http://groups.msn.com/LIDS-Latexallergiesandthedangersofcondoms
Posted on 05/13/2005 8:40:19 AM PDT by Phantom Lord
"Everyone does it."
and the companion
"All the people whose parents told them to abstain are worse than I am."
Don't you guys ever get any new material? Most of us have actually been teenagers, and we know for a fact that everyone didn't do it, and still doesn't. And we know for a fact that plenty of the kids who abstained waited longer, some until their wedding night, and made smarter choices about sex and marriage than those who didn't.
In this context, your reply was:
Perhaps. But we [i.e. Abstinence-only supporters] also have stable, happy marriages, no out-of-wedlock pregnancies, and a 0% STD rate. You, of course, provide no actual data to support your position . . .
The study I cited suggests that abstinence-only supporters often do not practice that which they support, and do not have the trouble free lives that you suggest.
Sorry, but people are people - even if the spirit is willing, the flesh is weak. There are vast industries (diet, substance abuse, etc) founded on people's weakness and inability to resist temptation. As an abstract proposition your abstinence claims are correct, but the reality is far different.
The abstinence-only program pimps on my side of the voting aisle have never been able to provide a sufficient answer to the most basic, simple question I ask them when their positions come into question.
If one abstains from sex before marriage, how will one know if his (or her) mate is sexually compatable? There is literally no way that I can see that two people can know if they will enjoy a mutually satisfactory sex life in within the (ideally) life-long bounds of their marriage unless they have sex beforehand.
There is nothing more complicated as human sexuality, and there is no "one-size-fits-all" answer in this life as far as our sexual needs are concerned.
Condoms are quite safe......
....unless you could be the type of person to be concerned about trifles like cancer, death from inhalation problems and the odd birth defect (to name a few).
Latex is a natural rubber or is not in the slightest elastic (high modulus) until it undergoes a process called vulcanization.
This requires a large number of additives. Latex even in its natural form has proteins known to cause allergic reactions (Types I, II and IV -fatal).
The additives in vulcanization include: -
Benzene - Short term exposure to benzene may cause irritation to the nose, throat and lungs. It can also affect the nervous system, causing headaches, dizziness and slurred speech. At high levels of inhalation shallow breathing and death can result. Death has occurred after exposure to 20.000ppm for five to ten minutes or 7.500ppm for 30 minutes.
Skin irritation, including redness and blistering can occur with skin contact. It is also absorbed very slowly through the skin.
Long term exposure to this substance -- even at low concentrations -- can cause a number of symptoms including appetite loss, nausea, fatigue, headaches and dizziness.
Mild anemia has been reported after exposure to 25ppm for several years and 100ppm for three months. At levels of 100ppm and 200ppm for periods of six months, or more, severe irreversible blood changes and damage to the liver and heart can occur. Benzene is a known carcinogen and it has been linked to increased risk of several forms of leukemia. In May 1977 the National Institute of Occupation Safety and Health (NIOSH) recommended that the TLV for benzene be reduced from 10ppm to 1ppm because of its carcinogenicity. NIOSH recommended that exposure to benzene be kept as low as possible and that the use of benzene as a solvent or dilutent in open operations should be prohibited. This standard of 1ppm was legally challenged by industry groups and never enforced.
Although some rubber companies said they expected to meet the 1ppm recommendation, the established TLV remains at l0ppm.
Sampling in rubber plants reveals that the level of benzene in the air is generally slightly greater than the NIOSH recommended standard of 1ppm. Researchers investigating solvent use in the rubber industry found that in order to maintain benzene vapour below 1ppm, mixtures of solvents could not contain greater than 0.1% benzene.
Toluene - This solvent, which is the major substitute for benzene, cannot be considered a completely safe alternative even though it has not been proven to be carcinogenic. The harmf ul effects of toluene include irritation of eyes, respiratory tract (nose, throat, lungs) and skin. Repeated or prolonged contact with the liquid can cause removal of all the natural oils from the skin resulting in dry, cracked skin. When splashed in the eyes, it can cause irritation and reversible damage. Acute exposure above the TLV of 100ppm can result in central nervous system depressions with symptoms including headache, dizziness, fatigue and muscular weakness as well as drowsiness and incoordination.
Thiazoles - Cause dermatitis reactions. 2-mercaptobenzothiozole is said to be especially irritating to the skin, eyes and respiratory tract.
Dithiocarbamates - Have been shown to be irritating to the skin, eyes and respiratory organs. Possible carcinogens.
•Nitrosamines (N-nitrosodiphenylamine)
Many nitrosamines are potent carcinogens but until recently this nitrosamine used as a retarder was not considered harmful. Recent experiments with rats indicted N-nitrosodiphenylam ine as a cause of cancer in the test animals. This substance also combines with other rubber chemicals to form other nitrosamines especially N-nitrosomorpholne which is linked with liver and respiratory cancer and kidney tumours.
In addittion almost all condoms have some type of lubricant such as carcinogenic talc or silicone (almost identical to that used in breast implants). Some even use the highly lethal N9 as a lubricant and spermicide.
If that was not enough in order to cause the vulcanized latex to gel on the former a coagulant is required. These salts are all highly toxic and not water soluable so the crystals remain embeded in the inner surface of the condom.
Condoms, cause for concern? You decide. It's your life after all.
Are condoms a greater health risk than the std's they don't really protect against?
It is politically correct to advocate condoms but every day the evidence increases that they do little to protect and may pose a very serious health risk. It is hard for the CDC and FDA to examine these risks as they have been so vocal in promoting condoms but could their silence lead to dire consequences. I for one having done exaustive research strongly feel so.
"...... new concerns are arising regarding allergic or other toxic reactions to various components of latex condoms such as vulcanization accelerators, latex proteins, spermicides and finishing powders."
"* Studies are needed to evaluate the best lubricants to use in the manufacture of condoms. Evidence suggests that the right quantity, type and placement of lubricant is important for condom functionality, acceptability and safety.
In addition, the added value and risk presented by spermicidal lubricants and by dry finishing powders (e.g. talc or cornstarch) should be critically examined."
"Since the late 1980s the reported incidence
of allergy to natural rubber latex has increased dramatically, as much as 12 -fold."
"Latex allergy is incurable, although the symptoms, such as itching, soreness, painful blistering, runny noses, swollen eyes, asthma symptoms and anaphylaxis can be ameliorated.
Everyone who has contact wi th natural rubber latex is potentially at risk from sensitisation.
Both patients and health care workers can be at risk from allergic reactions to natural rubber latex. Over the past decade, allergic reactions to natural
rubber latex have become a major public health concern."
" Once a person has developed latex allergy, however mild, they are “sensitised” to latex and are at risk from severe allergic reactions."
"Delayed cell-mediated reactions are the most common form of hypersensitivity reaction to natural rubber latex. These reactions are to individual chemical residues from the production process such as accelerants used in the vulcanisation process which is required to strengthen the product.
The residual chemicals may bloo on the surface of the products and can be absorbed through the skin upon contact."
"Potent Carcinogen found in Most Condoms
Recent study has discovered the presence of a very potent carcinogen in most condoms. Small amounts of this chemical are released whenever condoms are used.
Nobody knows whether this is serious yet however it is not likely to be healthy to expose the reproductive organs to cancer-causing substances on a regular basis.
This is a potentially serious issue for much of the world's population that cannot afford or access other forms of birth control. I hope further studies will follow on this soon. Could this be related to the rise in cancer in women, and men as well? "
"Talc...(on condoms)...may result in fallopian tube fibrosis with resultant infertility. Question raised by Doctors Kasper and Chandler in Journal of the American Medical Association. (JAMA) 3/15/95
-from Nutrition Health Review, Summer 1995 n73p8(1)"
"A possible tie between talcum powder and ovarian cancer, long suspected because of talc's chemical similarity to asbestos, was strongly supported last week when a study found a higher risk of the cancer among women who used feminine deodorant sprays. The study, published in the American Journal of Epidemiology, found that women who used talcum powder in the genital area had an increased ovarian cancer risk of 60% and women who used feminine deodorant sprays had a 90% increased risk."
-from The University of California, Berkeley Wellness Letter, April 1993 v9n7p1
"Benzene. In addition to the effect on fertility, some researchers believe overexposure to chemicals may also contribute to testicular cancers. In fact, a 2000 study concluded that there was a link between sperm abnormalities and testicular cancer.
Among the study participants, men in couples with fertility problems were more likely to develop testicular cancer. In addition, low semen concentration, poor sperm motility, and abnormal sperm morphology were all associated with increased risk for testicular cancer."
"a recent Lancet study (2002;360:971-977) found frequent use may in fact increase the risk of HIV transmission.
The head of the Australian Federation of AIDS Organizations, Don Baxter, said up to 10 percent of condoms sold in Australia include nonoxynol-9 as a lubricant. "Not a high percentage of condoms use nonoxynol-9, it's usually a particular brand, but they are fairly widely available," he said. Baxter advised all gay men to avoid using condoms with nonoxynol-9 and said AFAO would call for the product to be withdrawn from pharmacy shelves. "
"The allergens that cause reactions in individuals with spina bifida are particle bound proteins that are less able to be dissolved in water than some of the other latex proteins"
* Talc - This is found in baby powders, face powders, body powders as well as some contraceptives such as condoms. Talc is a known carcinogen and is a major cause of ovarian cancer when used in the genital area. It can be harmful if inhaled as it can lodge in the lungs, causing respiratory disorders."
Condoms contain compounds known to cause cancer and serious birth defects in substantial quantities
SOURCES. Condom Industry web site, medical publications and Beacon Pharmaceuticals.
Do Condoms Protect Against Small Viruses?
The use of condoms is widely recommended to prevent sexually transmitted diseases, including those caused by such viruses as herpes simplex, hepatitis B, and human immunodeficiency virus (HIV).
The efficacy of condoms in these circumstances, however, is unknown.
The water-leak test used to ensure the integrity of condoms can detect holes as small as 3 to 4 m in diameter, but sexually transmitted viruses are much smaller, with diameters of 0.04 to 0.15 m. A previous study demonstrated that about one third of condoms tested allowed penetration of HIV-sized polystyrene spheres.
Condom Use Linked to Risk of Preeclampsia
http://www.medscape.com/viewarticle/433419?srcmp=wh-051002
LOS ANGELES (Reuters Health) May 09 - Women who are not exposed to a partner's sperm prior to pregnancy because the couple used condoms may be at increased risk for developing preeclampsia, a new study presented here concludes.
The findings suggest that when the uterus is repeatedly exposed to sperm, a woman's immune system may become accustomed to this "foreign" genetic material, said Dr. Jon I. Einarsson, an obstetrician/gynecologist at Baylor College of Medicine in Houston.
However, when a woman's body has only recently been introduced to the sperm because she stopped using barrier contraception and was trying to conceive, she may have an immune reaction to the paternal genetic material that causes arterial damage and contributes to preeclampsia, Dr. Einarsson suggested. This reaction may be heightened because the placenta produces paternal proteins similar to those on sperm, he told Reuters Health.
Preeclampsia affects about 7% of pregnant women, yet little is understood about why the condition develops, according to the American College of Obstetricians and Gynecologists (ACOG). The Baylor study findings were presented Wednesday during the College's annual meeting.
Dr. Einarsson described his team's findings for 113 women who developed preeclampsia during their pregnancies and another 226 women who did not.
He said those who used barrier methods and had only been having sex with their partners for a short period of time were most at risk. "Women who used barrier methods who had been having sex with their partners for less than 4 months prior to getting pregnant had a 6.5-fold increased risk of getting preeclampsia, compared with women who did not use barrier methods and had been in a sexual relationship for more than 12 months," he said.
Most women in the study who reported using barrier contraception relied on condoms, while some also used diaphragms. Women who relied on the withdrawal method also were included in this group.
"Women who use barrier methods exclusively prior to pregnancy should consider changing to an alternative method 4 to 6 months prior to getting pregnant, especially if they have other risk factors for preeclampsia, such as diabetes, high blood pressure, or if they are overweight," Dr. Einarsson recommended.
" Perhaps. But we also have stable, happy marriages, no out-of-wedlock pregnancies, and a 0% STD rate."
This is very interesting because last I checked the Baptists were very big on abstinence only and more of them were pregnant in my high school than any other group.
The True Love Waits program also doesn't significantly lower the rate of pregnancy either.
BOTH of my grandmothers and grandfathers were pure on their wedding day. My mother was pure on her wedding day (can't vouch for Dad, I never asked him about it). I was stupid enough to forsake my mother's sage advice and consented, after four years in a relationship and an engagement ring on my finger, to "liberate myself" with my then-fiancee. I ultimately dumped him before finishing college and renewed my vow of chastity UNTIL my husband, who was more than happy to wait for me.
My husband and I plan to raise our kids with the same expectations; if you aren't ready to be parents, aren't ready to get married, you keep your clothes ON. They will also avoid risking STDs, teen pregnancy, the loss of self-esteem, and the stupid emotional entanglements that come from venturing into the adult world too soon. Young people confuse SEX with LOVE, when there is all the world between the two. One need not lie to make their points; the truth is strong enough.
As a teen I thought it did not matter if I was married before I had sex or not. One thing I would say -- especially for a lot of girls -- is that abstinence is the best option. It takes a toll emotionally, as well as physically. I really wish I had waited.
It's possible, David, to get cancer from using latex condoms during sex. It's also possible to get struck by lightening, and probably more likely to get killed in a terrorist bombing than by condom cancer or whatever.
My point is this: Every time you get behind the wheel of a car you take your life into your own hands, nomatter how carefully you drive. Every time a cop, or a fireman, or a construction worker goes on the job, they take a risk or life and limb-- not to mention a soldier.
Why do they take those risks? Why do we take those risks? Because they are necessary for us. NECESSARY. Because a life without the benefits they offer is unthinkable. A life without freedom of movement or transportation is unthinkable. And this may be a little hard for the more hermit-like FReepers among us to understand, but a life without sex is (to me and millions of others) equally unthinkable.
We want it. We need it. We share it. Sex is beautiful and brilliant and pure when it's done between two people who love each other, and who want to explore what God has given them. There's nothing wrong with it-- and marriage or the lack thereof in a relationship does not necessarily effect it's charms in any notable way as far as I can tell.
Oh, and let me fire this one pre-emptively.
YES, I am religious.
NO, I am not THAT religious.
YES, I am a conservative.
NO, I am not a "cultural conservative".
YES, I support abstinance training in sex-education.
NO, I do NOT support abstinance-only training.
YES, I am a Republican.
BUT, I lean libertarian, ESPECIALLY on sexual matters.
I've learned my lesson on previous "sex-education" threads here on FR. I will not be misrepresented again.
Actually you are wrong. Between 18 and 20 million Americans are now sensitive to latex (up from zero recorded cases 20 years ago) and latex related deaths are sky rocketing.
The FDA admits only 1% are even recorded. At this rate some believe that latex related deaths (LIDS) could soon be in the top ten killer disease list within ten years.
Your risk of death from latex is FAR, FAR greater than from any std.
In short: - WITH A GLOVE, IT'S NOT LOVE!
_______
THE FDA SAYS ONLY 1% OF LATEX DEATHS ARE REPORTED
Delayed contact dermatitis from chemicals in rubber has been recognized since the 1930s.4 But except for rare early reports, clinicians did not appreciate systemic allergic reactions to latex proteins until 1979, when case reports began to appear in Europe. 5
Latex allergy erupted in the United States shortly after the Centers for Disease Control introduced universal precautions in 1987. By late 1992, the Food and Drug Administration (FDA) received 1133 reports of serious allergic reactions and anaphylaxis occurring to patients and health care staff associated with 30 classes of latex medical devices. There were 15 patient deaths associated with latex barium enema catheters.5,6
The FDA estimated that the reports represented only 1% of actual occurrences.6
Today, researchers hypothesize that the latex allergy outbreak is the result of multiple factors including deficiencies in manufacturing processes, increased latex exposure, hand care practices, immunological cross reactivity, and changes in latex agricultural practices.1,7,8, 45
Latex allergy affects between 8%-12% of workers in all health disciplines. Latex allergy also affects up to 51% of children with spina bifida, and approximately 1% of the general population.
http://www.nursingworld.org/readroom/position/workplac/wklatex.htm
____________
New US government website attacked for comments on sexuality and effectiveness of condoms
The wording of information about condoms on the site is also potentially misleading (they mean factual). US abstinence education programmes usually only mention condoms when referring to their potential for failure.
The 4parents.com site suggests that condoms offer only “moderate” protection against HIV and gonorrhoea, “less” protection against Chlamidya, herpes and human papilloma virus, and that the ability of condoms to protect against syphilis “has not been well studied.” Although these claims are backed by reference to studies looking at the effectiveness of condoms, they do not acknowledge that the studies were, almost exclusively, conducted in populations with a high prevalence, or risk of sexually transmitted infections.
____
The rest of the article (attacking the new semi honest official statements on condoms) is a pathetic attempt to defend condoms citing the one and only study (if you can call it that) conducted over twelve years ago that claimed that condoms reduced 'AIDS' in the 132 couples studied. As usual the 'conclusions' section of that report which said 'in real world use condoms failed up to 32% of the time' was ignored.
This study has been contradicted by ALL the 400 subsequent studies almost without exception.
________
Do Condoms Protect Against Small Viruses?
The use of condoms is widely recommended to prevent sexually transmitted diseases, including those caused by such viruses as herpes simplex, hepatitis B, and human immunodeficiency virus (HIV). The efficacy of condoms in these circumstances, however, is unknown.
The water-leak test used to ensure the integrity of condoms can detect holes as small as 3 to 4 m in diameter, but sexually transmitted viruses are much smaller, with diameters of 0.04 to 0.15 m. A previous study demonstrated that about one third of condoms tested allowed penetration of HIV-sized polystyrene spheres.
________
Condom Use Linked to Risk of Preeclampsia
http://www.medscape.com/viewarticle/433419?srcmp=wh-051002
LOS ANGELES (Reuters Health) May 09 - Women who are not exposed to a partner's sperm prior to pregnancy because the couple used condoms may be at increased risk for developing preeclampsia, a new study presented here concludes.
The findings suggest that when the uterus is repeatedly exposed to sperm, a woman's immune system may become accustomed to this "foreign" genetic material, said Dr. Jon I. Einarsson, an obstetrician/gynecologist at Baylor College of Medicine in Houston.
However, when a woman's body has only recently been introduced to the sperm because she stopped using barrier contraception and was trying to conceive, she may have an immune reaction to the paternal genetic material that causes arterial damage and contributes to preeclampsia, Dr. Einarsson suggested. This reaction may be heightened because the placenta produces paternal proteins similar to those on sperm, he told Reuters Health.
Preeclampsia affects about 7% of pregnant women, yet little is understood about why the condition develops, according to the American College of Obstetricians and Gynecologists (ACOG). The Baylor study findings were presented Wednesday during the College's annual meeting.
Dr. Einarsson described his team's findings for 113 women who developed preeclampsia during their pregnancies and another 226 women who did not.
He said those who used barrier methods and had only been having sex with their partners for a short period of time were most at risk. "Women who used barrier methods who had been having sex with their partners for less than 4 months prior to getting pregnant had a 6.5-fold increased risk of getting preeclampsia, compared with women who did not use barrier methods and had been in a sexual relationship for more than 12 months," he said.
Most women in the study who reported using barrier contraception relied on condoms, while some also used diaphragms. Women who relied on the withdrawal method also were included in this group.
"Women who use barrier methods exclusively prior to pregnancy should consider changing to an alternative method 4 to 6 months prior to getting pregnant, especially if they have other risk factors for preeclampsia, such as diabetes, high blood pressure, or if they are overweight," Dr. Einarsson recommended.
http://groups.msn.com/LIDS-Latexallergiesandthedangersofcondoms
Maybe sex education should be left up to the parents?
Spina bifida and latex
Individuals born with spina bifida have an extremely high incidence of latex allergy. According to the Spina Bifida Association of America (SBAA), research has shown that up to 73% of children and adolescents with spina bifida are latex sensitive. Latex sensitivity was determined by a blood test or by history of an allergic reaction. You can access the SBAA website at http://www.sbaa.org. (I’ve also included a link to the SBAA list of non-latex alternative products in my top five recommended websites.)
It’s theorized that the increased sensitization in this population is related to early, frequent exposure to rubber products such as catheters used in bladder programs. These children also tend to have frequent surgeries and diagnostic tests, which increases their exposure to latex gloves. (Frequent surgical intervention is a risk factor even in children who do not have spina bifida; sensitivity to latex has been found in 34.1% of children with a history of three or more surgical procedures. Interestingly, this was not found to be true in adults without spina bifida.)
There have been some advances in latex allergy research, in regard to spina bifida. The specific latex proteins that are the primary allergens for individuals with spina bifida have been isolated, and it’s been discovered that they are not the same proteins that are the primary allergens in healthcare workers who have occupational exposure to latex. This may be explained by a difference in the routes of exposure between the two groups. The allergens that cause reactions in individuals with spina bifida are particle bound proteins that are less able to be dissolved in water than some of the other latex proteins. Sensitization to these particular proteins may be caused by repeated contact between the latex and mucus membranes (such as repeated urinary catheterizations).
The SBAA recommends that all individuals with spina bifida should be treated as though they are latex sensitive from birth, and they should avoid all contact with latex products in all settings. This includes home, school, day care, and camp, as well as medical facilities. The SBAA has resources available to help parents work with their child’s school to create a latex safe environment. Sample letters to school personnel are available on the SBAA website. In addition, individuals who have had allergic reactions to latex should wear a medic-alert bracelet http://www.medicalert.org and should carry auto-injectable epinephrine, non-latex gloves, and other non-latex equipment for emergency use.
April 12, 1999
MEMORANDUM FOR: REGIONAL ADMINISTRATORS
THROUGH:
R. DAVIS LAYNE
Deputy Assistant Secretary
FROM:
STEVEN F. WITT
Director
SUBJECT:
Technical Information Bulletin(1):
Potential for Allergy to Natural
Rubber Latex Gloves and other Natural Rubber Products
THIS INFORMATION ALSO APPLIES TO CONDOMS - LASG
Use of natural rubber products may result in several varieties of reactions (see table). These reactions include irritant and several types of allergic reactions. They can vary from localized redness and rash to nasal, sinus, and eye symptoms to asthmatic manifestations including cough, wheeze, shortness of breath, and chest tightness; and rarely, systemic reactions with swelling of the face, lips, and airways that may progress rapidly to shock and, potentially, death.
When gloves are associated with skin lesions, the most common reaction is irritant contact dermatitis. Irritant contact dermatitis may be due to direct irritation from gloves or glove powder, but may also be due to other causes, such as irritation from soaps or detergents, other chemicals, or incomplete hand drying. Irritant contact dermatitis presents as dried, cracked, split skin.
Although irritant contact dermatitis is not in itself an allergic reaction, the breaking of the intact skin barrier due to these lesions may afford a pathway for latex proteins to gain access, and thus promote development of allergy.25
The second type of reaction that may be associated with glove use is allergic contact dermatitis (also known as type IV delayed hypersensitivity or allergic contact sensitivity). When glove use has been associated with this reaction, it appears to be due to the chemicals used in processing NRL or other glove materials. The allergic contact dermatitis has an appearance similar to the typical poison ivy reaction, with blistering, itching, crusting, oozing lesions. Also, like poison ivy, this dermatitis may appear a day or two after the use of gloves or exposure to other sources of chemical sensitizers.
The third and potentially most serious type of reaction sometimes associated with glove use is a true IgE/histamine-mediated (also called immediate or type I hypersensitivity) to glove protein [in the case of NRL allergy, to NRL protein(s)].
This of reaction can involve local or systemic symptoms. Localized symptoms include contact urticaria (hives) which appear in the area where contact occurred (in the case of gloves, the hands), but which can spread beyond that area and become generalized. More generalized reactions include allergic rhinoconjunctivitis and asthma.
The presence of allergic manifestations to NRL indicates an increased risk for anaphylaxis, a rare but serious reaction experienced by some individuals who have developed an allergy to certain proteins (e.g., insect stings, natural rubber, penicillin). This type I reaction can occur within seconds to minutes of exposure to the allergen (in the case of NRL, to natural rubber proteins) either by touching a product with the allergen (e.g., gloves) or by inhaling the allergen (e.g., powder to which natural rubber proteins from gloves have adsorbed). When such a reaction occurs, it can progress rapidly from swelling of the lips and airways to shortness of, and may progress to shock and death, sometimes within minutes.
While any of these signs and symptoms may be the first indication of allergy, in many workers with continued exposure to the allergen (in the case of NRL allergy, to natural rubber), there is progression from skin…
Sobering news for rubber contraceptive users.
A German scientific research institute has warned that most condoms on the market contain a cancer-causing chemical and has urged that their manufacture be subjected to stringent quality control.
The Chemical and Veterinary Investigation Institute in Stuttgart said on Friday it had found the carcinogen N-Nitrosamine in 29 of 32 types of condoms it tested in simulated conditions.
The condoms, which were kept in a solution with artificial sweat, exuded huge amounts of cancer-causing N-Nitrosamine from its rubber coating. Researchers measured amounts of N-Nitrosamine, that were way above the prescribed limits for other rubber products such as baby pacifiers.
"N-Nitrosamine is one of the most carcinogenic substances," the study's authors said. "There is a pressing need for manufacturers to tackle this problem."
The study said that the carcinogen is thought to be present in a substance used to improve condom elasticity. When the rubber material comes in contact with human bodily fluids, it can release traces of N-Nitrosamine.
But since there are no prescribed limits of N-Nitrosamine for condoms, the study hasn't caused panic among manufacturers or mass-recalling of the products from counters.
Manufacturers should use alternative substances
Germany's Federal Institute for Risk Assessment said that daily condom use exposed users to N-Nitrosamine levels up to three times higher than levels naturally present in food.
Werner Altkofer, head of the Stuttgart-based Chemical and Veterinary Investigation Institute said that though the production of rubber usually uses chemicals that can exude N-Nitrosamine, condom manufacturers could bypass it by using more expensive alternative substances available on the market that didn't form the carcinogen.
"We believe that it's up to the manufacturers to use other production processes so that no N-Nitrosamine is formed in condoms," Altkofer said.
He added that the latter was technically possible going by the fact that products of some manufacturers didn't show traces of the carcinogen during the testing.
Beate Uhse taking no chances
Germany's biggest erotica compnay Beate Uhse however, has decided to play it safe.
Shortly after the results of the study were introduced on Friday, the group banned chocolate-flavored condoms from its range. That was because the study had show that condoms laced with a chocolate flavoring had overwhelming high levels of N-Nitrosamine.
October 10, 1989
MEMORANDUM FOR: REGIONAL ADMINISTRATORS
THROUGH: LEO CAREY
Director
Office of Field Programs
FROM: EDWARD BAIER
Director
Directorate of Technical Support
SUBJECT: Health Hazard Information Bulletin: N-Nitrosamine in the Rubber Industry
Information provided to the Occupational Safety and Health Administration (OSHA) from the United Rubber, Cork, Linoleum and Plastic Workers of America (URW) indicated their concern with a number of amine compounds (in rubber or as rubber additives) that may be nitrosated with nitrogen oxides from the air during mixing, milling, extrusion, molding, calendaring, curing, including warehousing and storage.
These amines are potent animal carcinogens, and may be close to aflatoxin in risk. There are also other health effects besides the cancer risk and they could include the target organs of the liver, kidney, lungs, skin and eyes.
Individual substances may vary on symptoms such as but not limited to headache, fever, weakness, stomach upsets, enlargement of the liver and jaundice.
Nearly all producers of rubber products will at some point in their manufacturing process produce some of the amine compounds listed below that the International Agency for Research on Cancer (IARC) has classified as Group 2A or Group 2B and the National Toxicology Program (NTP) has designated as an anticipated human carcinogen.
1- N-Nitroso-di-n-butylamine
2- N-Nitroso-di-ethanolamine
3- N-Nitroso-di-ethylamine
4- N-Nitroso-di-methylamine
5- N-Nitroso-di-isopropylamine
6- N-Nitroso-di-n-propylamine
7- N-Nitroso-morpholine
8- N-Nitroso-piperidine
9- N-Nitroso-pyrrolidine
We found that the National Institute for Occupational Health's (NIOSH) literature states exposures occur in many operations in the rubber industry including, Mill Operator, Banbury Operator, Tray Compounder, Extruder Operator, Cure Heater Operator, Mold Press Operator, Press Operator, Laminator, Calendar Operator and others (see attachments).
NIOSH conducted personal sampling in a number of rubber plants and found levels that range as low as:
0.1 ug/m(3) to 11.1 ug/m(3) NDMA, NDEA, NDBA, NMOR; Geauga Company
0.08 ug/m(3) to 1.8 ug/m(3) NDMA; B.F. Goodrich Company
0.63 ug/m(3) to 37 ug/m(3) NMOR; B.F. Goodrich Company
3.3 ug/m(3) to 109 ug/m(3) DENA, DMNA, NMOR, NDPhA; Uniroyal, Inc.
0.11 ug/m(3) to 11 ug/m(3) NMOR, NDPhA; Kelly Springfield Tire Co.
0.05 ug/m(3) to 0.98 ug/m(3) NDMA, NMOR; St. Clair Rubber Company
(See Attachments)
Other levels of nitrosamines found in the rubber and tire industries:
NDMA 50 ug Nitrosamine/day
NDEA 50 ug Nitrosamine/day
NDBA 50 ug Nitrosamine/day
NMDR 50 ug Nitrosamine/day
NMPHA 50 ug Nitrosamine/day
(See Attachment)
Currently there are no OSHA Permissible Exposure Limits (PELs) for these amine compounds. OSHA does regulate N-Nitrosodimethylamine under 29 CFR 1910.1016. Use of the OSHA General Duty Clause, 5(a)(1) of the OSHA Act may be considered if the four elements needed to support a 5(a)(1) violation are met. Any levels of employee exposure should be considered serious. (Refer tothe OSHA Field Operations Manual (FOM) Chapter IV, A.2.a.)
At present, OSHA uses Thermosorb/N media or a 15 ml isopropanol bubbler for air sampling and these samples are analyzed by using the Thermal Energy Analyzer (TEA) or High Pressure Liquid Chromatography for most N-Nitrosamines. OSHA's Salt Lake City Analytical Laboratory (SLCAL) stated that in general there are no problems except for N-Nitrosophenylamine which is unstable in isopropanol used in the bubbler. Bubbler samples must be protected for light during and after sampling. Samples must be either stored in a freezer or analyzed within six days after collection. The limit of detection for most nitrosamines is as low as .02 ug per 75 liter of collected sample, according to the OSHA SLCAL.
OSHA Compliance Officers should be aware of the hazards of N-Nitroso compounds in the rubber and related industries to avoid potential exposures to themselves.
Appropriate compliance action, based on available information, should be taken to ensure that proper engineering controls, work practices, protective clothing and respirators are being utilized.
Engineering controls should include process enclosure, dilution or general ventilation and local exhaust ventilation. Isolation of the operation or equipment should also be considered.
Protective clothing, should include gloves, gowns, masks, and goggles, especially in laboratory settings, for the protection of the face, skin, eyes and other parts of the body.
At any detectable concentration, respirators should include full facepiece self-contained breathing apparatus operated in a pressure-demand or other positive pressure mode or a full facepiece supplied air respirator operated in a pressure-demand or other positive pressure mode in combination with an auxiliary self-contained breathing apparatus operated in a pressure-demand or other positive pressure mode.
Please disseminate this bulletin to all Area Offices, State Plan States and Consultation Project Officers.
The following are references on N-Nitrosamine that include specific operations in the rubber industry where significant amounts were found:
1. Fine, D.H.: Exposure Assessment to Preformed Environmental N-Nitroso Compounds from the Point of View of our own Studies; Oncology, 37, pp. 99-202, 1980.
2. Hydes, D.J.:, N-Nitroamines in the Rubber and Tire Industry, Science, Vol. 205, pp 1262-1264, September, 1979.
3. IARC, N-Nitroso Compounds: Occurrence, Biological Effects and Relevance to Human Cancer, Proceedings of the VIII International Symposium, I.K. O'Neill, Editor, IARC Scientific Publication No. 57, pp. 937-942, 1984.
4. NIOSH, Health Hazard Evaluation Report # HHE 79-126-951, U.S. HHS, CDC, NIOSH; St. Clair Rubber Company, Marysville, Michigan.
5. NIOSH, Health Hazard Evaluation Report # TA 80-121-919, U.S. HHS, CDC, NIOSH; Kelly-Springfield Tire Company, Freeport, Illinois.
6. NIOSH, Health Hazard Evaluation Report # HETA 81-045B-1216, U.S. HHS, CDC, NIOSH; Uniroyal, Incorporated, Mishawaka, Indiana.
7. NIOSH, Health Hazard Evaluation Report # HETA 85-003-1834, U.S. HHS, CDC, NIOSH; B.F. Goodrich, Woodburn, Indiana.
8. NIOSH, Health Hazard Evaluation Report # HETA 81-107-1331, U.S. HHS, CDC, NIOSH; Geauga Company, Middlefield, Ohio.
9. NIOSH, Industry Wide Report IWS-72.32, U.S. HHS, NIOSH; Survey for N-Nitroso Compounds at Oaks Tire Plant, B.F. Goodrich Company, Oaks, Pa., January 23, 1979.
10. NIOSH Technical Report # 83-114, U.S. HHS, CDC NIOSH; N-Nitroso Compounds in the Factory Environment, June 1983.
http://www.families-first.com/features/ovariancancer.htm
One or more of the following characteristics puts you at above average risk of ovarian cancer:
Family history of ovarian cancer, breast cancer, colon cancer.
Personal history of breast cancer, endometrial cancer, colon cancer.
No pregnancies or no birth control use and infertility (uninterrupted ovulation).
Exposure to talc or asbestos (industrial contamination, frequently used douches, CONDOMS, dusting powder containing talc, used in the genital area.
Increasing age.
Breast-Ovarian Cancer Syndrome(s)
Ashkenazi Jewish population.
Fertility drugs taken for more than three cycles has been linked to an
increased risk.
Why Don’t Condoms Stop HPV?
Human papillomavirus differs from other sexual disease in its method of transmission; it is not spread from one person to another through
the exchange of bodily fluids. Rather, it spreads through skin-to-skin contact. Since HPV is a regional, multicentric disease, it infects the
entire genital area: the penis, scrotum, vulva and surrounding areas.
Condoms do not cover the scrotum, nor most of the other areas that can be infected with the virus. There also tends to be contact between the anogenital skin of the partners before a condom can be correctly placed on the penis. "No known effective barrier exists that will protect the vulva or prevent vulvar transfer of the virus," according to Barbara S. M.D., M.S., clinical associate professor of family practice, University of Michigan Medical School. Adds Mary E. Verdon, M.D., of the American Academy of Family Physicians, "In the 1970s, it was demonstrated that a single sexual contact with a person infected with external genital warts carries about a 60 percent chance of transmission."
However, there are several different strains of HPV that do not cause genital warts; therefore, transmission can occur without the presence of any visible symptoms.
These strains are more likely to be cancerous.
-o0o-
Are condoms safe?
Dr. Patrick Dixon
A spokesman from the London Rubber Company (Durex) admitted that if incorrectly used, the failure rate of condoms could be anything from 25% up to 100%, and there are real problems with teaching people how to use them---not least because of illiteracy. Problems of illiteracy are so bad in the United States (one in five adults) that the army printed manuals in cartoon form for the Gulf War. In the United Kingdom, Durex instructions now contain illustrations for the one in ten who cannot read.
The condom is the least reliable contraceptive in wide use---it's as bad as the diaphragm or cap with spermicide. The only thing less reliable is the sponge (up to 25% pregnant each year). Many violently disagree. They say it is a superb contraceptive, it is people who are unreliable: they put it on too late or inside out, tear it, forget it, let it fall off. They say people are unreliable but the condom is reliable, if properly used.
Condoms may be too small for one in five men.
Recently there was an outcry about how dangerous three-wheeled invalid vehicles were. `Unsafe,' people said. No one went on TV to say that the vehicles were perfectly safe, it's just that people need to be careful when driving them when going round corners.
On the contrary, I think most people saw that average drivers could very easily have accidents through no fault of their own. It is easy to have an accident with a condom. Condoms are unreliable compared to, for example, the pill. That is why the pill is so popular---not just because it is a more convenient method.
Things are worse than they appear from the pregnancy rates. Out of 100 couples, ten will have great difficulty in conceiving anyway. Five will probably never be able to conceive for various reasons, including previous infections with sexually-transmitted diseases.
After four months of trying to conceive, only about half of an average group of women will succeed in becoming pregnant. If they used a perfectly safe method two out of three times that they had intercourse, it would take a year for half to become pregnant.
If they used the method for ten out of twelve months of the year, then twenty-five out of a hundred could be expected to get pregnant in a year. If they had unprotected sex for one month a year and used the method for eleven months, then it could be expected that over twelve would become pregnant in a year.
What this means is that if condoms produce a failure rate of around twelve in a hundred per year, then they must be leaking often. It is about the same thing as having intercourse for a whole month without any protection at all but taking the pill the rest of the year. Somehow or other secretions from a man and a woman are very frequently meeting each other.
This conclusion is confirmed by a study of 2,000 acts of intercourse by eighty heterosexual and seven homosexual couples, with fourteen types of condoms.
The overall failure rate from slippage or rupture was 11.3%, even higher than the one in twelve (8.3%) theoretical rate predicted above.
Are Condoms Really Safe?
Fact: Latex condoms have tiny intrinsic holes called "voids." The AIDS virus is 50 to 700 times smaller than these tiny holes which makes it easy for the virus to pass through them (5), about as easy as a dime passing through a basketball hoop.
References
(1) "Contraceptive Failure Rate in the U.S.: Estimates from the 1982 National Survey of Family Growth, " M.D. Hayward and J. Yogi, Family Planning Perspectives, Sept/Oct. 1986, p. 204.
(2) "Contraceptive Failure Rate in the U.S.: Revised Estimates From the 1982 Natl. Survey of Family Growth," E.F. Jones and J.D. Forrest, Family Planning Perspectives, May/June 1989, p. 103.
(3) "Condom 'Cure' Questioned by top AIDS researcher," Russell Shaw, Our Sunday Visitor, 1/23/94.
(4) "Condoms: Experts Fear False Sense of Security," The New York Times, 8/18/87.
(5) Dr. C.M. Roland, Editor of Rubber Chemistry and Technology, Letter to the Editor, The Washington Times, 4/22/92.
(6) Sources for STD statistics: The Alan Guttmacher Institute, New York and the Centers for Disease Control, Atlanta.
-o0o-
Condoms have an annual contraceptive failure rate of 18.4 percent for girls under age 18 (1). And among young, unmarried, minority women the annual failure rate is 36.3 percent; among unmarried Hispanic women it is as high as 44.5 percent (2).
(2) "Contraceptive Failure Rate in the U.S.: Revised Estimates From the 1982 Natl. Survey of Family Growth," E.F. Jones and J.D. Forrest, Family Planning Perspectives, May/June 1989, p. 103.
1.Because syphilis can be spread through direct contact with infected material, condoms may NOT be completely effective in preventing the
spread of syphilis.
From: - AIDS Project Los Angeles Web Site
http://www.apla.org/apla/ed/syphilis.html
What You Need to Know About Latex Allergy
Find out how to protect your patients, your colleagues, and yourself from harm.
By: Sharon Burt, RN, C, ANP, MSN
Occupational Health Nurse Practitioner
Children’s Hospital of Philadelphia
Philadelphia, PA
A FEW WEEKS AGO, A STAFF NURSE CAME TO THE employee health department to be evaluated for symptoms related to latex exposure. Four years ago, when she started working in the cardiac care unit, she noticed that her hands were always dry and cracking. A year later, she developed pruritus with erythema, blisters, and welts on her hands when wearing powdered latex examination gloves. When she switched to synthetic gloves, her hands improved dramatically. Her colleagues in the cardiac care unit continued to use powdered latex gloves.
She's now experiencing intermittent episodes of ocular swelling and pruritus with blisters around her eyes when at work. Recently, while attending a birthday party, she had itchy, swollen eyes about an hour after two balloons were punctured nearby. Her medical history includes eczema as a child, food allergies, and a recent diagnosis of hay fever.
Does this scenario sound like you or someone you know? Latex allergy poses a serious problem for nurses and other health care workers; an estimated 8% to 17% of health care workers are allergic to latex, compared with 1% to 6% of people in the general population. According to a 1996 survey, 75% of U.S. hospitals employ workers with diagnosed latex allergies, up from 62% in 1995.
Anaphylactic reactions to latex can be fatal: As of June 1996, 28 latex-related deaths had been reported to the Food and Drug Administration (FDA).
What's behind the recent epidemic of allergic reactions to latex? Experts point to several possible factors:
* Healthcare workers' exposure to latex has increased dramatically since universal precautions against bloodborne pathogens were mandated in 1987. Latex gloves, already popular for their low cost and flexibility, were considered the barrier of choice against human immunodeficiency virus (HIV). Glove use-some of it unnecessary-skyrocketed. (For more on appropriate and inappropriate glove use, see "Your Guide to Gloves," Nursing97, March.)
* With the demand for latex gloves rising exponentially, inexperienced manufacturers hopped on the bandwagon. Depending on the manufacturer and the source of the latex, the amount of latex protein remaining in gloves reportedly has varied as much as 3,000-fold.
In this article, I'll discuss the pathophysiology and types of latex allergy, diagnostic criteria, and practical steps that you can take to protect yourself, your colleagues, and your patients.
A latex primer
Natural rubber latex can be found in numerous household and medical products, including balloons, condoms, envelope glue, television remote controls, some carpet backing, bandages, stethoscope tubing, catheters, injection ports, and, of course, gloves. But the term "latex" doesn't always mean natural rubber latex; for example, latex paint usually contains no natural latex.
Natural rubber latex comes from the milky sap of the Brazilian rubber tree (Hevea brasiliensis). The sap contains rubber globules and tree proteins. To keep the latex from degrading and its bacteria count from increasing, preservatives and chemicals-which also can cause skin irritation and allergy-are added during the collection and manufacturing processes.
The production method plays a role in a product's allergenicity. Dipped latex rubber products-for example, gloves, condoms, and balloons-have a higher extractable protein level and are more allergenic than products such as tires, erasers, and injection ports, which are made from dry gum rubber.
The trouble begins
Latex proteins can enter your body in various ways-through skin or mucous membranes, intravascularly, or via inhalation. The cornstarch powder used to make latex gloves easier to slip on is a carrier of latex proteins. Cornstarch absorbs the latex proteins from
the gloves; when you don or remove gloves, these particles become airborne-and can remain so for hours. From the air, they can be inhaled or settle on clothing, skin, or mucous membranes.
Latex can trigger three types of reactions (see Latex's Triple Threat): irritant contact dermatitis (irritation from chemicals; not a true allergy because the immune system isn't involved); allergic contact dermatitis, also known as delayed hypersensitivity or Type IV allergy, the most common type of reaction; and immediate hypersensitivity, a systemic reaction, also called Type I IgEmediated reaction. Although some people use the term "latex allergy" when describing irritant contact dermatitis or allergic contact dermatitis, it really refers only to immediate hypersensitivity reactions.
If you suffer irritant contact dermatitis, you may be tempted to use hand lotion under your gloves. But this can actually make the situation worse: petroleum-based lotions leach latex proteins out of the glove, increasing skin exposure and the risk of developing a true allergy. Likewise, skin breakdown associated with irritation allows more latex protein or chemical additives to enter the body, contributing to the development of true allergy.
Who's at risk?
You are-and so is anyone routinely exposed to latex. Children with spina bifida or congenital urologic abnormalities, for example, are especially vulnerable because they typically undergo repeated surgeries or catheterizations that involve latex contact with the mucosa. Workers in plants that manufacture latex-containing items are also at high risk.
Besides repeated exposure to latex products, other risk factors include a history of allergies, including food allergies and eczema. Whether contact dermatitis is a risk factor for immediate hypersensitivity reactions remains controversial; some published research has suggested it's not a key factor.
Suspect latex sensitivity in anyone-yourself, a colleague, or a patient-who develops itchy, watery, or red eyes; nasal or sinus irritation; contact dermatitis of the hands; hives; shortness of breath; dry coughing or wheezing; chest tightness; or flushing, tachycardia, and hypotension after exposure to latex.
Diagnosing latex allergy
If you work in an area where you make frequent glove changes-the intensive care unit, emergency department, delivery room, or operating room, for example-you should wear synthetic examination gloves unless there's a risk of contact with infectious material (if so, wear low-protein, powder-free latex gloves). You may also want to be tested to detect latex sensitivity early, before it becomes serious enough to endanger your position or your life. But testing also has implications: Job and insurance discrimination is illegal, but it can still happen.
A detailed history is the primary way of diagnosing immediate hypersensitivity. Blood and skin tests-preferably done by a specialist in latex allergy-may also be done, but no test is 100% accurate, and someone who's symptomatic may have false-negative test results. (A recent study found that two blood tests-AlaStat and CAP-were positive in only 50% of patients with a strongly positive history and positive skin test.) A symptomatic person with negative test results should be considered allergic to latex.
The skin-prick test is performed by placing a drop of dilute latex allergen extract (made by cutting up latex gloves and soaking them in saline) on the skin, which is then pricked with a lancet. If a wheal and flare develop within 15 minutes, the test result is positive. This test can trigger serious allergic reactions, including anaphylactic shock, in people who are severely allergic, so be prepared to treat a reaction.
Researchers have tested a standard latex extract in clinical trials, and the data have been submitted to the FDA for approval.
The RAST (radioallergosorbent testing) immunoassay is a blood test that measures the serum level of latex-specific IgE. This test simply involves drawing a blood specimen, so it poses no risk of triggering anaphylaxis; there's no exposure to latex. But it isn't as sensitive as a skin-prick test.
Patch tests, which reveal sensitivities to latex and synthetic rubber additives, are used to diagnose allergic contact dermatitis. In these tests, patches of gloves containing various allergenic rubber chemical additives are taped to the person's back and left in place for 48 to 96 hours. The skin reaction beneath each patch is checked at 48 hours and again at 96 hours to determine which additives cause sensitivity.
Patch tests are reliable for delayed hypersensitivity allergy. Anaphylaxis is a risk if latex glove patches are used and the person also has an immediate hypersensitivity to latex.
I'm allergic: What now?
Because latex is complex, desensitizing injections (like those available to manage other allergies) are potentially dangerous and need to be studied; a clinical trial of desensitization injections is under way in Europe. More than 200 proteins are found in latex, and more than 50 can cause allergy. Different people react to different proteins.
Completely avoiding highly allergenic latex-containing items is important. But avoiding all latex is more difficult; latex is in more than 20,000 medical products. A product can be latex-free, but an environment is generally described as "latex-safe" if the most allergenic latex items and any latex that would come in contact with the patient have been removed.
If you're latex- sensitive, take these steps to reduce your risk of an allergic reaction, lessen the severity if a reaction occurs, and obtain information on latex allergy:
* Investigate your facility's policies for latex-sensitive employees. Managing latex-sensitive employees is controversial, and experts offer a wide range of advice. Some suggest that if you have symptoms of allergy at work, everyone in the unit should switch to synthetic gloves. Others believe that latex-sensitive health care workers should transfer to a safer environment, perhaps outside health care. Some workers have been able to return to work by switching to synthetic gloves although their colleagues continue to use latex gloves.
Many hospitals are going latex-safe, starting with the universal use of low-protein, powder-free latex examination gloves, then switching to synthetic versions of products, such as catheters, that come in contact with mucosa. Hospitals, like other workplaces, have a legal responsibility to provide a safe work environment and, under the Americans with Disabilities Act, must make reasonable accommodation for latex-sensitive workers.
* Avoid latex exposure by using synthetic gloves. All latex gloves have some level of latex protein, and continued exposure, even to low-protein latex gloves, can continue to sensitize you and cause worse reactions.
* Learn which medical and household items contain latex and what substitutes are available.
* Tell your health care providers (such as your dentist) that you're latex-sensitive. Make sure they wear synthetic gloves when treating you. Consider taking a supply with you to appointments, and encourage them to use latex-safe products with all their patients.
* If you have immediate hypersensitivity reactions to latex, carry a quick-acting oral antihistamine and an epinephrine autoinjector at all times.
* Wear a medical-alert bracelet or tag and carry a wallet card stating “latex allergy.”
* Join a latex allergy support group for support and information. Two newsletters also are available: Latex Allergy News ([860] 482-6869) and Alert (1-888-97-ALERT).
Taking latex to task
Managing latex allergy and preventing sensitization of others go hand in hand. Whether or not you're latex-sensitive, get involved with the latex allergy task force at your facility. If a task force doesn't exist, organize one. Housekeeping, food service, and lab workers, for example, often wear gloves and are at risk for latex sensitivity and should be represented on a latex allergy task force. They also can expose patients allergic to latex. Latex proteins readily transfer, and persons who are latex-sensitive may react to food handled by workers wearing latex gloves.
A latex task force's goals should be to:
* develop facility policies for safely caring for latex-sensitive patients and for preventing staff sensitization (see Caringfor Latex-Sensitive Patients)
* educate staff members about latex allergy and its prevention
* review glove use and create a latex-safe environment. Synthetic gloves should be the standard when caring for a latex-sensitive patient. Double-gloving (putting a latex glove over a synthetic -one) is dangerous because latex particles still can become aerosolized during glove changes. (For more on glove types, see A Guide to Gloves.)
Hope for the future
As public awareness-and pressure-grows, glove and medical-device manufacturers are working to develop better latex and latex-free alternatives at a reasonable cost. Meanwhile, researchers are trying to identify which latex protein, or proteins, cause allergy-information that would improve diagnostic tests and treatment options. For now, the key is to work with regulatory agencies, industry, and each other to prevent health care workers and patients from becoming sensitized-and to protect those who already are.
SELECTED REFERENCES
Kelly, K.: "Management of the Latex Allergic Patient," Immunology and Allergy Clinics of North America. 15(l):139-157, February 1995.
Kelly, K., et al.: "The Diagnosis of Natural Rubber Latex Allergy," Journal of Allergy and Clinical Immunology. 93(5):813816, May 1994.
Kim, K., et al.: "Diagnostic Evaluation of Type I Latex Allergy," Annals of Allergy, Asthma, and Immunology. 80(l):66-70, January 1998.
Kim, K., et al.: "Implementation Recommendations for Making Health Care Facilities Latex Safe," AORN Journal. 67(3):615632, March 1998.
SELECTED WEB SITES NIOSH's Latex Allergy Alert: http://www.cdc.gov/niosh/latexalt.html
Foundation for Latex Allergy Research and Education: http://www.flare.org
Latex Allergy Links: http://www.netcom.com/-naml/latex-allergy.html
Latex Allergy Help: http://www.latexallergyhelp.com
Last accessed on August 24, 1998.
COMMON LUBRICANTS AND THEIR SIDE EFFECTS
Nonoxynol 9: Poison by intraperitoneal route. Mutation data reported. When to decomposition, it emits acrid smoke and fumes (HC, . 958).
Parrafin: Possible carcinogen with experimental tumorigenic data by implant route. (HC, p. 982; HOP, p. 212).
Chlorhexidine: Mildly toxic by ingestion. Skin irritant. Mutation data reported (HC, p. 167).
Lidocaine: Poison by ingestion and subcutaneous routes. Excitement, hallucinations, distorted perceptions, changes in heart rate, and dyspnea. Anaesthetic rapidly absorbed by mucous membranes. Excessive doses may cause methemoglobinemia (HC, p. 439;
HOP, p.341.)
Mineral oil/petrolatum: A human teratogen that causes testicular tumors in the fetus.
of vapor or particles can cause pneumonia.
Possibly
produces gastrointestinal tumors. Deposits accumulate in the lymphnodes and dissolves and prevents the absorption of vitamin A from the intestines (HC, p. 885; HOP. p. 206, 410.)
Polyethylene glycol: Moderately toxic. Eye irritant. Possible carcinogen and flammable. Many glycols produce severe acidosis, central nervous system damage, and congestion (HC, p. 1053; HOP, pp. 193-195.)
Sodium borate: A.K.A. borax. Toxic to all cells. Prolonged absorption casues anorexia, vomiting, diarrhea, and anemia (HOP, p. 396).
Propylene glycol: Slightly toxic. Causes convulsions, mutations, and surface EEG changes (HC, p. 1086).
Carboxymethylcellulose,
hydroxymethylcellulose,
polyscorbate 60:
The first of these compounds has been shown to cause cancer in animals. Used in cosmetics, inhalation of these products could cause chemical pneumonitis. Bodily implantation of these substances will cause foreign body [antibody] reaction (HOP, p. 308).
Triethanolamine: Moderately toxic by ingestion. Liver and kidney damage has been demonstrated in animals from chronic exposure. Possible carcinogen (HC, p. 1273).
Methylparaben, propylparaben: Close chemical cousins of benzoic acid. Poisonous and moderately toxic. An allergen. Causes dyspnea and allergic dermatitis (HC. pp. 132, 695, 702).
Source: The Hazardous Chemicals Desk reference (HC) and The Handbook of Poisoning (HOP).
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