Allergenicity of latex rubber products used in South African dental schools

Background: Allergens from latex products in healthcare settings have been known to trigger latex induced allergic reactions in healthcare workers (HCWs). There is a need to quantify individual latex allergens in products in order to assess the allergenicity of latex products used in health care settings, so as to minimize the risk of sensitisation to these proteins. Methods: Fourteen latex examination gloves representing six brands (powdered and non-powdered) and five dental rubber dams from five dental academic institutions were analysed for latex allergens and total protein. Total protein content was determined using the BIORAD DC protein assay kit and natural rubber allergen levels using a capture ELISA assay specific for hev b 1, hev b 3, hev b 5 and hev b 6.02. Results: Hev b 6.02 was found in higher concentrations than other NRL allergens in the products analysed. Hev b 5 content ranged from 0 to 9.2µg/g and hev b 6.02 from 0.09 to 61.5µg/g of sample. Hev b 1 levels were below the detection limit (DL) for 79% of the samples (15/19). Dental dams showed higher allergen levels (median: 80.91µg/g) in comparison to latex gloves (median: 11.34µg/g). Powdered rubber samples also showed higher allergen levels (median: 40.54µg/g) compared to non-powdered samples (median: 5.31µg/g). A statistically significant correlation was observed between total protein and total allergen (r=0.74, p<0.001) concentrations. Conclusion Natural rubber latex (NRL) allergen concentrations differ significantly by product and brand. This study has demonstrated that NRL allergens in latex containing products used in South African dental institutions are present at sufficiently high levels to pose an allergic health risk.