Allergic and irritant reactions to rubber gloves in medical health services

The preparation of food in restaurant kitchens carries a high risk of occupational dermatoses. Analysis of 33 cases revealed four different etiological types. Simple irritant dermatitis was rare (2 cases), plain contact dermatitis was more common (6 cases). Fifteen patients had relevant patch tests and scratch tests; ten had positive scratch tests only to explain the cause of their dermatitis. The last type was termed protein contact dermatitis. The major type IV allergens incriminated were metals, onion and garlic. The major proteinaceous allergens indicated by history and test results were fish and shell-fish. Open patch tests with the incriminated foods may cause erythema or oedema on normal skin after 20 minutes. Previously eczematous, now normal looking, skin often responds with a crop of dyshidrotic vesicles preceded by erythema and itching 30 minutes after the application of an open test. Examination for specific IgE is not always positive in such cases. Inhalant allergy was rare. The results indicate that food handlers are sensitized by the protein they touch, and then react to later contact with the proteins. Protein contact dermatitis is similarly common among veterinary surgeons, while the importance in other occupational groups remains to be studied.

Latex surgical gloves may cause contact urticaria and serious allergic reactions in sensitized persons, but the frequency of this allergy is not known. In the present study, 512 hospital employees were screened with a latex-glove scratch-chamber test; 23 (4.5%) were suspected and 15 (2.9%) were proven allergic with latex prick and use tests. All of them were doctors and nurses, and 12 had had contact urticaria but no serious symptoms. They could continue their routine work using cotton or vinyl undergloves or special latex surgical gloves. Atopy, hand eczema and surgical work seemed to be predisposing factors. In operating units, 7.4% of the doctors and 5.6% of the nurses were allergic; the frequency was lower in non-operating units and among laboratory personnel. The high frequency of latex glove allergy, especially in operating units, focuses attention on the quality of surgical latex gloves.