Allergic to latex
Latex allergies are a lot more than just a rash caused by gloves. For many victims allergies have had life changing, and in some cases, life threatening consequences. Helen Tomlin explains the type of latex allergies that exist and the responsibilities that employers have to sufferers
Tanya Dodd lives in constant fear of coming into contact with latex. The life and career of the former trainee nurse at Scarborough General Hospital was blighted after developing type 1 latex allergy from gloves worn routinely as part of her job.
Any contact with latex could send her into potentially fatal anaphylactic shock. Tanya has to live in a latex free environment, which has included replacing everyday items such as hairbrushes, pens, mobile phones and shoes with latex-free alternatives. She has also been forced to change her diet to eliminate foods that have similar proteins to latex, such as melon and grapes.
Thompsons, instructed by UNISON, secured a six figure compensation settlement for Tanya. But no amount of compensation can make up for the loss of her career and the devastating impact that the allergy has had on her life.
Tanya was in the middle of her nursing training when her symptoms developed. The hospital had not mentioned the dangers of latex to her and she was never advised to minimise her exposure to it.
The only type of glove available on the wards was latex based and Tanya was told that if she was caught using latex-free gloves without special authorisation from occupational health and the ward sister, she could face disciplinary action.
Dugmore
Yet the dangers of developing latex allergy are well documented. It is hard to believe that health sector employers have not taken heed of the widely publicised case of Alison Dugmore, whose eight-year battle for compensation resulted in the groundbreaking legal decision holding employers strictly liable for ensuring that employees are protected from harmful substances such as latex.
This meant that employers could no longer argue that they didn’t know a substance was harmful.
In Dugmore, the employers argued that Mrs Dugmore’s latex allergy had developed before they could have reasonably been expected to be aware of it. However, on appeal, the court held that this was no defence.
Under the COSHH Regulations 2002, Dugmore established that regulation 7(1) imposes an absolute duty that employers shall either prevent or control exposure of employees to harmful substances. Therefore, an employers’ duty to prevent or control exposure is not confined to foreseeable risks, nor is it dependent upon the results of a risk assessment. The duty is absolute, non-delegable and strict.
There is no way of predicting who is likely to develop a latex allergy, or what type of the three reactions they will suffer. The least serious, irritant contact dermatitis, manifests itself as an itchy skin rash, located in the area that has been in contact with the latex product.
The second is Type IV latex allergy, which is an allergy to the chemicals used in the NRL products and results in a red scaly area on the skin of the affected person. This typically occurs within six to 48 hours of exposure.
And the most serious Type 1 latex allergy sees the sufferer develop urticaria, asthma, hayfever-type symptoms, incessant itching and in some cases anaphylaxis.
There is no cure and the more an allergic person is exposed to latex, the more serious the reaction becomes.
Risk assessments
The risk assessment is the most useful tool in identifying areas where staff are at risk of developing latex allergy.
As no one knows who will develop allergic reactions to latex, all staff must be protected through a risk assessment. The risk assessment should look at work done and risk of infection. Where there is a risk of infection, latex gloves may be provided. But employers can also use the risk assessment to look at eliminating the risk from unnecessary exposure to latex, substituting other materials where feasible, such as vinyl or nitrile gloves, and generally limiting exposure to latex.
The risk assessment should simply ask “do we need to use latex-based products to complete this task, or is there an alternative?” It should be recorded and staff given appropriate training and health information based on its findings to enable them to protect themselves.
The employer also has a duty to positively monitor employees’ health. Staff must undergo regular health surveillance to monitor for asthma or dermatitis reactions.
This includes an assessment of previous medical history for respiratory or skin problems before they start a job where there is a risk of latex exposure, yearly checks on all staff’s respiratory and skin conditions and a written record made of the findings.
For staff known to be particularly at risk of developing a reaction to latex, such as those with asthma, these checks should be more frequent.
Where a positive result is identified from the health checks, or a person is suspected of having contracted latex allergy, they should report the matter immediately to the identified person within their employer, who should then refer the person for testing and diagnosis through the occupational health department.
Steps should then be taken to assist the person in avoiding further exposure to latex by providing latex-free equipment and a latex-free environment.