Latex Allergy & Chemical Sensitivity Policy

Policy Owner: Associate Dean for Patient Care & Clinic Services

Policy Contact: Quality & Compliance Officer

POLICY STATEMENT

The School of Dentistry strives to protect its students, staff, and faculty from exposure to latex particles. The School must respond to and accommodate, to the best of its ability, persons who develop latex or other chemical allergies or sensitivity by providing alternative personal protective equipment (PPE).

REASON FOR POLICY

Exposure to latex, accelerants, and other chemicals used in PPE and dental supplies may result in allergic reactions or chemical sensitivities. Reports of allergies and chemical sensitivity have increased in recent years, especially among health care workers due to exposure to the chemicals. 

Latex allergies affect 1-6% of the general population and 8-12% of healthcare workers. Some studies report higher numbers including that approximately one third of dental care workers experience latex allergies. Multiple chemical sensitivity is medically diagnosed in 12.8% of the population, but 25.9% report chemical sensitivity whether medically diagnosed or not. Data is not available regarding prevalence of this condition in health care and dental health care providers, but observational data suggest that the rate of chemical sensitivity is rising. See Cleveland Clinic for more information.

Latex has been used in many items used in healthcare including dental health care. In 2016 the Food and Drug Administration banned powdered surgeon’s and examination gloves in healthcare settings after studies determined that it was the powder in gloves that allowed the latex particles to become airborne. The FDA made further recommendations on labeling products to inform users that they are “Not made with natural rubber latex” but not that they are latex-free since there are no test methods that can demonstrate the absence of latex particles.

Susceptibility to and Progression of Latex Allergy or Chemical Sensitivity

• Frequent exposure to latex, accelerants, and other chemicals over time increases the risk of developing sensitivity or allergy. People at highest risk include:
• Healthcare workers,
• people with spina bifida or urinary tract disorders ,
• persons who have undergone multiple surgical procedures
• Latex allergies are progressive, meaning they worsen with repeated exposure to latex. People report that chemical sensitivities also worsen over time although there are no tests to prove this.

Certain food allergies may be linked to a higher susceptibility to latex allergy because these foods contain the same proteins that are in latex:

• Bananas
• Avocados
• Chestnuts

Severity of Reaction to Latex and Other Chemicals

• Latex or Other Chemical Allergy is a Type I or immediate reaction to proteins and begins within minutes of exposure.
• Reactions include runny nose, itchy eyes, hives, and burning skin.
• Rare severe reactions include breathing difficulty or anaphylaxis.
• Irritant Contact Dermatitis develops as dry, itchy, or irritated skin in contact with PPE, usually on the hands or face. It is also associated with frequent hand washing and is not an allergic reaction
• Type IV Contact Dermatitis is a delayed allergic reaction or hypersensitivity usually to accelerants or other chemicals used in the manufacturing of PPE. Reactions are usually localized to the contact area and occur within 12-48 hours of exposure.

Considerations

• Dermatologic conditions should be diagnosed by a qualified medical provider.
• The School must provide alternatives to accommodate students, staff, or faculty who develop chemical allergies or sensitivities.

All providers use non-latex gloves, and all materials that directly touch providers and patients are not made with latex.

PROCEDURES

A. Exposure Control for Clinical Students, Staff and Faculty 

1. Latex gloves are not used anywhere on the clinic floors.
2. Non-latex gloves are used in all clinic areas for all applications including patient care, laboratory work, and housekeeping tasks.
3. Alternatives to latex include nitrile, neoprene, thermoplastic elastomer (TPE), polyethylene (plastic), and vinyl.
4. Supply chain issues were encountered during the pandemic, and latex gloves were used in some applications to conserve the supply of non-latex gloves for patient and research subject treatment as well as for students and employees with existing sensitivity. Supply chain issues will be addressed in future pandemics.
5. If clinical students, staff, or faculty develop sensitivity to the PPE they use or other chemicals/items they are exposed to, they should report to the Health and Safety Compliance Office. The Compliance Officer will provide them with alternatives. (See below for details on the process for addressing sensitivity.

B. Exposure Control for Patients and Research Participants

1. Non-latex gloves are worn during patient treatment and when working with research participants.
2. When taking or updating medical histories, make sure to ask patients if they have any known allergies including latex allergies.
3. The School of Dentistry is not a latex-free clinic but we have latex-free options for clinical care if requested by patients. .
4. If a patient exhibits an allergic reaction during treatment to any materials or reagents, initiate the medical emergency protocol. Begin with first aid measures to manage the event and proceed to calling for a response team if required.
5. New products under review for use in patient care should be confirmed as not made from latex.
6. Items used in patient treatment should be monitored to confirm that the packaging includes the symbol that indicates they are not made from latex.

C. Exposure Control in the Preclinic

1. Non-latex gloves are worn in the preclinic when completing simulation or laboratory exercises.
2. For the most part, materials used in simulation patient treatment in the preclinic are the same materials that are used for patient treatment in the clinic and are labeled as not made with latex.
3. If students, staff, or faculty develop sensitivity to the PPE they use or other chemicals/items they are exposed to in the preclinic, they should report to the preclinic dispensary team or Health and Safety Compliance Office. The preclinic dispensary or Compliance Officer will provide them with alternatives. (See below for details on the process for addressing sensitivity.)

D. Exposure Control in Research and Other Areas within Moos Tower

1. Most research areas use nitrile gloves for their bench work, but latex gloves and latex-containing materials may still be present in research areas as well as elsewhere in non-clinical areas of Moos Tower.
2. Research lab managers must attempt to minimize the presence of latex in their labs. If their research requires the use of latex-containing materials or if lab managers know that there is latex present in their lab, they may consider posting signage that informs others that there is latex in the area.
3. If students, staff, or faculty develop sensitivity to their PPE or other chemicals/items they are exposed to in their research, they should report it to their lab manager, their PI, or the Health and Safety Compliance Office. Their lab manager or PI must determine if the items can be replaced with items that do not contain the chemical presenting the sensitivity. The Health and Safety Compliance Office can assist with identifying alternative gloves or masks that the lab can order for their students, staff, and faculty. (See below for details on the process for addressing sensitivity.)
4. If exposure control cannot be maintained, use of respirators may be required.

E. Balloons and Decorations in Public Areas of Moos Towers

1. Latex balloons and latex-containing decorations are not allowed in public areas in the School of Dentistry’s Moos Tower Building or at celebrations hosted by the School of Dentistry.
2. Alternatives to latex balloons include Mylar foil balloons, plastic balloons, or vinyl decorations.
3. The School of Dentistry does not control all areas of Moos Tower and cannot control the presence of latex in all spaces in Moos Tower.
4. If latex decorations are knowingly used in non-public areas of the Dental School, signs should be posted alerting students, staff, faculty, and visitors that there is latex present in the area.

F. Responding to Students and Employees who Develop Allergies or Sensitivity

1. Students in the preclinic who develop sensitivity to their PPE or other materials should inform preclinic faculty, the preclinic dispensary team, and the Health and Safety Compliance Office. The Health and Safety Compliance Office will suggest alternative items, and the preclinic dispensary will order the alternative items and maintain stock in the preclinic dispensary.
2. Students in the clinic who develop sensitivity to their PPE or other materials should inform their color group leader and the Health and Safety Compliance Office. The Health and Safety Compliance Office will suggest alternative items and will order the alternative items and maintain stock in the Health and Safety Office.
3. Staff and faculty in the clinic should inform the Health and Safety Compliance Office. The Health and Safety Compliance Office will suggest alternative items and will order the alternative items and maintain stock in the Health and Safety Office.
4. Students, staff, and faculty who wear alternative PPE in the clinic are responsible for carrying their own PPE supplies. The alternative PPE is not stocked in the dispensing area.
5. If symptoms are not ameliorated with the use of alternative PPE or other materials, the student, staff, or faculty member should consult their health care provider for allergy testing and diagnosis.
6. The School must provide accommodations for students and employees with a diagnosed latex or chemical allergy.
7. If the condition cannot be addressed with the use of alternative PPE, the Health and Safety Compliance Office will consult with the University Occupational Health Program to determine if other alternatives exist or if respirator use is an option.
8. The School of Dentistry is not responsible if a clinical partner or off-campus activity cannot provide a latex-free environment. Providers with concerns regarding exposures during outreach experiences should bring their concerns to their color group leader or the Health and Safety Compliance Office. Concerns will be discussed with the outreach facility and every effort will be made to accommodate learners, staff, and faculty.

FORMS/INSTRUCTIONS

There are no forms associated with this policy.

APPENDICES

There are no appendices associated with this guideline.

FREQUENTLY ASKED QUESTIONS

There is no FAQ associated with this policy.

DEFINITIONS

Anaphylaxis: an acute, life-threatening hypersensitivity disorder, defined as a generalized, rapidly evolving, multi-systemic allergic reaction. Physical presentations of anaphylaxis range from mild skin flushing and pruritus to severe respiratory symptoms. See National Institutes of Health (NIH) or Mayo Clinic for more information.

Dermatitis: a condition of the skin in which it becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it. See Mayo Clinic for more information.

Accelerant: substances that increase the rate of a natural or artificial chemical process. They play a major role in chemistry, as most chemical reactions can be hastened with an accelerant. Accelerants alter chemical bonds, speed up chemical processes, or change the reaction conditions. They are commonly used in sulfur vulcanization to produce rubber products.

RESPONSIBILITIES

There are no responsibilities associated with this policy. 

RELATED INFORMATION

Mayo Clinic

NIH

Cleveland Clinic

Roseman University of Health Sciences Latex Allergy Policy

HISTORY

• Approving Body: Council of Chairs
• Date Approved: June 2018
• Date Amended: December 2024

ADDITIONAL CONTACTS