"Exposure to Natural Rubber Latex (NRL)"
Exposure to Natural Rubber Latex (NRL) The Management of Health and Safety at Work Regulations, 1992, places duties on employers to assess all workplace risks and to take all reasonably practicable action to minimise those risks. This includes exposure to natural rubber latex (NRL). The Control Of Substances Hazardous to Health Regulations 2002 (COSHH) requires employers to assess any substance used at work that is hazardous to health. As NRL is hazardous to health, these regulations are applicable. It is the proteins within the NRL that are responsible for the allergies. Allergies may result from direct contact with the skin or from inhalation of the powder from latex gloves. Both the skin and respiratory systems may be affected with reactions ranging from non-allergic irritation of the skin to permanent allergy which may manifest in an anaphylactic shock. Use of NRL NRL has many benefits and is a cost effective and widely used material. The majority of the population (approximately 94-99%) are not sensitive to NRL and have no problems when exposed to it. NRL therefore presents no clinical risk to this group. The real importance of risk assessment is to make an informed decision as to whether NRL products are essential for the task. There are many other alternatives that may be more suitable and it may not be necessary to use NRL products for many tasks e.g. where there is no contact with bodily fluids. Medical Equipment Some products may contain NRL but may not be labelled as such. It is therefore extremely important that those employees who are sensitised to NRL inform their employer to ensure that only non NRL equipment is provided. Types of Latex allergy There are two types of NRL latex, Type I and Type IV allergy. Type I is caused by the natural proteins in NRL and Type IV is caused by chemicals that are used to convert the NRL to a usable item. Type I allergy Those who have a type I allergy have an immediate allergic reaction to NRL proteins. This allergy is potentially life threatening and deaths have been reported as a result of latex allergy. Symptoms These may include Urticaria (Hives) Asthma Hay fever symptoms In extreme cases – Anaphylaxis (severe drop in blood pressure leading to loss of consciousness or severe breathing difficulties) Sensitised individuals may have had months or even years of exposure to NRL without any symptoms. Often, symptoms become progressively worse with repeated NRL exposure. Sensitised individuals may only need to be in the same room as the NRL allergen for exposure to take place. The powder on the gloves enables the NRL allergen to become airborne which may then be inhaled. Management of Type I allergy The best and most effective treatment is avoidance of the allergen. There is no cure for the NRL allergy but medications may be used to treat he symptoms caused by it. Type IV allergy People who have a Type IV allergy react to the accelerator chemicals which are used in the manufacturing process of NRL. The reaction is a delayed hypersensitivity and occurs between 6 and 48 hours after exposure. Symptoms A red, itchy, scaly rash develops which is localised around the area of use but which may spread to other areas. Management of allergy Sensitised individuals should avoid specific chemicals and occupational health or medical advice should be sought. Products containing NRL There are many consumer products and pieces of medical equipment that contain NRL. Employers should ensure that latex- free medical supplies are available for use on, or by sensitised individuals. Reporting incidents Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR), employers have a duty to report incidences of occupational dermatitis and asthma attributable to NRL, to the Health and Safety Executive (HSE). Employers should also have a reporting procedure in place which maybe through occupational health for employees to be referred to or diagnosed. Employer’s responsibilities Employers should provide employees, patients and other members of staff with necessary guidelines and information to ensure their protection from risks to health associated with NRL products. Employers should also where possible provide alternative products and encourage staff not to use NRL products where possible but use alternatives instead. Employers should also provide health checks to identify early warning signs of a reaction to NRL Preventative Measures Individuals who are sensitive to NRL allergens should avoid contact at all times. To ensure this the following steps may be taken. Avoid contact where possible with NRL products Inform employers immediately of NRL allergy Avoid areas where inhalation of NRL allergy may occur from powdered products. Wear a medic alert bracelet which states a NRL allergy