Latex allergy is a significant occupational hazard affecting 5% to 10% of health care workers. Latex-related illness causes severe morbidity and potentially life-threatening anaphylactic shock [1]. A clear hospital policy is necessary to deal with this increasingly important problem.

Nonallergenic natural rubber latex is not currently available. Because latex-allergic patients have reported severe clinical allergy to low-protein latex gloves, we cannot recommend their use in persons with a positive history, skin test result, or radioallergosorbent test result. Patients with clear histories of latex-induced contact urticaria, rhinitis, conjunctivitis, asthma, and anaphylaxis can safely use most nonlatex alternatives to prevent allergic consequences.

However, several issues are important in choosing an alternative. Studies have reported increased viral leakage through vinyl substitutes [2]. We do not believe that vinyl be considered as an adequate alternative to latex in high-risk situations. Other nonlatex substitutes are available and should be used by patients allergic to latex.

The use of powder-free latex will not prevent clinical allergy in sensitized persons but will decrease airborne latex and allow allergic patients to continue to work [3]. Powder-free gloves would significantly decrease but not completely eliminate inhalation of latex, one very important route of sensitization. Powder-free gloves would also reduce other complications in surgery [4].

The cost of powder-free latex gloves is competitive with that of powdered examination and surgical gloves, but there may be limited availability. We recommend that low-allergen, powder-free latex gloves be used by all health care workers except patients with known latex allergies.

Government agencies must recognize latex allergy as a real and significant health hazard. The government must also regulate the safe use of latex. This includes adequate labeling of products so that the material of manufacture is clearly identified. The term hypoallergenic should be removed and replaced by meaningful values for latex protein, chemical additives, and glove powder. Manufacturers must voluntarily lower the allergenic content of their latex gloves to prevent sensitization and latex allergic illness.