Living with Latex
Hundreds of nurses and health care workers are unable to set foot in the clinics and hospitals where they once worked because of a life-threatening allergy.
By Lisa Legge
When her toddler broke his leg this spring, Julibeth Petter did what most nurses who are parents would do: She assessed his leg, elevated and iced it, then called her urgent care clinic to say she was on the way.
But next — as 2-year-old Joshua screamed in pain — she ran to her medicine cabinet, swallowed several antihistamines and grabbed her emergency traveling kit, complete with a particulate filter mask and epinephrine. Meanwhile, the urgent care staff prepared a room not just for Joshua, but for Petter as well, knowing of her severe latex allergy.
“I wanted to risk my life to be there for my 2-year-old,” says Petter, RN. “I did fine, but for subsequent visits, I had to drop him off at the front door.” Nursing staff or her husband took him from there.
Petter is one of hundreds of nurses and other health care workers unable to set foot in the clinics and hospitals where they once worked because of the prevalence of natural rubber latex. Through prolonged exposure to the substance, allergists say, their bodies develop allergic reactions ranging from skin rashes and rhinitis to the rare cases of anaphylactic shock and death. The National Institute of Occupational Safety and Health (NIOSH) estimates that 8 percent to 12 percent of health care workers in the U.S. is allergic to natural rubber latex.
Across the country, hospitals and clinics are beginning to use gloves of alternative materials or specially treated latex, thanks in part to activists like Petter.
She is a member of ELASTIC — or Education for Latex Allergy / Support Team and Information Coalition — an organization that seeks to rein in use of the substance that can cripple careers, banish allergy sufferers from their life’s work and, for some, cause life-long disabilities.
“Nurses are really leading this cause,” says Kristi Miller, RNC, MS, CNS, a pioneer in latex-allergy safety who helped Petter start the Minnesota chapter of ELASTIC.
A latex-allergic nurse, Miller turned her expertise on the subject into a profession and serves as latex consultant for Allina Health System. She has been instrumental in educating Allina’s 17,000 employees and is helping the health system’s 12 hospitals, 62 clinics and home health department clear their air of latex particles. She also consults with nurses and other health care workers as they form latex allergy task forces elsewhere in the state.
“Appropriate” latex use includes eliminating any latex gloves containing the cornstarch powder that makes them easier to put on and take off. The powder renders latex proteins airborne, sending contaminants throughout buildings and ventilation systems. In addition, ELASTIC urges health care facilities to manage glove use more effectively. Institutions could cut their latex use simply by buying synthetic gloves for non-invasive procedures, they argue. Latex gloves with low allergen content, processed through an extra chlorination to remove more of the offending proteins, are also available.
Health care workers also need to be alert for patients who may develop latex allergies — those with spina bifida, other allergies or a history of prolonged latex exposure, either through frequent surgeries or their work. Miller urges health care systems to formulate policies and protocols for latex allergic patients and employees.
ELASTIC activists also want other businesses to manage their latex use for the safety of workers and consumers. Restaurants, daycare facilities and hair salons, for example, don’t need such barrier protection and should use gloves of vinyl and other synthetic materials, they say.
Making clinics latex safe
Miller believes education is key to changing. At United, physician speakers she brought from Mayo Clinic — which is now latex safe for patients and continues to employ about 150 people with latex allergies — led Allina to hire her to implement a latex strategy system-wide.
“United took a very positive, proactive stance with me,” Miller said.
Petter, who has filed a lawsuit against several manufacturers of the gloves she wore as an ICU nurse, believes bottom line issues are forcing a change in the latex industry. “The glove companies are figuring out that it’s a big problem and they’re trying to change their product to accommodate it,” she said. “They’ll wise up because of the litigation, the FDA complaints, the workers’ compensation issues, the death issues.”
The Food and Drug Administration may require mandatory labeling of latex elastic in clothing and other products, with a warning about allergic reaction, Petter says. The agency is collecting data on the problem, inviting those with natural-latex allergic reactions to report those on its MedWatch line.
ELASTIC is also in touch with buyers in health care organizations, discussing ways to make their facilities safe.
Once a building is rid of all latex particles, health care workers just need to follow a simple rule, Petter says. “If a latex allergic individual doesn’t inhale it, wear it, eat it, or insert in through a mucous membrane, latex should not be a problem,” she said.
“That’s why people who are latex sensitive continue to work in a latex-safe environment,” she says. “Because there’s a minimal possibility of airborne problems. If they’re going to insert, say, a urinary catheter made from latex material into a patient, they would use common sense and wear vinyl gloves as they do so.”
A Limited Life
The inhalation problem is a big one for Petter. Late last month, she visited her legislator to discuss the latex issue. But workers at the Capitol office building were ripping up carpet, sending off particles debilitating to Petter. She was ill for several days and did her business with the legislator over the telephone.
Because of Petter’s allergy — and the pervasiveness of latex in our everyday lives — her life is severely limited, she says. She can no longer attend her children’s events at school or drop in at a restaurant with her family. Balloons, toys, elastic in clothing and — more insidiously — gloves worn by food preparation workers keep her constantly on the alert. She has to be well prepared when leaving her Plymouth home.
“My little 5-year-old is on a balloon watch all the time,” says Petter, who knows of only a handful of restaurants where workers don’t use latex gloves.
Petter’s symptoms began innocently enough. Like others who developed allergies to natural rubber latex, she had a ragweed allergy. After about three years of heavy latex glove use, she noticed a rash on her hands that disappeared after a few days off work. She began using powder-free, non-latex gloves at work and took antihistamines before her shifts began. But when she noticed the rhinitis occurring away from work — for example, near a balloon bouquet — her supervisor noted the allergy possibility and told her not to return to work until seeing an allergist. Ten days later, the positive diagnosis forced Petter, who was 33 at the time, to stay home and receive workers’ compensation.
Petter sought to have her employer, a large Twin Cities hospital, change the types of gloves it uses and clear the air of latex powder. Several facilities had done so already: Mayo, Rice Memorial Hospital in Willmar, Cambridge Medical Center and United and Gillette Children’s hospitals in the Twin Cities among them. She has enlisted the help of the Equal Employment Opportunity Commission to get her job back. In the meantime, Petter works from home for a Twin Cities health care organization, calling patients to follow up after procedures and medication changes.
Miller’s symptoms are less severe, but the allergy still affects her job. After corporate restructuring left her unemployed, Miller — a newly minted clinical nurse specialist — was unable to find another work site she could tolerate. Instead, she wrote a proposal for her current position, and won an 18-month appointment. She conducts information sessions via telemedicine lines with facilities not yet safe for latex-allergic people.
For Petter, ELASTIC brought much-needed information about her condition, but also a network of others coping daily with the effects of latex sensitivity. She carries the hope that — in a safe environment — she could resume the job and life she loved.
“My hope is that one day, I’ll be able to work in a job as satisfying as my job in PACU and ICU,” she says. “My hope is that my coworkers won’t come down with this. My hope is to be able to walk in with my children as they get their needed health care. And my hope is that my husband and I will be able to live what we consider a full life.”
“[Life] is not going to be the same,” she says. “Everything requires an incredible amount of planning every time I walk out this door. And there are no guarantees when I do.”
[photo caption: Julibeth Petter, RN, wants her nursing colleagues to be aware they’re at risk of developing a sensitization to latex. She also wants those who are allergic to latex to know: “You are not alone.”]
Reprinted with permission from Nursing Minnesota. Send comments or subscription requests to: or Nursing Minnesota, PO Box 3802, Minneapolis MN 55403-0802.