What is the prevalence of latex allergy in the united states
- Awareness and understanding that latex allergy remains a relatively high-risk condition for this group.
- Avoidance of latex-containing products used for personal care, medical care, and community participation (e.g., adhesive bandages, latex gloves, surgeries in medical setting that may not be latex-free.)
- Avoidance of skin contact with latex protein in the environment and inhalation of powder that contains latex (i.e. gloves).
- Avoidance of every direct contact to natural rubber latex.
- Awareness of signs and symptoms of latex allergy.
Persons with known latex allergy routinely wear medical-alert identification.
- Persons with known latex allergy and their family know the signs of life-threatening anaphylaxis.
- Persons with known latex allergy and their family own a pre-arranged plan for action in the event of a severe, life-threatening anaphylaxis.
Main article: Food allergy
|Balsam of Peru||Redness, swelling, itching, allergiccontact dermatitis reactions, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngealmucosa, or angles of their mouth), pruritus, hand eczema, generalized or resistant plantardermatitis, rhinitis, conjunctivitis, and blisters.||Present in numerous foods, such as coffee, flavored tea, wine, beer, gin, liqueurs, apéritifs (e.g. vermouth, bitters), soft drinks including cola, juice, citrus, citrus fruit peel, marmalade, tomatoes and tomato-containing products, Mexican and Italian foods with red sauces, ketchup, spices (e.g. cloves, Jamaica pepper (allspice), cinnamon, nutmeg, paprika, curry, anise, and ginger), chili sauce, barbecue sauce, chutney, pickles, pickled vegetables, chocolate, vanilla, baked goods and pastries, pudding, ice cream, chewing gum, and candy.|
|Egg||Anaphylaxis, swelling, sometimes flatulence and vomiting||An allergic individual may not own any reaction to consuming food only prepared with yolk and not glair, or vice versa.|
|Fish||Respiratory reactions, Anaphylaxis, oral allergy syndrome, sometimes vomiting||One of three allergies to seafood, not to be conflated with allergies to crustaceans and mollusks. Fish allergy sufferers own a 50% likelihood of being cross reactive with another fish species, but some individuals are only allergic to one species, such as; tilapia, salmon,  or cod.
A proper diagnosis is considered complicated due to these cross reactivity between fish species and other seafood allergies.  Hazard extends to exposure to cooking vapors or handling.
|Fruit||Mild itching, rash, generalized urticaria, oral allergy syndrome, abdominal pain, vomiting, anaphylaxis||Mango, strawberries, banana, avocado, and kiwi are common problems. Severe allergies to tomatoes own also been reported.
|Garlic||Dermatitis, asymmetrical pattern of fissure, thickening/shedding of the outer skin layers,anaphylaxis|
|Hot peppers||Skin rash, hives, throat tightness, tongue swelling, possible vomiting|
|Oats||Dermatitis, respiratory problems, anaphylaxis|
|Maize||Hives, pallor, confusion, dizziness, stomach pain, swelling, vomiting, indigestion, diarrhea, cough, tightness in throat, wheezing, shortness of breath, anaphylaxis||Often a hard allergy to manage due to the various food products which contain various forms of corn.|
|Milk||Skin rash, hives, vomiting, diarrhea, constipation, stomach pain, flatulence, nasal congestion, dermatitis, blisters, anaphylaxis||Not to be confused with lactose intolerance.|
|Peanut||Anaphylaxis and swelling, sometimes vomiting||Includes some cold-pressed peanut oils. Distinct from tree nut allergy, as peanuts are legumes.|
|Poultry Meat||Hives, swelling of, or under the dermis, nausea, vomiting, diarrhea, severe oral allergy syndrome, shortness of breath, rarely anaphylactic shock||Very rare allergies to chicken, turkey, squab, and sometimes more mildly to other avian meats.
Not to be confused with secondary reactions of bird-egg syndrome. The genuine allergy has no causal relationship with egg allergy, nor is there any shut association with red meat allergy. Prevalence still unknown as of 2016.
|Red Meat||Hives, swelling, dermatitis, stomach pain, nausea, vomiting, dizziness, fainting, shortness of breath,, rarely anaphylaxis||Allergies to the sugar carbohydrate found in beef, venison, lamb, and pork called alpha-gal.
It is brought on by tick bites. Allergic reaction to pork is an exception, as it may also be caused by pork-cat syndrome instead of alpha-gal allergy.
|Rice||Sneezing, runny nose, itching, stomachache, eczema.||People with a rice allergy can be affected by eating rice or breathing in rice steam.|
|Sesame||Possible respiratory, skin, and gastrointestinal reactions which can trigger serious systemic anaphylactic responses.||By law, foods containing sesame must be labeled so in European Union, Canada, Australia, and New Zealand.|
|Shellfish||Respiratory symptoms, Anaphylaxis, oral allergy syndrome, gastrointestinal symptoms, rhinitis, conjunctivitis||Shellfish allergies are highly cross reactive, but its prevalence is generally higher than that of fish allergy.
As of 2018 six allergens own been identified to prawn alone; along with crab it‘s the major culprit of seafood anaphylaxis. In reference to it as one of the “Big 8”  or “major 14” allergens it is sometimes specified as a “crustacean shellfish” allergy, or more simply, a “crustacean allergy”. Sometimes it is conflated with an allergy to molluscan shellfish but finish tolerance to one but not the other isn’t unusual. Most generally, a mono-sensitive individual will experience a crustacean allergy alone with tolerance to mollusks, rather than vice versa.
|Soy||Anaphylaxis, sometimes vomiting|
|Sulfites||Hives, rash, redness of skin, headache (particular frontal), burning behind eyes, breathing difficulties (anaphylaxis)||Used as a preserving agent in numerous diverse foods, such as raisins, dried peaches, various other dried fruit, canned or frozen fruits and vegetables, wines, vinegars and processed meats.
|Tartrazine||Skin irritation, hives, rash||Synthetic yellow food coloring, also used for bright green coloring|
|Tree nut||Anaphylaxis, swelling, rash, hives, sometimes vomiting||Hazard extends to exposure to cooking vapors, or handling. Distinct from peanut allergy, as peanuts are legumes.|
|Wheat||Eczema (atopic dermatitis), Hives, asthma, hay fever, angioedema, abdominal cramps, Celiac disease, diarrhea, temporary (3 or 4 day) mental incompetence, anemia, nausea, and vomiting||Not to be confused with Celiac Disease or NCGS (Non Celiac Gluten Sensitivity).
While wheat allergies are «true» allergies, Celiac Disease is an autoimmune disease.
Main article: Allergy § Other environmental factors
|Balsam of Peru||Redness, swelling, itching, allergiccontact dermatitis reactions, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngealmucosa, or angles of their mouth), pruritus, hand eczema, generalized or resistant plantardermatitis, rhinitis, conjunctivitis, and blisters.||A number of national and international surveys own identified Balsam of Peru as being in the «top five» allergens most commonly causing patch test reactions in people referred to dermatology clinics.|
|Pollen||Sneezing, body ache, headache (in rare cases, extremely painful cluster headaches may happen due to allergic sinusitis; these may leave a temporary time period of 1 and a half to 2 days with eye sensitivity), allergic conjunctivitis (includes watery, red, swelled, itchy, and irritating eyes), runny nose, irritation of the nose, nasal congestion, minor fatigue, chest pain and discomfort, coughing, sore throat, facial discomfort (feeling of stuffed face) due to allergic sinusitis, possible asthma attack, wheezing|
|Cat||Sneezing, itchy swollen eyes, rash, congestion, wheezing|
|Dog||Rash, sneezing, congestion, wheezing, vomiting from coughing, Sometimes itchy welts.||Caused by dander, saliva or urine of dogs, or by dust, pollen or other allergens that own been carried on the fur. Allergy to dogs is present in as much as 10 percent of the population.|
|Insect sting||Hives, wheezing, possible anaphylaxis||Possible from bee or wasp stings, or bites from mosquitoes or flies love Leptoconops torrens.|
|Mold||Sneeze, coughing, itchy, discharge from the nose, respiratory irritation, congested feeling, joint aches, headaches, fatigue|
|Perfume||Itchy eyes, runny nose, sore throat, headaches, muscle/joint pain, asthma attack, wheezing, chest pain, blisters|
|Cosmetics||Contact dermatitis, irritant contact dermatitis, inflammation, redness, conjunctivitis ,sneezing|
|Semen||Burning, pain and swelling, possibly for days, swelling or blisters, vaginal redness, fever, runny nose, extreme fatigue||In a case study in Switzerland, a lady who was allergic to Balsam of Peru was allergic to her boyfriend’s semen following intercourse, after he drank large amounts of Coca-Cola.|
|Latex||Contact dermatitis, hypersensitivity|
|Water (see note)||Epidermal itching||Strictly aquagenic pruritus or aquagenic urticaria, but freezing urticaria may also be described as a «water allergy,» in which water may cause hives and anaphylaxis|
|House dust mite||Asthma||Home allergen reduction may be recommended|
|Nickel (nickel sulfate hexahydrate)||Allergic contact dermatitis, dyshidrotic eczema|
|Gold (gold sodium thiosulfate)||Allergic contact dermatitis|
|Chromium||Allergic contact dermatitis|
|Cobalt chloride||Allergic contact dermatitis|
|Formaldehyde||Allergic contact dermatitis|
|Photographic developers||Allergic contact dermatitis|
|Fungicide||Allergic contact dermatitis, fever, anaphylaxis|
Main article: Drug allergy
|Balsam of Peru||Redness, swelling, itching, allergiccontact dermatitis reactions, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngealmucosa, or angles of their mouth), pruritus, hand eczema, generalized or resistant plantardermatitis, rhinitis, conjunctivitis, and blisters.||Present in numerous drugs, such as hemorrhoid suppositories and ointment (e.g. Anusol), cough medicine/suppressant and lozenges, diaper rash ointments, oral and lip ointments, tincture of benzoin, wound spray (it has been reported to inhibit Mycobacterium tuberculosis as well as the common ulcer-causing bacteria H. pylori in test-tube studies), calamine lotion, surgical dressings, dental cement, eugenol used by dentists, some periodontal impression materials, and in the treatment of dry socket in dentistry.|
|Tetracycline||Many, including: severe headache, dizziness, blurred vision, fever, chills, body aches, flu symptoms, severe blistering, peeling, dark colored urine|
|Dilantin||Many, including: swollen glands, simple bruising or bleeding, fever, sore throat|
|Tegretol (carbamazepine)||Shortness of breath, wheezing or difficulty breathing, swelling of the face, lips, tongue etc., hives|
|Penicillin||Diarrhea, hypersensitivity, nausea, rash, neurotoxicity, urticaria|
|Cephalosporins||Maculopapular or morbilliform skin eruption, and less commonly urticaria, eosinophilia, serum-sickness–like reactions, and anaphylaxis.|
|Sulfonamides||Urinary tract disorders, haemopoietic disorders, porphyria and hypersensitivity reactions, Stevens–Johnson syndrometoxic epidermal necrolysis|
|Non-steroidal anti-inflammatories (cromolyn sodium, nedocromil sodium, etc.)||Many, including: swollen eyes, lips, or tongue, difficulty swallowing, shortness of breath, rapid heart rate|
|Intravenous contrast dye||Anaphylactoid reactions and contrast-induced nephropathy|
|Local anesthetics||Urticaria and rash, dyspnea, wheezing, flushing, cyanosis, tachycardia|
Many substances can cause an allergic reaction when in contact with the human integumentary system.
- Are health care providers becoming complacent about latex risks in hospital and office settings?
- How do we recognize infants who are most at risk or those that may turn positive?
- Inform parents and caregivers about latex allergy and ways to provide safe baby care while avoiding exposure to latex products.3-4,11-19
- Avoid using health care products that contain latex when caring for infants with Spina Bifida3-4,11-19
- Inform staff and families of any latex-containing products such as bottle nipples, pacifiers, teething rings, toys, and other items such as urinary catheters.3-4,11-19 (Appendix 1)
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Workgroup Members: Richard Adams, MD (Chair); Kevin Kelly, MD; Sue Lockwood, Allergy and Asthma Network; Suzanne McKee, RN BSN; Candice Walker, PhD
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(In these guidelines, “latex allergy” refers to type I hypersensitivity to Hevea brasiliensis, also known as natural rubber latex.)
The history of latex allergy and its intersection with people with Spina Bifida dates back to the tardy 1980’s in the United States with the advent of Universal Precautions and no regulation of latex in gloves. As clinical reports of severe allergic reactions, including anaphylaxis and a 500-fold increase of life-threatening events in surgery for Spina Bifida, efforts were made to better understand the patterns of these episodes.
In doing so, latex allergy was subsequently found to be the associated trigger in surgical procedures in patients with Spina Bifida and other conditions, particularly those with congenital neurogenic bladder conditions.1-2
As a result, by the early 1990’s there were efforts to systematically avoid exposing infants and children with Spina Bifida to natural rubber products such as red rubber catheters and surgical gloves, or latex products used in various settings such as in neonatal intensive care units or newborn nurseries. As the importance of these measures became more widely accepted, there followed an extension to other areas of children’s hospitals, emergency rooms, and to numerous pediatric offices where the children were subsequently seen.
Despite these efforts, exposure to latex remains relatively prevalent in the diverse environments frequented by people of every ages with Spina Bifida — hospitals, clinics, schools, homes, and community facilities. Exposure to latex could take put by direct contact or inhalation. Symptoms of latex allergy may initially be considered mild, such as skin irritations, rash, hives, flushed cheeks, itchy eyes, or sneezing. However, they can immediately progress or evolve related to subsequent exposures to more dramatic systemic responses such as generalized urticaria, wheezing, coughing, periorbital erythema and swelling, and even nausea and vomiting.3
Until better scientific explanations are available to specifically drive prevention and intervention, people with Spina Bifida should continue to avoid skin contact with latex protein in the environment including foods with similar proteins, and avoid inhalation of powder that contains latex.4-7 Avoidance of latex should extend to latex-containing products used for personal care, medical care, dental care, and community participation.8-9
Children, families and adults should be aware that caution should be taken regarding what has come to be labeled “latex fruit syndrome.” This remains incompletely understood and likely related to epigenetic factors.10 The protein allergen (example, Hev b 6 hevein) in some latex products makes up a considerable quantity of the entire protein.
This has been shown to own significant cross-reactivity to certain proteins (chitinases) in banana, avocado and chestnuts, for example. While these fruits own been the most commonly described, there are at least 25 other fruits that may own some level of cross-reactivity with latex. For example, potatoes, eggplant, and kiwi own been described as potential concerns.
At this time, it is helpful to understand that not every patients with true latex allergy own clinical reactions to fruit (~50%) and that few (~ 10%) of individuals with known allergy to a latex-cross-reacting fruit develop latex allergy symptoms.10 Parents and patients should be aware of potential “latex-fruit syndrome” reactions, but should also be aware of its relative risk.
For additional details and resources on latex allergy, please review Appendix 1: Latex Allergy Fact Sheets and Other Materials and Appendix 2: Latex Allergy and Foods.