The Springfield facility becomes one of the first hospitals in the nation to become “latex-safe”.

By Pat Cahill
Staff writer
Springfield Union
March 7, 1997

Pediatric nurse practitioner Ellen Meeropol of Shriners Hospital for Children in Springfield says that when she first proposed getting rid of latex at the hospital, she was “almost laughed out of the operating room.”

And no wonder. The strong, versatile material called latex is used everywhere in hospitals. Not just in gloves, which constitute the most obvious use. But also in band-aids, blood pressure cuffs, casts, crutches, enemas, stethoscopes, respirators, intravenous tubes, tourniquets, pacifiers, toys, balloons, rubber bands…

Still, Meeropol knew that some of her little patients reacted to rubber gloves with rashes. And evidence of more serious allergic reactions in children — some of it eventually documented by Meeropol and her colleagues — was mounting.

As a result, in 1993, Shriners Hospital in Springfield became one of the first hospitals in the nation to go “latex-safe”. To its areas of special expertise — most of them related to bone, muscle and joint diseases in children — Shriners now adds “latex allergies”.

Meeropol says it’s probably impossible to get rid of every shred of latex. Also, if a child is not allergic to latex, Shriners staff may use a latex item for that particular child (for example, a latex tourniquet for drawing blood).

She also says that not every hospital needs to banish latex, and that not all latex is the same (there’s a continuum of quality and safety). But so effective has been the campaign at Shriners that in the last three years she has documented “only one minor reaction” to latex.

Meeropol first grew concerned about the life-threatening potential of latex in 1989, when the New England Journal of Medicine (NEJM) published an article describing severe allergic reactions to rubber in two children with spina bifida.

Spina bifida is a serious birth defect affecting the development of the brain and spinal cord.

As a member of the Northeast Myelodysplasia (spina bifida) Association, Meeropol learned that other health professionals in the group had observed similar reactions to latex. She and several other “advanced practice” nurses decided to do their own investigation.

The resulting article, titled “Children at Risk: Latex Allergy and Spina Bifida,” appeared in NEJM in December 1992 under the names of Meeropol and Robin Leger of Yale University School of Nursing in New Haven, Conn.

Of 185 young patients with spina bifida, the authors found that 20.4 percent exhibited symptoms of latex allergy — hives, swelling, watery eyes or respiratory symptoms. In a control group of 87 children without spina bifida, 1.1 percent had an allergic reaction.

Why children — and spina bifida in particular? Meeropol explains that typically, these children have surgery in the first few days of life, so they are exposed very early to huge amounts of latex in ongoing routine diagnostic studies and often in surgery. Their tiny bodies may be handled with latex gloves, and medicine injected into the bloodstream may go through latex tubing.

Also at risk are other children who have had multiple operations “particularly if the first one was in the first year of life”) and children who have other allergies, asthma or eczema.

Why wasn’t the public told about latex allergies earlier? Aside from health care workers, “it’s pretty unusual in the general population,” says Meeropol. Latex condoms, for example, are “not high on the list” of products likely to cause an allergic reaction.

Also, the use of latex hasn’t always been as widespread as it is today. Although this naturally occurring tree product was first used more than a century ago, the mid-1980’s witnessed an explosion of latex products, due to the spread of such diseases as AIDS and hepatitis. Finding synthetic alternatives is “an ongoing battle,” she says. Even latex balloons, which the Shriners loved to twist into animal shapes for the kids, had to go.

Part of the problem is that in many products, latex is a “hidden” ingredient. Nobody knows it’s there until little eyes start to water or little lungs to wheeze. Part of Meeropol’s mission has been to have the U.S. Food and Drug Administration require labeling to indicate that a product contains latex.

At the FDA, spokesperson Sharon Snyder said the labeling proposal was entered into the Federal Register in June, and comments are currently being reviewed. If the regulation is finalized, it will go into effect six months later. “It’s moving along quickly,” said Snyder.

[photo caption: Ellen Meeropol, pediatric nurse practitioner at Shriners Hospital for Children in Springfield, uses latex-free gloves to check bandages on Leonard Lipari, of Ware, who is allergic to latex.]