase dissemination of allergy-causing proteins and sensitization, so every effort should be made to use powder-free gloves.
The department does not have a surveillance system for tracking latex-related allergies. However, the Occupational Health Surveillance Program does conduct surveillance on all types of work-related asthma, including asthma attributable to latex exposure. Work-related asthma, including new onset and work-aggravated, is reportable by law. Enclosed is a brochure on reporting regulations, as well as reporting form. Please feel free to copy this form and distribute it among your staff.
We urge that you share the NIOSH Alert with your department heads and employees.

NIOSH Alert: "Preventing Allergic Reactions to Natural Rubber Latex in the Workplace"