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Erschienen in: International Archives of Occupational and Environmental Health 5/2005

01.06.2005 | Original Article

Effectiveness of a nationwide interdisciplinary preventive programme for latex allergy

verfasst von: Ute Latza, Frank Haamann, Xaver Baur

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 5/2005

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Abstract

Objectives: The increasing prevalence of latex allergy among healthcare workers is a large socio-economical problem for the society and affected individuals. The objective of this study was to describe and evaluate a nationwide, interdisciplinary campaign by the institution for the German workers’ compensation scheme for non-public healthcare providers that targeted the reduction of exposure to powdered high-protein latex gloves. Methods: The effectiveness of the prevention programme is described and evaluated with a before-and-after design comparing data on compensation claims for latex-related skin and airway diseases of the German statutory compensation scheme for work-related diseases in non-public health services. A survey on change in glove use was conducted after the programme. Results: The main feature of the campaign among healthcare workers (budget €340,000) was to increase awareness by means of educational components on the aetiology of latex hypersensitivity for healthcare workers and their providers, and professional trainers. The number of reported compensation claims for latex-induced skin diseases increased from a pre-measure of 664 in 1996 to 884 during the programme in 1998 and decreased after the programme (post-measure n=567 in 1999 and n=204 in 2002). Doctors’ assistants in practices and nurses/nurse assistants/midwives filed most claims. Similar decreases were observed for confirmed claims and latex-related respiratory diseases, while two other prevalent occupational diseases in healthcare workers (low-back disorders, infections) increased during this time period. The survey demonstrated a considerable concurrent drop in the use of powdered latex gloves (hospitals 76% vs 37% for unsterile gloves and 86% vs 62% for sterile gloves). Conclusions: The campaign against latex allergy in connection with concurrent corresponding recommendations, activities of State authorities for worker protection, and regulations, is an example for the successful incorporation of research results into preventive measures that directly affect the frequency of a work-related disease. This effective programme can be regarded as a model for the reduction of other occupational diseases such as bakers’ or isocyanate asthma.
Literatur
Zurück zum Zitat Allmers H, Brehler R, Chen Z, et al. (1998) Reduction of latex aeroallergens and latex-specific IgE antibodies in sensitized workers after removal of powdered natural rubber latex gloves in a hospital. J Allergy Clin Immunol 102:841–846PubMed Allmers H, Brehler R, Chen Z, et al. (1998) Reduction of latex aeroallergens and latex-specific IgE antibodies in sensitized workers after removal of powdered natural rubber latex gloves in a hospital. J Allergy Clin Immunol 102:841–846PubMed
Zurück zum Zitat Allmers H, Schmengler J, Skudlik C (2002) Primary prevention of latex allergy in the German health care system through education and intervention. J Allergy Clin Immunol 110:318–323PubMed Allmers H, Schmengler J, Skudlik C (2002) Primary prevention of latex allergy in the German health care system through education and intervention. J Allergy Clin Immunol 110:318–323PubMed
Zurück zum Zitat Allmers H, Schmengler J, John SM (2004) Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. J Allergy Clin Immunol 114:347–351PubMed Allmers H, Schmengler J, John SM (2004) Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. J Allergy Clin Immunol 114:347–351PubMed
Zurück zum Zitat Altman DG (1991) Proportions in two independent groups. In: Altman DG (ed) Practical statistics for medical research. Chapman & Hall, London, pp 232–235 Altman DG (1991) Proportions in two independent groups. In: Altman DG (ed) Practical statistics for medical research. Chapman & Hall, London, pp 232–235
Zurück zum Zitat Arellano R, Bradley J, Sussman G (1992) Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves. Anesthiology 77:905–908 Arellano R, Bradley J, Sussman G (1992) Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves. Anesthiology 77:905–908
Zurück zum Zitat Baur X, Ammon J, Chen Z, Beckmann U, Czuppon AB (1993) Health risk in hospitals through airborne allergens for patients presensitised to latex. Lancet 432:1148–1149 Baur X, Ammon J, Chen Z, Beckmann U, Czuppon AB (1993) Health risk in hospitals through airborne allergens for patients presensitised to latex. Lancet 432:1148–1149
Zurück zum Zitat Baur X (1996) Naturlatex-Allergie. Empfehlungen der Interdisziplinären Arbeitsgruppe. Arbeitsmed Sozialmed Umweltmed 31:471–474 Baur X (1996) Naturlatex-Allergie. Empfehlungen der Interdisziplinären Arbeitsgruppe. Arbeitsmed Sozialmed Umweltmed 31:471–474
Zurück zum Zitat Baur X, Chen Z (1999) Summary of appropriate measures to prevent natural latex allergy. Allergy Int 48:31–36 Baur X, Chen Z (1999) Summary of appropriate measures to prevent natural latex allergy. Allergy Int 48:31–36
Zurück zum Zitat Baur X, Chen Z, Allmers H, Raulf-Heimsoth M (1996) Reduktion des Allergierisikos durch Naturgummi-Produkte. Dtsch Ärztebl 16:A1043–A1045 Baur X, Chen Z, Allmers H, Raulf-Heimsoth M (1996) Reduktion des Allergierisikos durch Naturgummi-Produkte. Dtsch Ärztebl 16:A1043–A1045
Zurück zum Zitat Baur X, Chen Z, Allmers H (1998a) Can a threshold limit value for natural rubber latex airborne allergens be defined?. J Allergy Clin Immunol 101:24–27PubMed Baur X, Chen Z, Allmers H (1998a) Can a threshold limit value for natural rubber latex airborne allergens be defined?. J Allergy Clin Immunol 101:24–27PubMed
Zurück zum Zitat Baur X, Chen Z, Allmers H, Raulf-Heimsoth M (1998b) Results of wearing test with two different latex gloves with and without the use of skin-protection cream. Allergy 53:441–444PubMed Baur X, Chen Z, Allmers H, Raulf-Heimsoth M (1998b) Results of wearing test with two different latex gloves with and without the use of skin-protection cream. Allergy 53:441–444PubMed
Zurück zum Zitat Beezhold DH, Beck WC (1992) Surgical glove powders bind latex antigens. Arch Surg 127:1354–1357PubMed Beezhold DH, Beck WC (1992) Surgical glove powders bind latex antigens. Arch Surg 127:1354–1357PubMed
Zurück zum Zitat Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW) (1999). Allergiegefahr durch Latex-Einmalhandschuhe. Stand 10/99 [Allergy hazard through latex disposable gloves], Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege [Institution for Statutory Accident Insurance for Non-Public Healthcare and Welfare Providers in Germany], Hamburg, Germany, reference no. GUV 38.9 Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW) (1999). Allergiegefahr durch Latex-Einmalhandschuhe. Stand 10/99 [Allergy hazard through latex disposable gloves], Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege [Institution for Statutory Accident Insurance for Non-Public Healthcare and Welfare Providers in Germany], Hamburg, Germany, reference no. GUV 38.9
Zurück zum Zitat Brehler R, Rütter A, Kütting B (2002) Allergenicity of natural rubber latex gloves. Contact Dermatitis 46:65–71PubMed Brehler R, Rütter A, Kütting B (2002) Allergenicity of natural rubber latex gloves. Contact Dermatitis 46:65–71PubMed
Zurück zum Zitat Bundesministerium für Arbeit und Gesundheit [Ministry of Labour and Health] (1997) Technische Regeln für Gefahrstoffe, TRGS 540, Sensibilisierende Stoffe [Technical guidelines for hazardous substances, TRGS 540, sensitizing substances]. Bundesministerium für Wirtschaft und Arbeit [Ministry of Economics and Labour], Bonn, Germany Bundesarbeitsblatt 12:58-63. ISSN 007-5868. http://www.baua.de/prax/ags/trgs540.pdf:4 Bundesministerium für Arbeit und Gesundheit [Ministry of Labour and Health] (1997) Technische Regeln für Gefahrstoffe, TRGS 540, Sensibilisierende Stoffe [Technical guidelines for hazardous substances, TRGS 540, sensitizing substances]. Bundesministerium für Wirtschaft und Arbeit [Ministry of Economics and Labour], Bonn, Germany Bundesarbeitsblatt 12:58-63. ISSN 007-5868. http://​www.​baua.​de/​prax/​ags/​trgs540.​pdf:​4
Zurück zum Zitat Bundesverband Medizinprodukte e.V. [German Medical Technology Association] (1998) Verbrauch von gepuderten Latexhandschuhen [Consumption of powdered latex gloves]. Umwelt und Medizintechnik [Consumer Protection/Technical Issues], Berlin, Germany Bundesverband Medizinprodukte e.V. [German Medical Technology Association] (1998) Verbrauch von gepuderten Latexhandschuhen [Consumption of powdered latex gloves]. Umwelt und Medizintechnik [Consumer Protection/Technical Issues], Berlin, Germany
Zurück zum Zitat Charous B, Blanco C, Tarlo S, et al. (2002) Natural rubber latex allergy after twelve years: recommendations and perspectives. J Allergy Clin Immunol 109:31–34PubMed Charous B, Blanco C, Tarlo S, et al. (2002) Natural rubber latex allergy after twelve years: recommendations and perspectives. J Allergy Clin Immunol 109:31–34PubMed
Zurück zum Zitat Chen Z, Cremer P, Baur X (1997) Latex allergy correlates with operation. Allergy 2:873 Chen Z, Cremer P, Baur X (1997) Latex allergy correlates with operation. Allergy 2:873
Zurück zum Zitat Food and Drug Administration (1999) Medical glove guidance manual. US Department of Health and Human Services, Rockville, MD Food and Drug Administration (1999) Medical glove guidance manual. US Department of Health and Human Services, Rockville, MD
Zurück zum Zitat Fuchs Th (1995) Gummi und Allergie [Rubber and allergy]. Dustri-Verlag Dr. Karl Feistle, Munich-Deisenhofen, Germany, ISBN 3-87185-244-9 Fuchs Th (1995) Gummi und Allergie [Rubber and allergy]. Dustri-Verlag Dr. Karl Feistle, Munich-Deisenhofen, Germany, ISBN 3-87185-244-9
Zurück zum Zitat Gautrin D, Ghezzo H, Infante-Rivard C, Malo J-L (2000) Incidence and determinants of IgE-mediated sensitisation in apprentices. A prospective study. Am J Resp Crit Care Med 162:1222–1228PubMed Gautrin D, Ghezzo H, Infante-Rivard C, Malo J-L (2000) Incidence and determinants of IgE-mediated sensitisation in apprentices. A prospective study. Am J Resp Crit Care Med 162:1222–1228PubMed
Zurück zum Zitat Hammer AL, Paulsen PR (1997) Latex allergy: implementation of an agency program. Gastroenterology Nurs 20:156–161 Hammer AL, Paulsen PR (1997) Latex allergy: implementation of an agency program. Gastroenterology Nurs 20:156–161
Zurück zum Zitat Heilman DK, Jones RT, Swanson MC, Yunginger JW (1996) A prospective, controlled study showing that rubber gloves are the major contributor to latex aeroallergen levels in the operating room. J Allergy Clin Immunol 98:325–330PubMed Heilman DK, Jones RT, Swanson MC, Yunginger JW (1996) A prospective, controlled study showing that rubber gloves are the major contributor to latex aeroallergen levels in the operating room. J Allergy Clin Immunol 98:325–330PubMed
Zurück zum Zitat Hunt LW, Boone-Orke JL, Fransway AF, et al. (1996) A medical-center-wide, multidisciplinary approach to the problem of natural rubber latex allergy. J Occup Environ Med 38:765–770PubMed Hunt LW, Boone-Orke JL, Fransway AF, et al. (1996) A medical-center-wide, multidisciplinary approach to the problem of natural rubber latex allergy. J Occup Environ Med 38:765–770PubMed
Zurück zum Zitat Jäger D, Kleinhans D, Czuppon AB, Baur X (1992) Latex-specific proteins causing immediate-type cutaneous, nasal, bronchial, and systemic reactions. J Allergy Clin Immunol 89:759–768PubMed Jäger D, Kleinhans D, Czuppon AB, Baur X (1992) Latex-specific proteins causing immediate-type cutaneous, nasal, bronchial, and systemic reactions. J Allergy Clin Immunol 89:759–768PubMed
Zurück zum Zitat Konrad C, Fieber T, Gerber H, Schuepfer G, Muellner G (1997) The prevalence of latex sensitivity among anesthesiolgy staff. Anesth Analg 84:629–633PubMed Konrad C, Fieber T, Gerber H, Schuepfer G, Muellner G (1997) The prevalence of latex sensitivity among anesthesiolgy staff. Anesth Analg 84:629–633PubMed
Zurück zum Zitat Lagier F, Vervloet D, Lhermet I, Poyen D, Charpin D (1992) Prevalence of latex allergy in operating room nurses. J Allergy Clin Immunol 90:319–322PubMed Lagier F, Vervloet D, Lhermet I, Poyen D, Charpin D (1992) Prevalence of latex allergy in operating room nurses. J Allergy Clin Immunol 90:319–322PubMed
Zurück zum Zitat Leung R, Ho A, Chan J, Choy D, Lai C (1996) Prevalence of latex allergy in hospital staff in Hong Kong. Clin Exp Allergy 27:167–174 Leung R, Ho A, Chan J, Choy D, Lai C (1996) Prevalence of latex allergy in hospital staff in Hong Kong. Clin Exp Allergy 27:167–174
Zurück zum Zitat Levy D, Allouache S, Chabane MH, Leynadier F, Burney P (1999) Powder-free protein-poor natural rubber latex gloves and latex sensitisation. J Am Med Assoc 281:988 Levy D, Allouache S, Chabane MH, Leynadier F, Burney P (1999) Powder-free protein-poor natural rubber latex gloves and latex sensitisation. J Am Med Assoc 281:988
Zurück zum Zitat Liss GM, Tarlo SM (2000) Natural rubber latex-related occupational asthma: association with interventions and glove changes over time. Am J Ind Med 40:347–353 Liss GM, Tarlo SM (2000) Natural rubber latex-related occupational asthma: association with interventions and glove changes over time. Am J Ind Med 40:347–353
Zurück zum Zitat Liss G, Sussman G, Deal K, Brown S, Cividino M, Siu S, et al. (1997) Latex allergy: epidemiologic study of 1351 hospital workers. Occup Environ Med 54:335–342PubMed Liss G, Sussman G, Deal K, Brown S, Cividino M, Siu S, et al. (1997) Latex allergy: epidemiologic study of 1351 hospital workers. Occup Environ Med 54:335–342PubMed
Zurück zum Zitat Mace S, Sussman G, Liss G, et al. (1998) Latex allergy in operating room nurses. Ann Allergy Asthma Immunol 80:252–256PubMed Mace S, Sussman G, Liss G, et al. (1998) Latex allergy in operating room nurses. Ann Allergy Asthma Immunol 80:252–256PubMed
Zurück zum Zitat Mahler V, Fischer S, Fuchs T, Ghannadan M, valent P, Fartasch M, Kraft D, Schuler G, Valenta R (2000) Prevention of allergy by selection of low-allergen gloves. Clin Exp Allergy 20:509–520 Mahler V, Fischer S, Fuchs T, Ghannadan M, valent P, Fartasch M, Kraft D, Schuler G, Valenta R (2000) Prevention of allergy by selection of low-allergen gloves. Clin Exp Allergy 20:509–520
Zurück zum Zitat Nolte B (1997) Vermeidung beruflich bedingter Naturlatexallergien [Avoidance of occupational natural rubber latex allergy]. Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege [Institution for Statutory Accident Insurance for Non-Public Healthcare and Welfare Providers in Germany], Hamburg, Germany Nolte B (1997) Vermeidung beruflich bedingter Naturlatexallergien [Avoidance of occupational natural rubber latex allergy]. Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege [Institution for Statutory Accident Insurance for Non-Public Healthcare and Welfare Providers in Germany], Hamburg, Germany
Zurück zum Zitat Phillips ML, Meagher CC, Johnson DL (2001) What is “powder free”? Characterisation of powder aerosol produced during simulated use of powdered and powder free latex gloves. Occup Environ Med 58:479–481PubMed Phillips ML, Meagher CC, Johnson DL (2001) What is “powder free”? Characterisation of powder aerosol produced during simulated use of powdered and powder free latex gloves. Occup Environ Med 58:479–481PubMed
Zurück zum Zitat Swanson MC, Bubak ME, Hunt LW, Yunginger JW, Warner MA, Reed CE (1994) Quantification of occupational latex aeroallergens in a medical center. J Allergy Clin Immunol 94:445–451PubMed Swanson MC, Bubak ME, Hunt LW, Yunginger JW, Warner MA, Reed CE (1994) Quantification of occupational latex aeroallergens in a medical center. J Allergy Clin Immunol 94:445–451PubMed
Zurück zum Zitat Tarlo SM, Wong L, Roos J, Booth N (1990) Occupational asthma caused by latex in a surgical glove manufacturing plant. J Allergy Clin Immunol 85:626–631PubMed Tarlo SM, Wong L, Roos J, Booth N (1990) Occupational asthma caused by latex in a surgical glove manufacturing plant. J Allergy Clin Immunol 85:626–631PubMed
Zurück zum Zitat Tarlo SM, Sussman GL, Contala A, Swanson MC (1994) Control of airborne latex by use of powder-free gloves. J Allergy Clin Immunol 93:985–989PubMed Tarlo SM, Sussman GL, Contala A, Swanson MC (1994) Control of airborne latex by use of powder-free gloves. J Allergy Clin Immunol 93:985–989PubMed
Zurück zum Zitat Tarlo SM, Sussman GL, Holness DL (1997) Latex sensitivity in dental students and staff: a cross-sectional study. J Allergy Clin Immunol 99:396–401PubMed Tarlo SM, Sussman GL, Holness DL (1997) Latex sensitivity in dental students and staff: a cross-sectional study. J Allergy Clin Immunol 99:396–401PubMed
Zurück zum Zitat Tarlo SM, Easty A, Eubanks K, et al. (2001) Outcomes of a natural rubber latex control program in an Ontario teaching hospital. J Allergy Clin Immunol 108:628–633PubMed Tarlo SM, Easty A, Eubanks K, et al. (2001) Outcomes of a natural rubber latex control program in an Ontario teaching hospital. J Allergy Clin Immunol 108:628–633PubMed
Zurück zum Zitat Tomazic VJ, Shampaine EL, Lamanna A, Withrow TJ (1994) Cornstarch powder on latex products is an allergen carrier. J Allergy Clin Immunol 93:751–758 Tomazic VJ, Shampaine EL, Lamanna A, Withrow TJ (1994) Cornstarch powder on latex products is an allergen carrier. J Allergy Clin Immunol 93:751–758
Zurück zum Zitat Turjanmaa K (1987) Incidence of immediate allergy to latex gloves in hospital personnel. Contact Dermatitis 17:270–275PubMed Turjanmaa K (1987) Incidence of immediate allergy to latex gloves in hospital personnel. Contact Dermatitis 17:270–275PubMed
Zurück zum Zitat Turjanmaa K, Reunala T, Alenius H, Brummer-Korvenkontio H, Palosuo T (1990) Allergens in latex surgical gloves and glove powder. Lancet 336:1588 Turjanmaa K, Reunala T, Alenius H, Brummer-Korvenkontio H, Palosuo T (1990) Allergens in latex surgical gloves and glove powder. Lancet 336:1588
Zurück zum Zitat Turjanmaa K, Kanto M, Kautiainen H, Reunala T, Palosuo T (2002) Long-term outcome of 160 adult patients with natural rubber latex allergy. J Allergy Clin Immunol 110:S70–S74PubMed Turjanmaa K, Kanto M, Kautiainen H, Reunala T, Palosuo T (2002) Long-term outcome of 160 adult patients with natural rubber latex allergy. J Allergy Clin Immunol 110:S70–S74PubMed
Zurück zum Zitat Vandenplas O, Delwiche JP, Evrard G, et al. (1995) Prevalence of occupational asthma due to latex among hospital personnel. Am J Respir Crit Care 151:54–60 Vandenplas O, Delwiche JP, Evrard G, et al. (1995) Prevalence of occupational asthma due to latex among hospital personnel. Am J Respir Crit Care 151:54–60
Zurück zum Zitat van der Meeren HLM, van Erp PEJ (1986) Life-threatening urticaria from glove powder. Contact Dermatitis 14:190–191PubMed van der Meeren HLM, van Erp PEJ (1986) Life-threatening urticaria from glove powder. Contact Dermatitis 14:190–191PubMed
Metadaten
Titel
Effectiveness of a nationwide interdisciplinary preventive programme for latex allergy
verfasst von
Ute Latza
Frank Haamann
Xaver Baur
Publikationsdatum
01.06.2005
Erschienen in
International Archives of Occupational and Environmental Health / Ausgabe 5/2005
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-004-0594-2

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