Self-reported hand symptoms: a role in monitoring health care workers for latex sensitization?

Background: The use of powdered natural rubber latex (NRL) gloves increased greatly in the 1980s because of concerns about transmission of blood-borne infections and the subsequent implementation of universal precautions. The most common clinical reactions to glove use are irritant and T-cell-mediated contact dermatitis. However, IgE-mediated immediate reactions to latex have become a serious concern for health care workers (HCWs). The diagnosis of latex allergy requires a comprehensive medical history and diagnostic tests. The skin prick test is the preferred diagnostic method, although it can be time-consuming. Objective: To determine the role of hand symptoms reported on questionnaires in monitoring HCWs for latex sensitization. Methods: Questionnaires were completed by 804 HCWs at 2 hospitals. Using a positive skin prick test (SPT) result as a criterion standard of latex sensitization, the diagnostic performance of hand symptoms was evaluated. Results: Increasing latex glove use was strongly related to increasing reports of hand symptoms. Hand symptoms were highly associated with glove-related respiratory and systemic symptoms. A positive SPT result was seen in 5% of HCWs and increased with the number of hand symptoms: 0 (1.6%), 1 to 2 (3.4%), and 3 to 7 (19.0%). Participants reporting more than 2 hand symptoms were 11 times more likely to have positive SPT results compared with those with 2 or fewer hand symptoms. Conclusion: Hand symptoms are closely associated with latex sensitization. Questionnaires should be useful in health monitoring for HCWs who use latex gloves. (C) 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.