By: Alex X. Martinez

Introduction

Latex, often also known as natural rubber latex, is a product derived from the rubber tree in the form of a milky fluid. Several types of synthetic rubber are also referred to as “latex,” but these do not release the proteins that cause allergic reactions.

Allergies are a condition in which the immune system reacts to substances in the environment that are normally considered harmless. Allergies can be grouped by the kind of trigger, time of year, or where symptoms appear on the body (e.g. food allergies, latex allergies, insect allergies, skin allergies, and eye allergies). The immune system controls how your body defends itself. During a latex allergy episode, your immune system identifies latex as an invader or allergen. Your immune system overreacts by producing antibodies that travel to cells that release chemicals, causing an allergic reaction. This reaction usually causes symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach, or on the skin. 

Latex allergy is a reaction to certain proteins in latex rubber. The amount of latex exposure needed to produce sensitization or an allergic reaction is unknown. Mild reactions to latex involve skin redness, rash, hives, or itching. More severe reactions may involve respiratory symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma (difficult breathing, coughing spells, and wheezing). In rare occasions shock may occur. Recently, there have been growing reports of allergic reactions to water-soluble proteins in latex products (e.g., rubber gloves, dental dams, condoms, and medical devices), particularly among medical personnel and individuals receiving medical care.

Latex allergies were first recognized in the late 1970s. Since then, this allergy has become a major health concern as an increased number of people in the workplace are affected. Health care workers exposed to latex gloves or medical products containing latex are especially at risk. Between 1988-1992, the Federal Drug Administration (FDA) received more than 1,000 reports of adverse health effects from exposure to latex, including 15 deaths due to such exposure. Between 1990 and 2000, more than half of all children with meningomyelocele (a form of spina bifida) developed an allergy to latex in childhood. Although the reason for this is unclear, the allergy seems to be more common in children who have frequent surgical procedures.

Anaphylaxis (an-a-fi-LAK-sis) is a serious, life-threatening allergic reaction. The most common anaphylactic reactions are to foods, insect stings, medications, and latex. Anaphylaxis typically affects more than one part of the body at the same time. Symptoms include: a feeling of warmth; flushing; a red, itchy rash; feelings of light-headedness; shortness of breath; throat tightness; anxiety; pain/cramps; and/or vomiting and diarrhea. In severe cases, you may experience a drop in blood pressure that results in a loss of consciousness and shock. People with anaphylaxis are treated with an injection of epinephrine and medical treatment.

Latex Allergies and Students with Disability

A person with a disability is described as someone who has a physical or intellectual disability that substantially limits one or more major life activities, or is regarded as having such impairments. Breathing, eating, working, and going to school are major life activities. Asthma and allergies are considered disabilities under the ADA (Americans with Disabilities Act) legislation, even if symptoms are controlled by medication. The ADA also affects school policies. For example, a private preschool cannot refuse to enroll children because giving medication to or adapting snacks for students with allergies requires special staff training or because insurance rates might go up. Public schools and programs cannot avoid their responsibility by claiming to have limited funds or resources.

Allergen Awareness

Awareness of allergies might be the first step to avoid allergic reactions. If you are not certain whether you have a specific allergy, you can consult an allergist. There are skin and blood tests designed to detect allergies and their respective allergens. Here are other recommendations to avoid allergies:  

• Use non-latex gloves for activities that are not likely to involve contact with infectious materials (food preparation, routine housekeeping and maintenance).
• Appropriate barrier protection is necessary when handling infectious materials. If you choose latex gloves, use powder-free gloves with reduced protein content.
• When wearing latex gloves, do not use oil-based hand creams or lotions (which can cause glove deterioration) unless they have been shown to reduce latex-related problems and maintain glove barrier protection.
• Frequently clean work areas contaminated with latex dust (upholstery, carpets and ventilation ducts).
• Frequently change the ventilation filters and vacuum bags used in latex-contaminated areas.
• Learn to recognize the symptoms of latex allergy such as skin rashes, hives, flushing, nasal or eye itching, sinus symptoms, asthma, and shock.
• If you develop symptoms of a latex allergy, avoid direct contact with latex gloves and products until you can see a physician experienced in treating latex allergy.
• If you have latex allergy, wear a medical bracelet.
• If you have latex allergy tell school staff and teachers. 
• Provided staff training about allergies and procedures.
• Establish an emergency plan and allergy protocol. 

Equipment Containing Latex

Latex is very common in household, schools, work and medical environments. If you have latex allergy, consider avoiding the following items: 

Latex in Schools

A safe school for latex sensitive children

Latex avoidance has become the accepted standard of care for children in a school system. However, safeguarding children in school from exposure to products made of natural rubber latex can be a challenge. Latex can be found in everything from classroom and janitorial supplies to gymnasium equipment. Latex can be harmful to latex-sensitive children such as those with spina bifida, cerebral palsy, asthma, eczema, or food allergies. Parents, teachers and school administrators can minimize exposure to latex by developing a school safety plan. Here are some ideas to help you develop a safety plan:

Educate School Staff about Latex Allergies

Before the start of the school year, parents should provide staff members with information about the link between disability and latex allergies. A school nurse, teacher, or counselor can help to communicate the message of latex avoidance to others on staff.

Identify Areas of Latex Exposure

Latex can be found in classroom supplies, such as erasers, rubber bands, and science lab equipment as well as in gymnasium equipment, such as rubber mats, flooring, balls, and racquet handles. Rubber gloves used by janitors to clean hallways, classrooms, or school bathrooms can leave a residue on surfaces or release latex proteins into the air. School bus tires also can release high levels of airborne latex particles especially during heavy traffic.

Develop an Emergency Plan

An emergency plan plays an important role in any school safety program. It can help save the life of a latex-sensitive student by enabling school personnel to recognize and treat latex reactions and determine the proper time to call for help.

Advocate for Social Change

Establish policies to avoid rubber balloons during graduation parties, homecoming dances, and senior proms. Thoughtful planning and minor adjustments, such as substituting mylar for latex balloons will allow students with spina bifida, cerebral palsy, or other conditions predisposed to latex allergies to attend school celebrations while being safe. Students with allergies are often subject to bullying. Making school events safe for all students helps to integrate latex-sensitive students into the student body at large and promotes greater understanding and peer acceptance of sensitized students by non-sensitized students.

Here some links where you can find and purchase sports equipment and school and office supplies that are latex-free:

• Sports equipment: http://latexallergyresources.org/consumer-products
• School/office supplies: http://latexallergyresources.org/consumer-products

Adopting “latex-free zones” in school environments is not as easy as it sounds. Commitment and communication efforts from the school community are needed in order to educate individuals about policies established within the school to avoid latex. Typically a “latex-free zone” is associated with extra spending to purchase new materials and to create informative and educational materials regarding latex allergy and policies. Students and teachers are a good resource to drive this information within the school community by creating meetings, newsletters, and newspaper articles. The Chicago Tribune covered the story of Oak Park and River Forest High School.   To remind students and to alert visitors of the policy, signs showing balloons with a slash through them were posted throughout the building. Additional information about the ban was added in the first page of the student handbook. The school also sent letters to 18 florists in the area to explain that balloons were not allowed on campus. The physical education department will spent about $1,000 more a year on synthetic silicone swim caps – $1.25 more per cap than the traditional latex caps. Although there may be some hurdles to jump when creating an environment that is inclusive for children with allergies, the inclusive benefits associated with such efforts are larger and more meaningful for the development of all students.

References:

1. American Academy of Allergy Asthma & Immunology (AAAA&I): http://www.aaaai.org/conditions-and-treatments/library/at-a-glance/allergic-reactions
2. American Latex Allergy Association (ALAA): http://latexallergyresources.org/articles/web-article-creating-safe-school-latex-sensitive-children
3. Asthma and Allergy Foundation of America:  http://www.aafa.org/display.cfm?id=9&sub= 19&cont=255
4. Centers for Disease Control and Prevention (CDC):https://www.cdc.gov/niosh/docs/97-135/pdfs/97-135.pdf https://www.cdc.gov/niosh/docs/98-113/pdfs/98-113.pdf
5. Liptak, G. S. (1997). Neural tube defects. Children with disabilities: A medical primer, 429-552.
6. MD Guidelines ™: http://www.mdguidelines.com/allergy
7. Occupational Safety and Health Administration: https://www.osha.gov/
8. Chicago Tribune: http://www.chicagotribune.com/lifestyles/health/92331695-132.html      http://articles.chicagotribune.com/2003-11 08/news/0311080049_1_balloon-elementary-disability-experts