RATIONALE: Health care workers (HCW) can develop allergies and occupational asthma from proteins in latex gloves. Hand symptoms reported on questionnaires may be useful indicators of latex sensitization. METHODS: Questionnaires were completed by 804 HCW at two hospitals, recording the type and frequency of glove use and hand symptoms during latex glove use (itching, redness, rash without hives, hives without rash, hives with rash, cracking, and blisters). Health outcomes included latex sensitization indicated by positive skin prick test (SPT+) to standardized latex antigens (clone 600) and glove-related respiratory or systemic symptoms. HCW were grouped by number of hand symptoms reported: 0, 1-2, or >2. Group comparisons of glove use and health outcomes were made using Mantel-Haenszel chi-square. Using SPT+ to define latex sensitization and >2 hand symptoms as the clinical index test, the diagnostic values of sensitivity, specificity, positive likelihood ratio (LR+), and negative predictive value (NPV) were computed using 2x2 tables. RESULTS: Increasing latex glove use was strongly related to increasing reports of hand symptoms. Hand symptoms were highly associated with glove-related respiratory and systemic symptoms. SPT+ was seen in 5% of HCW and increased with the number of hand symptoms (0=1.6%, 1-2=3.4%, 3-7=19.0%). Participants reporting >2 hand symptoms were 11 times more likely to show SPT+ compared to those with < / = 2 hand symptoms. The sensitivity, specificity, LR+, and NPV were 65%, 85.5%, 4.5, and 97.9%, respectively. CONCLUSIONS: Hand symptoms due to latex gloves are closely associated with latex sensitization, and may be useful in monitoring the health of HCW who use gloves.
Hand-protection; Health-care-personnel; Health-protection; Health-surveys; Allergic-dermatitis; Allergic-reactions; Allergies; Respiratory-hypersensitivity; Questionnaires; Statistical-analysis; Work-analysis; Work-practices; Worker-health; Workplace-studies; Sensitivity-testing; Pulmonary-system-disorders; Dermatitis; Surveillance