The Latex Allergy Crisis: A Forgotten Epidemic
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About this ebook
The HIV panic of the 1980s prompted CDC and OSHA to mandate the use of natural rubber latex gloves in health care. The increased use of rubber gloves created a latex allergy crisis for health care workers. Articles have been written on the causes, symptoms, and treatments of latex allergy; however, there are few, if any, written experiences of those living with a hypersensitivity to latex. Author Margaret Konieczny shares her experiences as well as the experiences of others who suffer from a latex allergy in the hopes that her personal story will help others. Margaret takes us through her early symptoms, diagnosis, Workers' Compensation issues, and employer accommodations.
Latex allergies affect the whole person, from the clothing they wear, foods they eat, places they visit, and their personal lifestyle. It is their emotional well-being in addition to their physical well-being that is affected. Latex allergies are permanent. There is no cure except strict avoidance which is difficult to do; latex is ubiquitous.
Margaret Konieczny
Margaret Konieczny is a registered nurse and has a master's degree in nursing science. She has had a successful career in nursing and had to alter her nursing career path after developing a severe latex allergy. She shares, in detail, her experiences after being diagnosed with a latex allergy.
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The Latex Allergy Crisis - Margaret Konieczny
This book is designed to bring information to the reader about how latex allergies became a crisis in the late 1980s. It is not the intention of the author to reprint all the material on the subject, but to explain what happened to her and to provide the interested reader with additional resources.
Every effort has been made to provide current and accurate information. This book should be used as a guide and not as the ultimate word on the subject of HIV/AIDS and the discovery of rubber.
The author and K and K Publishing shall have neither liability nor responsibility to any person or entity with respect to any loss or damage caused or alleged to have been caused, directly or indirectly, by the information contained in this book.
ACKNOWLEDGMENTS
John D. Saylor, MD FAAAP
Peggy Rourke-Nichols, RN MICN
Denise McCarthy
Victoria Powell RN
Mary Harper
Pam Waterman
Traci Hart, RN MSN
DEDICATION
This book was written so that others diagnosed with a latex allergy will feel validated, and for those who still have not yet identified their symptoms as a latex allergy, and to provide a source for healing.
INTRODUCTION
Articles have been written on the cause, symptoms, and treatments of latex allergy; however, there are few, if any, written experiences of those living with a hypersensitivity to latex. This book will cover my experience through early symptoms, diagnosis, Workers' Compensation issues and employer accommodations. The experiences of others living with a latex allergy are also included. There are several pictures in this book showing my anaphylactic reactions to latex. Viewers beware, these are not pretty, and I don't look happy.
Latex allergies affect the whole person, from the clothing they wear, foods they eat, places they visit, and their personal lifestyle. Their emotional as well as physical well being is affected. Latex allergies are permanent. There is no cure except strict avoidance, which is difficult to do; latex is ubiquitous.
In the 1980s people were dying from the newly identified, Human Immunodeficiency Virus (HIV). The virus spread through contact with infected blood and body fluids. The virus was not completely understood and, at first, it was causing fatal diseases in homosexual men. Later, hemophiliacs, needle drug users, and heterosexual men and women were presenting with the disease. As the death toll rose, fear and panic set in. In addition to HIV, hepatitis B was also becoming a significant health problem. Health care workers were at great risk of becoming infected with these viruses through needle sticks and dermal exposures to infected blood. By 1987, the Center for Disease Control (CDC) mandated that healthcare workers wear latex gloves when providing direct patient care. In 1988, the Occupational Safety and Health Administration (OSHA) joined with the CDC, in mandating Standard Precautions, the wearing of protective equipment, for all healthcare workers who are exposed to human blood and body fluids.
The incidence of latex allergies mushroomed with the increased use of latex gloves. By 1989, just two years after the CDC mandate, over 1,000 cases of latex allergy were reported including 15 deaths. The National Institute for Occupational Safety and Health (NIOSH) reported that since 1997 six percent of the general population and 18% of healthcare workers have become sensitized to latex proteins.
Reports of allergic contact dermatitis acquired from wearing rubber gloves were made as early as 1933 by Dr J.G. Downing. In his article, Dermatitis from Rubber Gloves, he indicates that glove manufacturers were aware of the allergic properties of latex proteins; however, there are over 60 different latex proteins. At the time, the glove manufacturers did not have the finances or expertise to determine which were the most allergenic.
Information about latex allergies came slowly and, by 1989, when the incidence of latex allergies had skyrocketed, physicians were unable to make definitive diagnoses of latex allergy and workers continued to be exposed to allergenic latex proteins.
The history of glove use in healthcare is surprisingly short. To those just entering the profession, it seems unbelievable, that gloves and other personal protective equipment were not always worn by healthcare workers. As you will read, clean aseptic technique was not appreciated in the medical field until the late nineteenth century. Rubber glove use for surgical procedures did not occur until the late 1890s and was not accepted as routine until the 1920s.
It is imperative that today's healthcare professional be aware of latex as an allergen for themselves and for the care of their patients who are latex allergic. Health care facilities may still be using latex gloves, and the even more allergenic, powdered latex glove. Those who are already sensitized can, with continued exposure to latex, develop a serious hypersensitivity.
CONTENTS
Cover
Disclaimer
Acknowledgments
Dedication
Introduction
PART I
Chapter 1 Why Natural Rubber Latex Gloves
Blood-borne Pathogens.
The Glove Mandate
Chapter 2 My Story
Finding a Physician who Knows
Chapter 3 Life After Diagnosis
Employer's Response
Healing
Workers' Compensation
Finding a Lawyer
PART II
Chapter 4 From Rubber Trees to Natural Rubber Latex Gloves
The Rubber Story
First Surgical Rubber Glove
Disposable Latex Glove Manufacturing
Powder-free Latex Glove
Allergenic Properties of Rubber
Chapter 5 History of Rubber Gloves in Health Care
Surgical Attire & Rubber Gloves
Cleanliness and Asepsis
Disposable Patient Care Items
Blood-borne Pathogens Change Everything
PART III
Chapter 6 The Allergic (Hypersensitivity) Response
Irritant Contact Dermatitis
Hypersensitivity Type IgE Mediated Hypersensitivity Type I
Cross-Reactivity/Fruit Syndrome
PART IV
Chapter 7 My Life 2002-2009
2007
2008
2009-10
Employment Issues Revisited
Chapter 8 Workers' Compensation Revisited
Epilogue
PART V
Chapter 9 Other Individual Latex Experiences
APPENDIX
Time Line of Glove Use in Health Care
REFERENCES
INDEX
Author Biography
FIGURES
Figure 1: Angioedema, April 1998
Figure 2: Post-surgery
Figure 3: From Eliason's Surgical Nursing (p.126).
Figure 4: From Eliason's Surgical Nursing (p. 129)
Figure 5: From Eliason's Surgical Nursing (p. 172)
Figure 6: Adapted from Edlich, R.F. (1997), Medicine's Deadly Dust; Heuther, S.E. & McCance, K.L. (2008), Understanding Pathophysiology
Figure 7: Adapted from Edlich, R.F. (1997), Medicine's Deadly Dust; Heuther, S.E. & McCance, K.L. (2008), Understanding Pathophysiology.
Figure 8: Cross Reactive Foods
Figure 9: Post hair salon visit / hair coloring
Figure 10.1: Post-restaurant visit
Figure 10.2: Post-restaurant visit
Figure 11: Post-gardening.
Part I
Chapter 1
WHY NATURAL RUBBER LATEX GLOVES
Prior to 1983 glove use was limited to surgery, and in the performance of sterile procedures. Basic patient care was performed without gloves. What prompted the use of gloves in the routine daily care of patients was the identification of blood-borne viruses: first hepatitis B and then HIV.
Blood-borne Pathogens.
Being diagnosed with the HIV infection was considered a death sentence. This virus causes the disease AIDS (Acquired Immuno-deficiency Syndrome) for which there is no cure. In the mid 1980s this mysterious infection spread rapidly throughout the United States. It first gained attention in 1981 when 5 homosexual males in Los Angeles presented with a strange opportunistic pneumonia and a rare cancer. This was the overt beginning of the gay sexual liberation, when gay men and women struggled to openly express their sexual orientation. It is not known why the disease first manifested in the gay American male; however, the lifestyle and openness of gay men's sexual relationships at that time helped the disease to spread rapidly. By the end of 1981 five to six new cases were being reported each week. Information about the disease was practically non-existent. It was assumed the virus originated in Haiti and was brought to the United States by Haitian immigrants. Initially, it was believed to be spread only by sexually active gay men. By the end of 1983, new cases of AIDS were being diagnosed in epidemic proportions; of the 3,064 new cases, 1292 died.
In 1984, the virus was finally identified by French researchers. The virus was called lymphadenopathy-associated virus (LAV). Later it was changed to HIV. At the time there was no treatment. Fear and panic took hold among the gay community. The social stigma of being gay was now in the news more than ever before. People who acquired the disease were now known to be, or branded as, homosexual. Coming out of the closest
was inevitable for gays when they presented with the disease. In 1985 a well known movie star, Rock Hudson,