A Move To Banish Latex Products

June 28, 2000

BOSTON (Boston Globe) — Josephine Pandolfo's illness began three years ago
as a slight rash on her hands, accompanied by chronic sinus headaches. But
it progressively got worse.

There were days when Pandolfo, a dentist, had difficulty breathing. Her
tongue would swell and she couldn't swallow. Then, she almost lost her
life after going into anaphylactic shock, an often fatal allergic
reaction, at Brigham and Women's Hospital in Boston.

Finally, a test confirmed it: Pandolfo had developed a severe reaction to
latex, the rubber that is found in everyday products from surgical gloves
to baby's pacifiers.

Pandolfo is one of an estimated 18 million Americans, or 6 percent of the
population, who have latex sensitivity. The allergy has been responsible
for at least 21 deaths nationwide since 1989, 16 as the result of an
allergy to the latex in barium enema tips, a product no longer on the
market.

Now, in one of the strongest moves ever taken against latex in New
England, Rhode Island Attorney General Sheldon Whitehouse is calling on
hospitals, restaurants and manufacturers to discontinue using latex
gloves. He has written a resolution recommending that the state health
department regulate the use of latex in the health-care, food-service and
day-care industries.

"I think the big message is to get the word out," Whitehouse said.
"Particularly in the food-service and day-care industries, there is no
need for the (latex) products. It's a little difficult in health care
where the alternatives have to meet the standards of latex gloves."

Whitehouse has met with Allegiance Healthcare Corp., a latex gloves
manufacturer, to encourage them to provide more non-latex products and
bring awareness about the allergy to the general population.

"It's a particularly difficult allergy because it's so hard (for
consumers) to find out if latex is in a product or not," he said.
"Therefore, the risk of exposure to latex is very high. You don't really
know if you are going to be exposed."

The natural, milky substance, made from the rubber tree Hevea
brasiliensis, is used in 40,000 products, including items such as
balloons, diaphragms, condoms, and even mouse pads. Of these 40,000
latex-containing products, 300 are medical items.

Ironically, the federal government greatly increased the use of latex in
1987, when new regulations required all health care workers to wear latex
gloves to prevent the spread of the HIV-virus. That year, Americans used 2
billion pairs of gloves for medical purposes. Today, the number is
estimated to be around 20 billion.

Along with the increase in latex use, the number of people with an allergy
to the natural rubber has dramatically risen. The Food and Drug
Administration reports that between January 1985 and March 1999, there
were five deaths from allergies to latex gloves and 2,330 allergic
reactions.

"Unfortunately, we see a significant increase (of allergic reactions)
because of the increased use of latex gloves," said Jim Brady, a
disability lawyer. Brady has represented more nurses with latex allergies
than any other lawyer in New England. "I think, among many people, there's
no awareness of the problem with latex gloves."

An allergic response generally triggers a poison-ivy-like rash 12 to 36
hours after contact. While this is not life-threatening, some people may
have a reaction to the latex protein itself. A full-blown allergic
response often affects the skin and other organs, producing hives,
swelling, asthma and, in extreme cases, anaphylactic shock.

Pandolfo has had reactions to food prepared by people wearing latex
gloves, latex powder residue left on a table at the doctor's office, and,
once, to a water glass that was handled by a girl wearing the gloves.

"I don't go out to eat anywhere unless I've talked to the chef first,"
Pandolfo said. "This is life-threatening."

When she travels, she telephones the hotel ahead of time to talk with the
chef. She brings her own food on an airplane. And she only uses
self-adhesive stamps.

"I can't lick a stamp. I can't lick an envelope," she said. "(Latex) is
out there everywhere, and you can just die."

Among the people who are most at risk are health-care workers. The
American Academy of Family Physicians estimates that between 10 and 17
percent of these workers, which include nurses, dentists and surgeons, are
at risk for latex reactions. Children with spina bifida, a disabling birth
defect, people exposed to products containing latex, and those who have
hay fever or other allergies are also at risk.

While many hospitals have voluntarily changed to non-latex products, some
health care facilities have been reluctant to discontinue its use. A
majority of restaurants, day-care centers and beauty salons continue to
use latex, unaware that they are messing with a deadly allergen.

"For the places that haven't changed over, education hasn't gotten out to
the degree that it needs to," said Gail Lenehen, editor for the Journal of
the Emergency Nurses Association. Lenehen went into anaphlyactic shock
three years ago while working in the emergency room of Massachusetts
General Hospital in Boston. "They haven't reached the average nurse,
physician or hairstylist."

In 1997, the National Institute of Occupational Safety and Health
recommended that non-latex gloves be used for all activities that are not
likely to involve contact with infectious materials, such as food
preparation, routine housekeeping and maintenance. That same year, the
Food and Drug Administration established rules for labeling all medical
devices that contain latex.

But still, said Whitehouse, who has been working on this campaign since
January 1999, progress is slow. While some Rhode Island restaurants have
volunteered to change to non-latex on their own, many are still using the
allergenic material.

While there are a number of non-latex products available, including gloves
made of vinyl or polyvinyl chloride, nitrile or other synthetics, many
hospitals are slow to change because of the additional cost.

"It's money," Brady said. "The vinyl gloves are not as cheap as latex
gloves. The latex gloves are very accessible, very easy."

Brady said, however, that the health-care industry is under the false
impression that latex gloves are always less expensive. He said a growing
number of non-latex gloves are just as good and priced competitively with
latex.

"The pro-active actions that need to be taken, which are to eliminate
latex gloves, are very doable, but there is tremendous reluctance at the
facilities," said Evelyn Bain, associate director of occupational safety
and health for the Massachusetts Nurses Association. "It doesn't make
sense not to do it."

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