Editing Latex allergy

{{Infobox medical condition (new)
| name            = Latex allergy
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| caption         = Latex [[medical glove]]
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| field           = [[Immunology]]
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'''Latex allergy''' is a medical term encompassing a range of [[allergic]] reactions to the [[protein]]s present in [[natural rubber]] latex.<ref>{{cite web|url=https://www.osha.gov/SLTC/latexallergy/ |title=Safety and Health Topics &#124; Latex Allergy |publisher=Osha.gov |access-date=2014-07-31}}</ref>  It generally develops after repeated exposure to products containing natural rubber latex. When latex-containing medical devices or supplies come in contact with [[mucous membrane]]s, the membranes may absorb latex [[protein]]s. In some susceptible people, the immune system produces [[Antibody|antibodies]] that react [[Immune response|immunologically]] with these [[antigen]]ic proteins.<ref>{{cite web |url=http://www.ada.org/en/member-center/oral-health-topics/allergy-to-latex-rubber |title=Allergy to Latex Rubber |publisher=American Dental Association}}</ref>  Many items contain or are made from natural rubber, including [[shoe sole]]s, pen grips, [[hot water bottle]]s, [[elastic bands]], [[rubber gloves]], [[condoms]], [[Baby bottle#Teats (or nipples)|baby-bottle nipples]], and [[balloons]]; consequently, there are many possible routes of exposure that may [[Allergic response|trigger a reaction]]. People with latex allergies may also have or develop allergic reactions to some fruits, such as bananas.<ref>{{cite journal |last1=Taylor |first1=J.S. |last2=Erkek |first2=E. |date=2004 |title=Latex allergy: diagnosis and management |journal=Dermatologic Therapy |volume=17 |issue=4 |pages=289–301 |pmid=15327474 |doi=10.1111/j.1396-0296.2004.04024.x |s2cid=24748498 |name-list-style=amp|doi-access=free }}</ref>

== Signs and symptoms ==
Allergic reactions to latex range from [[Type I hypersensitivity]], the most serious form of reaction, to [[Type IV hypersensitivity]].<ref>{{cite journal |last1=Sussman |first1=Gordon L. |last2=Tarlo |first2=Susan |last3=Dolovich |first3=Jerry |title=The Spectrum of IgE-Mediated Responses to Latex |url=https://jamanetwork.com/journals/jama/article-abstract/386099 |journal=JAMA: The Journal of the American Medical Association |date=June 5, 1991 |volume=265 |issue=21 |pages=2844–2847 |doi=10.1001/jama.1991.03460210090035 |pmid=2033741 |access-date=December 29, 2021|url-access=subscription }}</ref> Rate of onset is [[Proportionality (mathematics)|directly proportional]] to the degree of allergy: Type I responses will begin showing symptoms within minutes of exposure to latex, while Type IV responses may take hours or days to appear.<ref>{{cite journal |last1=Hamilton |first1=Robert G. |title=Diagnosis of natural rubber latex allergy |url=https://www.sciencedirect.com/science/article/pii/S1046202302000488 |journal=Methods |date=May 2002 |volume=27 |issue=1 |pages=22–31 |doi=10.1016/S1046-2023(02)00048-8 |pmid=12079414 |access-date=December 29, 2021|url-access=subscription }}</ref>

Most commonly, latex allergy presents with [[hives]] at the point of contact, followed by [[rhinitis]]. The most common physiological reaction to latex exposure is [[dermatitis]] at the point of contact, which gives way to soreness, itching, and redness. [[Angioedema]] is also a common response to oral, vaginal, or rectal contact.<ref>{{cite journal |last1=Turjanmaa |first1=K. |last2=Alenius |first2=H. |last3=Mäkinen-Kiljunen |first3=S. |last4=Reunala |first4=T. |last5=Palosuo |title=Natural rubber latex allergy |journal=Allergy |year=1996 |volume=51 |issue=9 |pages=593–602 |doi=10.1111/j.1398-9995.1996.tb04678.x |pmid=8899110 |s2cid=9316811 |issn=0105-4538 |doi-access=free }}</ref>

Symptoms of more severe hypersensitivity include both local and generalized hives; feelings of faintness or impending doom; [[angioedema]]; nausea and vomiting; abdominal cramps; rhinitis; [[bronchospasm]]; and [[anaphylaxis]]. Type IV responses typically include [[erythema]], blistering (forming [[Vesicle (dermatology)|vesicles]] and [[papule]]s), [[Pruritis|itching]], and [[Crust (dermatology)|crusting]] at the point of contact.<ref>{{cite journal |last1=Reddy |first1=Sumana |title=Latex Allergy |url=https://www.aafp.org/afp/1998/0101/p93.html |journal=American Family Physician |date=January 1, 1998 |volume=57 |issue=1 |pages=93–100 |pmid=9447217 |access-date=December 29, 2021}}</ref> This irritant contact dermatitis is considered a nonimmune reaction to latex.<ref>{{cite journal|last1=Hepner|first1=David L.|last2=Castells|first2=Mariana C.|date=April 2003|title=Latex Allergy: An Update|journal=Anesthesia & Analgesia|volume=96|issue=4|pages=1219–1229|doi=10.1213/01.ANE.0000050768.04953.16|pmid=12651689|s2cid=2753609|doi-access=free}}</ref> The degree of reaction is directly proportional to the duration of exposure, as well as skin temperature.

Among those with a latex allergy, 40% will experience irritant contact dermatitis; 33.1% will experience a Type I allergic reaction; 20.4% will experience Type IV allergic contact dermatitis; and 6.5% will experience both Type I and Type IV symptoms.<ref>{{cite journal|last1=Heese|first1=A.|last2=Peters|first2=K. P.|last3=Koch|first3=H. U.|date=January 1, 1997|title=Type I allergies to latex and the aeroallergenic problem|url=https://europepmc.org/article/med/9195178|journal=The European Journal of Surgery Supplement|volume=579|issue=579|pages=19–22|pmid=9195178|access-date=December 29, 2021}}</ref>

== Causes ==

=== Occupational exposure ===
[[File:Hickman line catheter with 2 lumens.jpg|thumb|Central line with latex cap]]
The prevalence of latex allergy is greater in certain populations with increased exposure and has historically been studied in this context. <ref name=":0">{{Cite journal |last1=Nucera |first1=Eleonora |last2=Aruanno |first2=Arianna |last3=Rizzi |first3=Angela |last4=Centrone |first4=Michele |date=2020-09-28 |title=Latex Allergy: Current Status and Future Perspectives |journal=Journal of Asthma and Allergy |volume=13 |pages=385–398 |doi=10.2147/JAA.S242058 |doi-access=free |issn=1178-6965 |pmc=7532063 |pmid=33061465}}</ref> Specifically, regular and prolonged occupational exposure to latex is a known risk factor for the development of an allergy. <ref name=":15">{{Cite journal |last1=Parisi |first1=Claudio A.S. |last2=Kelly |first2=Kevin J. |last3=Ansotegui |first3=Ignacio J. |last4=Gonzalez-Díaz |first4=Sandra Nora |last5=Bilò |first5=Maria Beatrice |last6=Cardona |first6=Victoria |last7=Park |first7=Hae-Sim |last8=Braschi |first8=Maria Chiara |last9=Macias-Weinmann |first9=Alejandra |last10=Piga |first10=Mario A. |last11=Acuña-Ortega |first11=Natalhie |last12=Sánchez-Borges |first12=Mario |last13=Yañez |first13=Anahí |date=2021-07-28 |title=Update on latex allergy: New insights into an old problem |journal=The World Allergy Organization Journal |volume=14 |issue=8 |pages=100569 |doi=10.1016/j.waojou.2021.100569 |issn=1939-4551 |pmc=8335653 |pmid=34386153}}</ref> Healthcare workers, dental specialists, food service workers, cosmetologists, rubber industry workers, law enforcement personnel, and painters are among some of the highest-risk occupations.<ref name=":15" /> It is estimated that the worldwide prevalence of latex allergy in healthcare workers is 9.7%-12.4%.<ref name=":0" />

Latex allergy became a more common problem in healthcare in the 1980s and 1990s with the adoption of [[universal precautions]], which involved frequent use of latex gloves, with the emergence of [[HIV/AIDS|HIV/AIDs]].<ref name=":0" /> The rates of latex allergy dropped to 4-7% in the healthcare setting with the widespread introduction of non-powdered latex gloves.<ref name=":24">{{Cite web |title=Latex allergy: Epidemiology, clinical manifestations, and diagnosis |url=https://medilib.ir/uptodate/show/5543#rid43 |access-date=2024-02-15 |website=medilib.ir}}</ref> On December 19, 2016, the [[Food and Drug Administration|FDA]] officially banned the use of powdered gloves in the US healthcare setting, citing the unnecessary burden of potential injury due to allergy. <ref>{{Cite journal |last=Health |first=Center for Devices and Radiological |date=2023-05-01 |title=Medical Gloves |url=https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/medical-gloves |archive-url=https://web.archive.org/web/20190929031202/https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/medical-gloves |url-status=dead |archive-date=September 29, 2019 |journal=FDA |language=en}}</ref> General latex avoidance protocols have been put in to place in healthcare settings in the US and many other developed countries with the switch to [[Nitrile rubber|nitrile gloves]].<ref name=":15" /><ref name=":24" /> However, latex exposure in healthcare settings in developing countries from latex gloves or latex components of medical devices such as urinary catheters, dialysis ports, or vial stoppers, remains a significant concern.<ref name=":15" /><ref name=":24" />

=== Alternative latex exposure ===
While most reported allergic reactions to latex have occurred in medical settings, non-healthcare workers show similar levels of latex antibodies, suggesting that they are sensitized to natural rubber latex through other sources, both inside the home and as medical patients.<ref>{{cite journal |last1=Condemi |first1=John J. |title=Allergic reactions to natural rubber latex at home, to rubber products, and to cross-reacting foods |url=https://www.sciencedirect.com/science/article/pii/S0091674902001112 |journal=Journal of Allergy and Clinical Immunology |date=August 2002 |volume=110 |issue=2 |pages=107–110 |pmid=12170250 |doi=10.1067/mai.2002.124968 |access-date=December 29, 2021}}</ref> In particular, individuals with chronic health concerns that lead to repeated surgeries or [[catheter]]izations thus experience greater exposure to latex allergens and may develop an allergy.<ref>{{cite journal |last1=Kumar |first1=R. Pradeep |title=Latex Allergy in Clinical Practice |journal=Indian Journal of Dermatology |date=January 2012 |volume=57 |issue=1 |pages=66–70 |pmid=22470217 |doi=10.4103/0019-5154.92686 |pmc=3312665 |doi-access=free }}</ref> Outside of hospital environments, latex allergy may develop in amateur and professional athletes whose sports equipment includes natural rubber, such as swimsuits or running shoes. Rubber [[Basketball (ball)|basketballs]], in particular, may lead to contact dermatitis on the hands and fingertips.<ref>{{cite journal |last1=Kockentiet |first1=Brett |last2=Adams |first2=Brian B. |title=Contact dermatitis in athletes |url=https://www.sciencedirect.com/science/article/pii/S0190962207000175 |journal=Journal of the American Academy of Dermatology |date=June 2007 |volume=56 |issue=6 |pages=1048–1055 |pmid=17307275 |doi=10.1016/j.jaad.2006.12.025 |access-date=December 29, 2021|url-access=subscription }}</ref> The sensitization to latex in athletes may be accelerated by the use of topical [[analgesic]]s and other agents that diminish the skin barrier and increase contact.<ref>{{cite journal |last1=Ventura |first1=M. T. |last2=Dagnello |first2=M. |last3=Matino |first3=M. G. |last4=Di Corato |first4=R. |last5=Giuliano |first5=G. |last6=Tursi |first6=A. |title=Contact dermatitis in students practicing sports: incidence of rubber sensitisation |url=https://bjsm.bmj.com/content/35/2/100 |journal=British Journal of Sports Medicine |date=April 2001 |volume=35 |issue=2 |pages=100–102 |pmid=11273970 |doi=10.1136/bjsm.35.2.100 |pmc=1724305 |access-date=December 29, 2021}}</ref> It has also been hypothesized that young children may develop a latex allergy due to exposure in the home and school environment from objects such as rubber balloons, boots, gloves, and toys.<ref>{{cite journal |last1=Ylitalo |first1=L. |last2=Alenius |first2=H. |last3=Turjanmaa |first3=K. |last4=Palosuo |first4=T. |last5=Reunala |first5=T. |title=Natural rubber latex allergy in children: a follow-up study |url=https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2222.2000.00924.x |journal=Clinical and Experimental Allergy |date=November 2000 |volume=30 |issue=11 |pages=1611–1617 |pmid=11069571 |doi=10.1046/j.1365-2222.2000.00924.x |s2cid=32522055 |access-date=December 29, 2021|url-access=subscription }}</ref><ref>{{cite journal |last1=Sorva |first1=R. |last2=Mäkinen-Kiljunen |first2=S. |last3=Suvilehto |first3=K. |last4=Juntunen-Backman |first4=K. |last5=Haahtela |first5=T. |title=Latex allergy in children with no known risk factor for latex sensitization |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.1995.tb00255.x |journal=Pediatric Allergy and Immunology |date=February 1995 |volume=6 |issue=1 |pages=36–38 |pmid=7550763 |doi=10.1111/j.1399-3038.1995.tb00255.x |s2cid=20620438 |access-date=December 29, 2021|url-access=subscription }}</ref>

=== Spina bifida ===
People with [[spina bifida]] often have latex allergies. Up to 68% of children with this condition will have a reaction to latex.<ref name="sd08">{{cite web|url=http://www.ivanhoe.com/science/story/2008/12/511a.html |title=Protect Yourself from Latex Allergies |publisher=Ivanhoe Broadcast News |date=December 2008 |access-date=June 12, 2015 |url-status=dead |archive-url=https://web.archive.org/web/20150709020701/http://www.ivanhoe.com/science/story/2008/12/511a.html |archive-date=July 9, 2015 }}</ref>  The mechanism of this association between spina bifida and latex allergy is not clearly defined. However, spina bifida patients may become sensitized to latex early in life as they often require frequent surgeries and medical procedures that involve exposure to latex products.  <ref>{{Cite web |title=Latex Allergy |url=http://sbanys.org/secondary-conditions/latex-allergy/ |access-date=2024-02-07 |website=Spina Bifida Association of New York State |language=en}}</ref> The most important latex allergens which senstize spina bifida patients are: Hev b 1, Her b 3 and Hev b 6.01.<ref name=":1">{{Cite journal |last1=Gromek |first1=Weronika |last2=Kołdej |first2=Natalia |last3=Świtała |first3=Szymon |last4=Majsiak |first4=Emilia |last5=Kurowski |first5=Marcin |date=2024-07-19 |title=Revisiting Latex-Fruit Syndrome after 30 Years of Research: A Comprehensive Literature Review and Description of Two Cases |journal=Journal of Clinical Medicine |language=en |volume=13 |issue=14 |pages=4222 |doi=10.3390/jcm13144222 |doi-access=free |issn=2077-0383 |pmc=11278189 |pmid=39064262}}</ref>

=== Latex-fruit syndrome ===
People who have latex allergy also may have or develop an allergic response to some plants and/or products of these plants (such as fruits). This is known as ''latex-fruit syndrome (LFS)''.<ref name="pmid9188921">{{cite journal |last1=Brehler |first1=R. |last2=Theissen |first2=U. |last3=Mohr |first3=C. |last4=Luger |first4=T. |title='Latex-fruit syndrome': frequency of cross-reacting IgE antibodies |journal=Allergy |volume=52 |issue=4 |year=1997 |pages=404–10 |doi=10.1111/j.1398-9995.1997.tb01019.x |pmid=9188921 |s2cid=27995880 }}</ref> This syndrome was described for the first time by Bianco et. al in 1994. Recent review by Gromek published in 2024, have summarised the last 30 years of research on LFS and analyzed 14 original studies.The analysis of original studies demonstrated a significant variability in the prevalence of latex-fruit syndrome (LFS), ranging from 4% to 88%. This variation was attributed to the use of diverse diagnostic tools, differences in geographical regions, and the size of study populations. The most commonly reported allergenic fruits among patients with LFS were [[banana]], [[avocado]],  [[kiwifruit]], and  [[papaya]].<ref name=":1" />  

The primary latex allergens implicated in latex-fruit syndrome (LFS) include Hev b 2, Hev b 6.02, Hev b 7, Hev b 8, and Hev b 12. Genetic studies have suggested an association between LFS and specific human leukocyte antigen (HLA) types, particularly HLA-DQB1*0201, DRB1*0301, DRB1*0901, and the HLA-DR functional group E.<ref>{{Cite journal |last1=Gromek |first1=Weronika |last2=Kołdej |first2=Natalia |last3=Świtała |first3=Szymon |last4=Majsiak |first4=Emilia |last5=Kurowski |first5=Marcin |date=2024-07-19 |title=Revisiting Latex-Fruit Syndrome after 30 Years of Research: A Comprehensive Literature Review and Description of Two Cases |journal=Journal of Clinical Medicine |language=en |volume=13 |issue=14 |pages=4222 |doi=10.3390/jcm13144222 |doi-access=free |issn=2077-0383 |pmc=11278189 |pmid=39064262}}</ref>

==== Pathomechanism ====
One group of allergens that may contribute to the cross-reactivity between latex and certain fruits is [[Chitinase|chitinases]]. These enzymes catalyze the breakdown of β-1,4-N-acetyl-D-glucosamine bonds in [[chitin]], a polymer widely found in nature. Chitinases are produced by various organisms, including bacteria, fungi, insects, plants, and vertebrates. Class I chitinases identified in fruits such as [[Banana|bananas]] (Mus a 2) and [[Avocado|avocados]] (Pers a 1) have been shown to cross-react with class I chitinases in latex, specifically Hev b 6.01 (Prohevein) and Hev b 6.02 (Hevein). Chitinases have also been found in other fruits, including [[chestnut]] (class I), [[tomato]] (class II), I[[Ziziphus mauritiana|ndian jujube]] (class III), [[raspberry]] (class III), and [[grape]] (class IV). However, in the case of [[Kiwifruit|kiwi]] and [[papaya]], no specific allergens with chitinase activity have been identified to date. Other latex allergens involved in cross-reactivity with fruits may include [[Profilin|profilins]], [[Glucanase|glucanases]], and non-specific lipid transfer proteins (nsLTPs). 

Natural rubber latex contains several conformational [[epitope]]s located on several [[enzyme]]s such as ''Hev b 1'',<ref>{{cite journal |last1=Chen |first1=Zhiping |last2=Cremer |first2=Reinhold |last3=Posch |first3=Anton |last4=Raulf-Heimsoth |first4=Monika |last5=Rihs |first5=Hans-Peter |last6=Baur |first6=Xaver |title=On the allergenicity of Hev b 1 among health care workers and patients with spina bifida allergic to natural rubber latex |journal=Journal of Allergy and Clinical Immunology |volume=100 |issue=5 |year=1997|pages=684–93 |doi=10.1016/S0091-6749(97)70174-X |pmid=9389300 |doi-access=free }}</ref> ''Hev b 2'',<ref>{{cite journal |last1=Barre |first1=Annick |last2=Culerrier |first2=Raphaël |last3=Granier |first3=Claude |last4=Selman |first4=Laetitia |last5=Peumans |first5=Willy J. |last6=Van Damme |first6=Els J.M. |last7=Bienvenu |first7=Françoise |last8=Bienvenu |first8=Jacques |last9=Rougé |first9=Pierre |title=Mapping of IgE-binding epitopes on the major latex allergen Hev b 2 and the cross-reacting 1,3β-glucanase fruit allergens as a molecular basis for the latex-fruit syndrome |journal=Molecular Immunology |volume=46 |issue=8–9 |year=2009 |pages=1595–604 |doi=10.1016/j.molimm.2008.12.007 |pmid=19185347 |url=https://biblio.ugent.be/publication/666245/file/699979 |url-access=subscription }}</ref> ''Hev b 4'',<ref>{{cite journal |last1=Kolarich |first1=Daniel |last2=Altmann |first2=Friedrich |last3=Sunderasan |first3=Elumalai |title=Structural analysis of the glycoprotein allergen Hev b 4 from natural rubber latex by mass spectrometry |journal=Biochimica et Biophysica Acta (BBA) - General Subjects |volume=1760 |issue=4 |year=2006 |pages=715–20 |doi=10.1016/j.bbagen.2005.11.012 |pmid=16403599 }}</ref> ''Hev b 5''<ref>{{cite journal |last1=Beezhold |first1=Donald H. |last2=Hickey |first2=Vicky L. |last3=Slater |first3=Jay E. |last4=Sussman |first4=Gordon L. |title=Human IgE-binding epitopes of the latex allergen Hev b 5 |journal=Journal of Allergy and Clinical Immunology |volume=103 |issue=6 |year=1999 |pages=1166–72 |doi=10.1016/S0091-6749(99)70194-6 |pmid=10359901 }}</ref> and ''Hev b 6.02''.<ref>{{cite journal |last1=Reyes-López |first1=César A |last2=Hernández-Santoyo |first2=Alejandra |last3=Pedraza-Escalona |first3=Martha |last4=Mendoza |first4=Guillermo |last5=Hernández-Arana |first5=Andrés |last6=Rodrı́guez-Romero |first6=Adela |title=Insights into a conformational epitope of Hev b 6.02 (hevein) |journal=Biochemical and Biophysical Research Communications |volume=314 |issue=1 |year=2004 |pages=123–30 |doi=10.1016/j.bbrc.2003.12.068 |pmid=14715255 }}</ref><ref>{{cite journal |last1=Pedraza-Escalona |first1=Martha |last2=Becerril-Luján |first2=Baltazar |last3=Agundis |first3=Concepción |last4=Domínguez-Ramírez |first4=Lenin |last5=Pereyra |first5=Ali |last6=Riaño-Umbarila |first6=Lidia |last7=Rodríguez-Romero |first7=Adela |title=Analysis of B-cell epitopes from the allergen Hev b 6.02 revealed by using blocking antibodies |journal=Molecular Immunology |volume=46 |issue=4 |year=2009 |pages=668–76 |doi=10.1016/j.molimm.2008.08.282 |pmid=18930549 }}</ref>

Evaluation of hypersensitivity symptoms revealed that systemic allergic reactions accounted for 73% of reported cases, while only 27% presented with localized allergic manifestations. 

[[FITkit]] is a latex allergen testing method for quantification of the major natural rubber latex specific [[allergen]]s: Hev b 1, Hev b 3, Hev b 5, and Hev b 6.02.<ref name="Koh">{{cite journal |last1=Koh |first1=D. |last2=Ng |first2=V. |last3=Leow |first3=Y-H. |last4=Goh |first4=C.L. |title=A study of natural rubber latex allergens in gloves used by healthcare workers in Singapore |journal=British Journal of Dermatology |volume=153 |issue=5 |year=2005 |pages=954–9 |doi=10.1111/j.1365-2133.2005.06820.x |pmid=16225605 |s2cid=32823071 |doi-access=free }}</ref>

==Prevention==
The most effective form of [[primary prevention]] towards latex [[Sensitization (immunology)|sensitization]] is limiting or completely avoiding contact with latex, particularly among children with risk factors such as spina bifida.<ref>{{cite journal |last=Niggemann |first=Bodo |title=IgE-mediated latex allergy{{snd}}An exciting and instructive piece of allergy history |url=https://onlinelibrary.wiley.com/doi/full/10.1111/j.1399-3038.2010.01006.x |journal=Pediatric Allergy and Immunology |date=October 26, 2010 |volume=21 |issue=7 |pages=997–1001 |pmid=20977498 |doi=10.1111/j.1399-3038.2010.01006.x |s2cid=8236367 |access-date=December 30, 2021|url-access=subscription }}</ref><ref>{{cite journal |last1=Nieto |first1=Antonio |last2=Mazón |first2=Angel |last3=Pamies |first3=Rafael |last4=Lanuza |first4=Amparo |last5=Muñoz |first5=Alberto |last6=Estornell |first6=Francisco |last7=García-Ibarra |first7=Fernando |title=Efficacy of latex avoidance for primary prevention of latex sensitization in children with spina bifida |url=https://www.jpeds.com/article/S0022-3476(02)52610-X/pdf |journal=The Journal of Pediatrics |date=March 1, 2002 |volume=140 |issue=3 |pages=370–372 |pmid=11953738 |doi=10.1067/mpd.2002.122732 |s2cid=11967651 |access-date=December 30, 2021|url-access=subscription }}</ref> The limitation of powdered latex glove use in hospital settings has also proven an effective [[Preventive healthcare|primary prevention]] strategy among adult health care workers,<ref>{{cite journal |last1=Allmers |first1=Henning |last2=Schmengler |first2=Jörg |last3=Skudlik |first3=Christoph |title=Primary prevention of natural rubber latex allergy in the German health care system through education and intervention |journal=Journal of Allergy and Clinical Immunology |date=August 2002 |volume=110 |issue=2 |pages=318–323 |pmid=12170275 |doi=10.1067/mai.2002.126461 |doi-access=free }}</ref> and as secondary prevention for sensitized individuals.<ref>{{cite journal |last1=Allmers |first1=Henning |last2=Brehler |first2=Randolph |last3=Chen |first3=Zhipping |last4=Raulf-Heimsoth |first4=Monika |last5=Fels |first5=Hubert |last6=Bauer |first6=Xaver |title=Reduction of latex aeroallergens and latex-specific IgE antibodies in sensitized workers after removal of powdered natural rubber latex gloves in a hospital |url=https://www.sciencedirect.com/science/article/pii/S0091674998700260 |journal=  The Journal of Allergy and Clinical Immunology|date=November 1998 |volume=102 |issue=5 |pages=841–846 |pmid=9819303 |doi=10.1016/s0091-6749(98)70026-0 |access-date=December 30, 2021|url-access=subscription }}</ref><ref>{{cite journal |last1=Ruëff |first1=F. |last2=Thomas |first2=P. |last3=Reißig |first3=G. |last4=Przybilla |first4=B. |title=Natural rubber-latex allergy in patients not intensely exposed |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1398-9995.1998.tb03921.x |journal=European Journal of Allergy and Clinical Immunology |date=April 1998 |volume=53 |issue=4 |pages=445–449 |pmid=9574891 |doi=10.1111/j.1398-9995.1998.tb03921.x |s2cid=27245106 |access-date=December 30, 2021|url-access=subscription }}</ref>

==Epidemiology==
Latex allergy is uncommon in the general population, at least compared to high-risk groups such as hospital workers and spina bifida patients. Estimates suggest a worldwide [[prevalence]] of around 4.3% among the general population.<ref>{{cite journal |last1=Wu |first1=Miaozong |last2=McIntosh |first2=James |last3=Liu |first3=Jian |title=Current prevalence rate of latex allergy: Why it remains a problem? |journal=Journal of Occupational Health |date=March 20, 2016 |volume=58 |issue=2 |pages=138–144 |pmid=27010091 |doi=10.1539/joh.15-0275-RA |pmc=5356959 }}</ref> Between 1% and 6% of the general population in the United States has latex allergy; assays of antibody levels in the blood suggest that 2.7 million to 16 million Americans are affected by some form of latex sensitivity.<ref>{{cite journal |last1=Neugut |first1=Alfred I. |last2=Ghatak |first2=Anita T. |last3=Miller |first3=Rachel L. |title=Anaphylaxis in the United States: An Investigation Into Its Epidemiology |journal=Archives of Internal Medicine |date=January 8, 2001 |volume=161 |issue=1 |pages=15–21 |doi=10.1001/archinte.161.1.15 |pmid=11146694 |doi-access=free }}</ref> Females are approximately three times as likely as males to have latex allergies.<ref>{{cite journal |last1=Tomazic |first1=Vesna J. |last2=Withrow |first2=Thomas J. |last3=Fisher |first3=Benjamin R. |last4=Dillard |first4=Sharon F. |title=Latex-associated allergies and anaphylactic reactions |url=https://dx.doi.org/10.1016/0090-1229%2892%2990185-Q |journal=Clinical Immunology and Immunopathology |date=August 1992 |volume=64 |issue=2 |pages=89–97 |pmid=1643748 |doi=10.1016/0090-1229(92)90185-Q |access-date=December 29, 2021|url-access=subscription }}</ref> Possible [[risk factor]]s for the female population include increased employment in high-risk occupations and enhanced [[histamine]] release caused by [[Sex hormone|female hormones]].<ref name="warshaw">{{cite journal |last1=Warshaw |first1=Erin M. |title=Latex allergy |url=https://www.sciencedirect.com/science/article/pii/S0190962298703974 |journal=Journal of the American Academy of Dermatology |date=July 1998 |volume=39 |issue=1 |pages=1–24 |doi=10.1016/S0190-9622(98)70397-4 |pmid=9674393 |access-date=December 29, 2021|url-access=subscription }}</ref>

==Alternatives==
Alternatives to latex include:
*[[Synthetic rubber]]s (such as [[elastane]], [[neoprene]], [[nitrile]]) and artificially synthesized [[polyisoprene]] latex, which do not contain the proteins from the ''Hevea brasiliensis'' tree.<ref>{{cite web |url=http://std.about.com/od/condoms101/f/polyisolatexallergy.htm |title=Why do polyisoprene condoms work as latex allergy condom choices? |publisher=Std.about.com |access-date=2014-07-31 |archive-date=2016-01-07 |archive-url=https://web.archive.org/web/20160107221858/http://std.about.com/od/condoms101/f/polyisolatexallergy.htm |url-status=dead }}</ref>
*Products made from [[guayule]] natural rubber emulsions, which also do not contain the proteins from the ''[[Hevea]]'' rubber tree, and do not cause allergy in persons sensitized to ''Hevea'' proteins.<ref name="sd08" /><ref>{{cite book|url=https://books.google.com/books?id=De9RUVtQ5TQC&pg=PA33 |title = Emulsion Polymerisation and Latex Applications|isbn = 9781859573815|last1 = Anderson|first1 = Christopher D.|last2 = Daniels|first2 = Eric S.|year = 2003| publisher=iSmithers Rapra }}</ref><ref name="FDA don't be misled">{{cite web |url=https://www.anemoi.in/blogs/fda-recommendations-clarifying-labeling-practices-for-latex-allergies-in-medical-products/ |title=Don't be Misled by 'Latex Free' Claims |publisher=FDA |date=March 30, 2015}}</ref>
*Alternative materials like [[Vytex Natural Rubber Latex]] which reduce exposure to latex allergens while otherwise retaining the properties of natural rubber; these are made using chemical treatment to reduce the amount of [[antibody generator|antigenic proteins]] in ''Hevea'' latex.
*[[Polyurethane]]. 
The first polyurethane condoms, designed for people with latex allergies, were produced in 1994.

Some people are so sensitive that they may still have a reaction to replacement products made from alternative materials. This can occur when the alternative products are manufactured in the same facility as latex-containing products, leaving trace quantities of natural rubber latex on the non-latex products.<ref name="FDA don't be misled" />

== See also ==
* [[Food allergy]]
* [[Food intolerance]]
* [[List of allergies]]
* [[Oral allergy syndrome]]

==References==
{{Reflist}}

== External links ==
*{{webarchive |url=https://web.archive.org/web/20170208091032/http://latexallergyresources.org/ |title=The American Latex Allergy Association}}
*{{webarchive |url=https://web.archive.org/web/20160315023236/http://www.lasg.org.uk/ |title=Latex Allergy Support Group}}
*{{webarchive |url=https://web.archive.org/web/20071007185739/http://www.aafa.org/display.cfm?id=9&sub=21 |title=Asthma and Allergy Foundation of America}}

{{Allergic conditions}}
{{Hypersensitivity and autoimmune diseases}}
{{Medical resources
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|  eMedicineSubj  =  
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|  MeshID         = D020315
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{{Authority control}}

{{DEFAULTSORT:Latex Allergy}}
[[Category:Allergology]]
[[Category:Sensitivities]]
[[Category:Rubber properties]]
[[Category:Occupational hazards]]
[[Category:Gloves]]
[[Category:Protective gear]]