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About Latex Allergy
Latex allergy is a reaction to proteins present in latex derived from natural rubber latex (NRL), which is created from a variety of plants, but mainly the rubber tree, hevea brasiliensis). Latex allergy can result from repeated exposures to proteins in NRL through skin contact or inhalation. Reactions usually begin within minutes of exposure to latex, but they can occur hours later and can produce various symptoms. These include skin rash and inflammation, respiratory irritation, asthma, and in rare cases shock. In some instances, sensitized employees have experienced reactions so severe that they impeded the worker’s ability to continue working in specific jobs.
People at increased risk for developing latex allergy include workers with ongoing latex exposure, persons with a tendency to have multiple allergic conditions, and persons with spina bifida. Latex allergy is also associated with allergies to certain foods such as avocados, potatoes, bananas, tomatoes, chestnuts, kiwi fruit, and papaya. Workers who use gloves less frequently, such as law enforcement personnel, ambulance attendants, fire fighters, food service employees, painters, gardeners, housekeeping personnel outside the health-care industry, and funeral home employees, also may develop latex allergy. Workers in factories where NRL products are manufactured or used also may be affected.
Latex Allergy and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Latex Allergy
People with latex allergies may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with latex allergies will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available, and numerous other accommodation solutions may exist:
- Discontinue the use of latex gloves. Purchase alternative glove products such as vinyl or nitrile. The feasibility of using alternatives will likely depend upon the infection control needed to perform job tasks.
- If latex gloves must be used, switch to non-powdered latex with reduced protein content. Provide all employees within the individual's working environment with non-powdered gloves as well. If other employees continue to wear powdered latex gloves, the latex proteins can become airborne and create the potential for an allergic reaction.
- If powdered latex gloves are used, thoroughly clean the environment to remove powder residue from walls, equipment and HVAC vents.
- Implement a latex-safe department, clinic or facility. Eliminate the use of latex gloves and, when possible, switch to non-latex medical supplies. If the entire facility cannot be latex-safe, safeguard specific locations by creating latex-safe zones.
- Place the individual in the least latex-intensive environment possible.
- If the individual cannot be accommodated in the original position because of the need to eliminate exposure to latex, investigate reassignment as an accommodation. When possible, place the individual in a position that continues to take advantage of the employee’s clinical or technical skills. For example, if a nurse can no longer perform duties involving direct patient care, consider positions that still require nursing skills. Opportunities may exist in case management, occupational health nursing, health hotlines, poison control, the insurance industry, medical mal-practice or teaching.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
An office worker with latex allergy had to take rubber bands off bundles of papers and was having a reaction to the latex in the bands.
The employer switched to non-latex bands.
A registered nurse with latex allergies was having difficulty wearing latex gloves.
The employer provided her with non-latex gloves and started using non-powdered latex gloves for other staff to reduce the amount of latex in the environment.
A nurse aide with latex allergy was reassigned to an area of the hospital where few latex products were used, but the aide was still having problems with latex exposure.
The employer realized that the latex was being carried through the ventilation system so the employer worked with a heating, ventilation, and air-conditioning (HVAC) specialist to prevent the circulation of latex in the employee’s work area.
An emergency room nurse with a latex allergy needed reassigned.
She was reassigned to a nurse-consultant job that did not involve direct patient care or direct contact with latex products.
A chef could no longer wear latex gloves due to an allergy that developed from shingles on her arm.
He was accommodated with latex-free gloves.