Can a threshold limit value for natural rubber latex airborne allergens be defined?

BACKGROUND Recent studies have shown that systemic or respiratory occupational responses to latex can be induced by inhalation of latex aeroallergens. OBJECTIVE Our objectives were to study the relationship between exposure to different latex aeroallergen levels and type I allergic reactions in subjects with occupational contact with latex and to assess a threshold value for latex airborne allergens required for sensitization and symptom elicitation. METHODS We screened 145 subjects working in 32 hospitals or operating rooms with different latex aeroallergen levels. The quantified latex aeroallergen concentrations in the 32 rooms were compared with latex-related allergic symptoms. RESULTS Different latex aeroallergen concentrations could be detected in rooms where powdered latex gloves were used and no effective ventilation systems were installed. In environments with latex aeroallergen levels of 0.6 ng/m3 or greater, the reported workplace-related symptoms were significantly increased (p < 0.02). All 22 subjects with latex-specific IgE antibodies worked in rooms contaminated with latex aeroallergens (p < 0.05). CONCLUSIONS Our results demonstrate that symptoms and presence of latex-specific IgE antibodies in subjects are significantly associated with measurable levels of latex aeroallergens. A latex aeroallergen level of 0.6 ng/m3 is a critical threshold, especially for health care workers who are sensitized to natural rubber latex.