Latex allergy

Irritant contact dermatitis is a non-allergic skin rash that appears where the skin has had contact with latex products. The rash may take several days to appear. It is the most common type of latex allergy and is reversible.

Irritant contact dermatitis is caused by:

• moisture becoming trapped under the glove. This can be from not drying hands properly before putting gloves on or from sweating while wearing latex gloves
• not completely rinsing off detergent and soap after hand washing - these are then trapped under the glove
• corn starch, which is present in powdered latex gloves
• wearing latex gloves when handling chemicals that can permeate through the glove material.

Allergic contact dermatitis is an allergic skin rash that occurs up to 48 hours after skin has been exposed to latex products. It is also known as type IV or delayed hypersensitivity reaction, or rubber allergy.

Allergic contact dermatitis can spread beyond the area of contact if the skin is repeatedly exposed to latex. The skin rash goes away when skin stops being exposed to latex, but it will reappear if it is exposed again. It is most commonly caused when the skin becomes sensitised (allergic) to the chemicals used in latex products, such as thiurams and carbamates.

Immediate allergic reaction is the least common but most dangerous form of latex allergy. Immediate allergic reaction is also known as type 1 or immediate hypersensitivity reaction.

It is caused by sensitivity (allergy) to latex proteins and occurs within minutes to an hour after exposure.

The condition includes:

• local reaction at the site of contact, for example hives, redness and itching
• generalised reaction, for example widespread hives, swelling of the face, sneezing, itchy eyes, stuffy nose and wheezing
• anaphylaxis, which causes breathing difficulties and collapse. This is a medical emergency.

You can treat the symptoms of an immediate allergic reaction. However, symptoms will return and could get worse if you’re exposed to latex again.

Irritant and allergic contact dermatitis can increase the risk of a person developing an immediate allergic reaction.

A doctor can diagnose latex allergy using a number of tests including medical history, physical examination and allergy testing such as skin prick testing and blood tests.

The first step is to identify if your workers are being exposed to latex. This means identifying:

• any products at your place of work that contain latex
• any work that may expose workers to latex.

Also consider if others may be exposed to latex products at work, such as patients in healthcare settings or children in early childhood education and care services.

To identify the hazard, it’s important to understand how people can be exposed to latex. You can be exposed to latex by:

Respiratory exposure

Corn starch powder is sometimes added to disposable latex gloves to make them easier to put on. Latex proteins can leach into the powder and become airborne when the gloves are removed.

Inhaling the powder can cause respiratory sensitisation (allergy) in susceptible people.

Skin exposure

Skin exposure happens when you handle latex products or wear latex gloves. Latex proteins and the chemicals that are added during manufacturing can leach out of the glove material causing skin sensitisation (allergy) in susceptible people.

Skin exposure can also occur from touching surfaces that are contaminated with powder from powdered latex gloves.

Individual worker risk factors

Anyone can develop latex allergy, however people with the following risk factors are at increased risk:

• frequent and prolonged exposure to latex products
• food allergies for example bananas, avocado, kiwi fruit, papaya and chestnuts
• atopy, which is a tendency towards allergy such as asthma, hay fever or eczema
• prior or current dermatitis
• previous multiple surgical procedures involving repeated exposure to medical latex devices.

You can identify latex hazards at your place of work by:

Inspecting your business

Walk around your place of work and look for products, processes and environments that may create a latex allergy risk. Make a note of any housekeeping issues such as contamination of surfaces with powder from powdered latex gloves.

Talking to your workers

Talk to your workers to find out if they have any health and safety concerns. If you use latex products, find out if any of your workers have a latex allergy or are at an increased risk of having or developing a latex allergy.  You could do this before a worker starts work by engaging a qualified person to assess a worker’s risk using a latex allergy questionnaire.

You could also ask workers to complete a confidential survey which will provide an opportunity for workers who are less likely to speak out in public to provide feedback.

Reviewing available information

Make sure that you have read all relevant legislation and codes of practice. Stay up to date with information about hazards and risks in the workplace. Research how other places of work have managed latex allergy risks.

The How to manage work health and safety risks Code of Practice 2021 (PDF, 0.65 MB) outlines when you should do a risk assessment. You can use this risk assessment template (DOCX, 0.02 MB) to guide you and record your assessments.

A risk assessment can include:

• the nature of the task
• whether latex gloves are required, and if they are, can they be substituted for non-latex gloves
• frequency and duration of contact with latex products.

The best way to control latex allergy is to eliminate the risk. For example, don’t use latex gloves for tasks that don’t have an infection risk, such as catering, maintenance and routine housekeeping.

If eliminating latex products isn’t reasonably practicable, you must minimise the risk by using higher order control measures. These controls could include:

• substituting latex products for other products. For example:
  • use suitable vinyl or nitrile gloves for tasks that have an infection risk
  • when handling chemicals select gloves in accordance with the chemical’s safety data sheet (SDS).
  • If you use latex gloves, make sure you use low protein, powder-free latex gloves.
• using engineering controls such as
  • changing work processes and redesigning tasks to make sure workers don’t have to wear latex gloves for a long time
  • changing the physical work environment to locate hand washing facilities close to where workers remove their gloves.

Lower-level control measures used on their own tend to be least effective in minimising risk. They can be used when no other practical control measures are available, as an interim measure until a more effective way of managing the risk can be implemented and to support higher order control measures. These could include:

• developing and implementing latex policies and procedures
• providing information, instruction and training about:
  • latex allergy and how to protect against it
  • hand hygiene and skin care
  • reporting signs of latex allergy
• ongoing monitoring of workers’ health for signs and symptoms of latex allergy
• ensuring that workers who develop signs and symptoms of latex allergy seek medical advice. If a worker is diagnosed with latex allergy, follow any advice provided by the worker’s doctor including what gloves the worker should wear. If a worker is diagnosed with an immediate allergic reaction to latex, review the work environment to make sure it is latex-safe and seek specialist advice as needed
• identifying patients in healthcare settings who have a latex allergy and ensuring that they can be treated in a latex-safe environment with access to latex-free emergency equipment
• providing cotton glove liners to wear under the latex gloves in non-healthcare settings if sweat is contributing to latex allergy. The fingertips of the cotton gloves can be removed where greater dexterity is required. Wash cotton gloves in a mild detergent after use and rinse well to prevent residual detergent from accumulating under the glove
• washing and drying hands thoroughly after removing latex gloves
• using water-based hand care products because oil-based products can cause latex gloves to deteriorate and leach latex proteins.
• ensuring that key people are authorised and trained to use emergency medication (such as an Epi Pen), if a worker is at risk of anaphylaxis from latex allergy. You can read more about anaphylaxis and asthma medicines, their first aid use and purchase.

Risk management should be an ongoing process in your business and you should review your control measures regularly. You can read more about the circumstances when work health and safety laws require you to review your risk controls.