Strategies for distinguishing asymptomatic latex sensitization from true occupational allergy or asthma.

OBJECTIVE

To evaluate strategies for distinguishing those individuals with true occupational asthma caused by exposure to natural rubber latex from those individuals with allergic disease related to other allergens.

DATA SOURCES: Article published between January 1, 1981, and December 31, 2001, were identified via a MEDLINE search with the following keywords: latex, allergy, asthma, occupation asthma, and adverse reactions.

STUDY SELECTION: English-language reports concerning diagnostic methods in latex and other forms of occupational asthma.

RESULTS

Many methods have been evaluated for the diagnosis of latex allergy, including medical history, skin prick tests, in vitro tests, and various challenge tests. Skin prick tests with well characterized latex extracts are highly sensitive and specific predictors of latex-specific IgE antibodies; however, direct pulmonary challenge with latex allergen appears to be the only highly reliable method for diagnosis of latex-related occupational asthma.

CONCLUSIONS

It is difficult to optimally distinguish between occupational latex asthma and asymptomatic latex sensitization in a person with preexisting asthma using currently available techniques.