Reference

Vandenplas O, Delwiche JP, Evrard G et al, Prevalence of occupational asthma due to latex among hospital personnel, Am J Respir Crit Care Med, 1995;151:54-60,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

A questionnaire and skin-prick tests with latex and common inhalant allergens were administered to 273 of 289 members of the target population. 13/273 subjects showed skin reactivity to latex. No subject had history suggestive of occupational asthma among those who had negative skin tests to latex. A histamine inhalation challenge was then performed on 12 of 13 latex-sensitive subjects (including 5 subjects with a history of occupational asthma). These 12 subjects demonstrated significant bronchial hyper-responsiveness. All underwent specific inhalation challenges with latex gloves and 7 subjects developed a significant bronchial response. Authors conclude that occupational asthma due to latex occurred in 2.5% of hospital employees. Widespread use of latex gloves should therefore be considered a significant risk to the respiratory health of hospital employees.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

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In the clinical setting questionnaires that identify symptoms of wheeze and/or shortness of breath which improve on days away from work or on holiday have a high sensitivity, but relatively low specificity for occupational asthma.

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A large number of concordant studies from different centres using different methodologies demonstrated that increased non-specific reactivity is often found in workers with occupational asthma. There are however many reports of normal methacholine or histamine reactivity within 24 hours of exposure in workers with confirmed occupational asthma.

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Both skin prick and serological tests are highly sensitive for detecting specific IgE and occupational asthma caused by most high molecular weight agents, but are not specific for diagnosing asthma.