Latex Allergy and Sensitivity Management Policy

1. Policy Statement

It is the policy of this organization to minimize latex exposure throughout the care environment and to provide latex-sensitive and latex-allergic clinicians and patients with personal protective equipment, patient care equipment, and supplies manufactured without natural rubber latex. Latex-free alternatives shall be used consistently during care of all individuals with identified or suspected latex allergy or sensitivity. All staff shall be educated to recognize, document, and respond appropriately to latex sensitivity versus latex allergy presentations.

2. Purpose

This policy exists to:

• Protect patients and healthcare workers from preventable latex exposure, sensitization, and allergic reactions.
• Establish a systematic process for identifying, screening, and documenting at-risk individuals before they experience a latex reaction.
• Define the clinical distinction between latex sensitivity (type IV) and latex allergy (type I IgE-mediated) and the appropriate response to each.
• Eliminate or minimize latex-containing products from patient care environments where at-risk individuals are treated.
• Ensure emergency preparedness for anaphylactic reactions in latex-allergic patients and staff.

3. Scope

This policy applies to:

• All clinical personnel who provide direct patient care or who handle patient care equipment and supplies.
• All patients receiving care within the organization, with heightened requirements for at-risk populations.
• Supply Chain, Pharmacy, Infection Prevention, and Biomedical Engineering insofar as they procure, stock, or manage products that may contain latex.
• All care settings within the organization, including inpatient units, emergency departments, perioperative areas, ambulatory infusion centers, home health, and affiliated outpatient facilities.

4. Policy Requirements

4.1 Core Principles

4.1.1 The organization shall minimize latex exposure in the environment and provide latex-free patient care equipment and supplies to all latex-sensitive or latex-allergic clinicians and patients.

4.1.2 Latex-free alternatives shall be used consistently during patient care to prevent sensitization in previously unexposed individuals and to prevent reactions in already-sensitized individuals.

4.1.3 Non-powdered, non-latex gloves shall be used as standard practice across the organization. The organization shall not stock powdered latex gloves. The U.S. Food and Drug Administration has banned powdered surgeon’s gloves, powdered patient examination gloves, and absorbable powder for lubricating surgeon’s gloves; this organizational policy reflects that regulatory standard.

4.2 Identification of At-Risk Individuals

4.2.1 Healthcare Workers. The organization shall implement a process to screen and identify healthcare workers with latex allergy or sensitivity. Exposure to latex gloves is the most common cause of latex allergy in healthcare workers. Identified healthcare workers shall be provided with latex-free personal protective equipment and shall be accommodated in environments that minimize latex exposure.

4.2.2 At-Risk Patient Populations. All patients shall be assessed for latex allergy or sensitivity risk at or before the time of care. High-risk patient populations include:

• Children with birth defects, neurologic disorders, or genitourinary disorders.
• Patients with conditions requiring multiple surgical procedures or indwelling urinary catheters, particularly those with myelomeningocele (spina bifida). Patients with myelomeningocele who have undergone more than five surgical procedures are at particularly elevated risk.
• Patients with a history of atopy (allergic rhinitis, asthma, eczema).
• Patients with known allergies to tropical fruits and vegetables including avocado, banana, chestnut, kiwi, and tomato, which contain proteins with allergenic cross-reactivity to latex. Approximately 50% of patients with latex allergies will have reactions to one or more cross-reactive foods.

4.3 Documentation and Communication

4.3.1 Positive screens for latex sensitivity or allergy shall be documented prominently in the patient’s health record in a location accessible to all healthcare providers involved in care. Documentation shall be completed at the time of identification and shall not be deferred.

4.3.2 All healthcare providers involved in the patient’s care shall incorporate latex allergy precautions into the care plan before any interaction involving equipment or supplies that could contain latex.

4.3.3 Latex allergy alerts shall be communicated verbally at every care transition handoff and shall be visible in the EHR in a manner that generates appropriate alerts when latex-containing products are ordered or documented.

4.4 Clinical Recognition and Response

4.4.1 Latex Sensitivity (Allergic Contact Dermatitis — Type IV Reaction). Latex sensitivity is a delayed T cell-mediated reaction to chemicals used in latex manufacturing. Clinical presentation includes: acute eczema-like skin rash, vesicles, pruritus, erythema, or hives. Reaction typically occurs hours after contact, not immediately. With continued latex exposure, sensitivity can progress to latex allergy. Prevention of ongoing exposure is critical for sensitized individuals.

4.4.2 Latex Allergy (Type I IgE-Mediated Hypersensitivity). Latex allergy is an immediate IgE-mediated reaction occurring within minutes of latex exposure. Reactions range from mild presentations (urticaria, rhinoconjunctivitis) to severe manifestations including bronchospasm, hypotension, and anaphylaxis. The rapid onset and potential severity of type I reactions require immediate recognition and treatment. Clinical staff shall be educated to distinguish type I from type IV reactions and to initiate appropriate treatment for each.

4.4.3 Sublingual Immunotherapy. Evidence demonstrates that sublingual immunotherapy has been effective in decreasing the severity of reactions in sensitized individuals. Clinicians should be aware of this treatment option for patients with established latex allergy and should refer to appropriate specialist care.

4.5 Exposure Routes and Prevention

4.5.1 Healthcare workers shall recognize all potential routes of latex exposure:

• Direct skin contact with latex products.
• Airborne exposure (largely reduced with the use of powder-free gloves, as powder particles carry latex proteins into the air).
• Mucous membrane contact during invasive procedures.
• Food or medication contamination from medical devices and medication vials with latex stoppers.

4.5.2 Glove Selection. Non-powdered, non-latex gloves shall be used as the organizational standard. Powder-free latex and synthetic gloves shall be selected over powdered alternatives when latex-free alternatives are unavailable for a specific clinical application.

4.5.3 Environmental Management. Latex-containing products shall be removed from the patient care setting when treating latex-allergic or latex-sensitive patients. Staff shall review labels on medical devices, equipment, and supplies for latex content prior to use. FDA regulations require that latex be disclosed in product labeling.

4.5.4 Medication Vial Management. Healthcare workers shall access medication vials with latex stoppers only once to minimize latex particle introduction into medications. Most multidose vials no longer contain latex, but verification remains important. CDC guidelines list vaccines indicating presence or absence of latex in packaging.

4.5.5 Patient Education. Patients with latex allergy or sensitivity shall receive comprehensive education about avoiding latex exposure in healthcare settings and in daily life. This includes information about latex-containing household items such as balloons, condoms, adhesives, gloves, baby bottle nipples and pacifiers, and toys. Patients shall be directed to available lists of latex-containing products.

4.6 Organizational Planning

4.6.1 The organization shall consider involving allergists in the formation of interprofessional procurement committees to ensure product selection decisions incorporate allergy expertise and support latex-free care delivery across all settings.

4.6.2 Supply Chain shall maintain an approved list of latex-free products for each product category used in patient care and shall update this list whenever formulary changes occur.

4.7 Emergency Preparedness

4.7.1 Patients and clinicians with latex allergy shall be educated to recognize signs and symptoms of anaphylaxis and shall be instructed to wear medical alert bracelets or necklaces identifying their latex allergy.

4.7.2 All healthcare providers and, when applicable, caregivers (including teachers and babysitters for pediatric patients) shall be informed about the individual’s latex allergy and emergency response plan.

4.7.3 Epinephrine Auto-Injectors. Latex-allergic individuals shall carry two epinephrine auto-injectors, as approximately 20% of patients will require a second dose during anaphylactic reactions. Comprehensive education on proper use of epinephrine auto-injectors shall be provided and documented.

4.7.4 Anaphylaxis Response. Anaphylaxis protocols shall be readily accessible in all areas where latex-allergic patients receive care. Staff shall be trained to initiate anaphylaxis treatment immediately upon recognition of a severe reaction, including administration of epinephrine, activation of the emergency response system, and positioning and supportive care.

5. Compliance

5.1 Monitoring. Compliance shall be monitored through: tracking of latex allergy documentation completion rates at admission and care transitions, review of adverse events attributable to latex exposure, annual audit of latex-free product availability across all clinical areas, and concurrent observation of latex precaution adherence during clinical rounding.

5.2 Key Performance Indicators.

• Latex allergy documentation rate for at-risk patients at admission (target: 100%).
• Zero latex-related anaphylaxis events attributable to organizational failure to implement precautions.
• Latex-free product availability compliance across all clinical areas (target: 100%).

5.3 Enforcement. Failure to implement latex precautions for an identified latex-allergic or latex-sensitive patient resulting in an adverse event shall be investigated through the root cause analysis process. Systemic failures shall be addressed through process redesign; individual failures through the progressive corrective action process.

6. Exceptions

6.1 In emergent resuscitation situations where the only immediately available equipment contains latex, clinical judgment shall govern immediate patient care. The clinical rationale for using latex-containing equipment shall be documented, and latex-free alternatives shall be obtained as quickly as possible. The incident shall be reported through the safety reporting system.

6.2 No exception shall override the obligation to communicate known latex allergy status at care transitions.

7. Related Documents

• POL-001: Foundations of Clinical Practice and Specialized Population Management
• POL-003: Evidence-Based Selection and Clinical Monitoring Standards
• POL-009: Patient Education in Infusion Therapy
• POL-011: Informed Consent for Vascular Access Procedures
• Organizational Anaphylaxis Emergency Response Protocol
• Organizational Allergy Documentation Policy
• FDA Regulation: Banned Devices — Powdered Gloves (81 FR 91722)
• CDC Epidemiology and Prevention of Vaccine-Preventable Diseases: Appendix B (Latex)

8. Revision History