Latex allergy among operating room personnel in Turkey.

This study was performed to evaluate the prevalence of latex allergy among health care workers in Turkey, as well as to compare the medical histories with the skin test results and investigate the risk factors. Using a 1/100 weight/volume commercial skin prick test (SPT), we investigated latex sensitization in 206 health care workers who regularly use latex products. One hundred atopic and 100 nonatopic patients without occupational latex exposure were also examined as control groups. Latex SPTs were positive in 10 health care workers (9.22%), whereas none of the control patients was found to have positive SPT to latex. Health care workers were divided into two groups based on the latex SPT results. There was no significant difference between the latex SPT-positive and -negative health care worker groups according to age, sex and total exposure time to latex. In the latex SPT positive group, daily exposure time and daily glove use were significantly higher (p <0.05). The symptoms related to latex products were limited to hands and itching was present in all, however, erythema was found in 68.4%, and contact urticaria in 52.6% in the latex SPT positive group. These symptoms in the latex SPT negative health care group were 21.4%, 14.4%, and 1.6%, respectively (p <0.0001). History of allergic rhinitis, bronchial asthma and conjunctivitis were also higher in the SPT-positive group (p <0.05). Additionally, we found sensitivity to house dust mites and/or grass pollens in seven cases of latex allergy. Patch tests with rubber additives were positive in five out of 42 medical care workers. Two surgeons were found to have both type-I hypersensitivity to latex and type-IV hypersensitivity to rubber additives. Our results suggest that the frequency of latex allergy is higher in the atopic health care workers with a high exposure to latex, and that SPT is a sensitive, safe, cheap and easy method of testing the diagnosis of latex hypersensitivity.     

IgE-mediated metamizol allergy and the usefulness of the cellular allergen stimulation test

Metamizol is a pyrazolone-derivative nonsteroidal anti-inflammatory drug that is commonly associated with hypersensitivity reactions. Some of these reactions are IgE-mediated and potentially severe, which limits the diagnosis based on oral drug challenge. We describe 6 selective metamizol hypersensitivity cases, regarding clinical evaluation and diagnosis management, with focus on the usefulness of skin tests and the cellular allergen stimulation test (CAST). All patients were female, aged 27 to 50 years old. All had immediate reactions after metamizol administration: 3 had anaphylaxis and 3 had urticaria and angioedema. Skin prick tests with metamizol were positive in 2 patients. Intradermal tests were positive in the remaining, all with 1/100 dilution, and elicited systemic reactions in 2 of them. CAST to metamizol was negative in all cases. The patients tolerated other nonsteroidal anti-inflammatory drugs. Skin tests proved to be a good diagnostic method to identify IgE-mediated metamizol allergy, although skin tests elicited systemic symptoms in some cases. Despite this being a small sample, our results showed a very low sensitivity for CAST which differs from data previously reported in the literature.     

Asthma severity and morbidity in a population sample of Sydney schoolchildren: Part II - Importance of house dust mite allergens

Background : Despite an increasing prevalence of childhood asthma, few studies have quantified the strength of associations between asthma and its aetiological factors.
Aims : To quantify the risk factors associated with childhood asthma and to investigate the characteristics of children most at risk.
Methods : We studied a population sample of 1339 schoolchildren aged eight-11 years living in Sydney, NSW. Questionnaires were used to measure respiratory illness, histamine inhalation test to measure airway hyperresponsiveness (AHR), skin prick tests to measure atopy and ELISA assay to measure house dust mite allergen ( Der p I ) levels. 'Current asthma' was defined as the presence of wheeze in the previous year and AHR.
Results : The mean Der p I level in 72 homes was 22.5 μg/gm dust which is high compared to suggested thresholds of 2 μg/gm for sensitisation and 10 μg/gm for exacerbation of symptoms. Sensitisation to house dust mites was the most important risk factor for current asthma (odds ratio 7.0, 95% CI 9.4, 22.2). Sensitisation to ryegrass was of minor importance (odds ratio 2.0, 95% CI 1.4, 3.1). The presence of AHR was strongly related to the degree of sensitisation to house dust mite allergen and children with skin wheals greater than 4 mm had frequent morbidity caused by asthma.
Conclusions : To reduce the high prevalence of childhood asthma in NSW, it is imperative that we design interventions which recognise that house dust mite allergens are a dominant risk factor and that children with large skin wheal reactions to this allergen are most at risk for severe illness including disturbed sleep, days missed from school and urgent medical attention.     

ANALYSIS OF ALLERGEN–SPECIFIC IgE RESPONSES IN 341 ALLERGIC PATIENTS. ASSOCIATIONS BETWEEN ALLERGENS AND BETWEEN ALLERGEN GROUPS AND CLINICAL DIAGNOSES

Abstract: An allergic population of 341 patients was studied using 14 different allergen extracts in skin prick tests and radioallergosorbent tests (RAST) in an attempt to identify important allergen sources in the Sydney area and to examine relationships between these diagnostic methods and a number of clinical parameters. A computer based statistical analysis of the data revealed that: (a) male patients showed a significantly higher frequency of skin test reactivity to extracts of house dust and the house dust mite Dermatophagoides farinae; (b) the incidence of positive prick test reactions declined with age; (c) cross–reactive allergenic determinants were found in taxonomically–related extracts ( e.g. between different house dust mites, pollens, and fungi); (d) a clear correlation emerged between relative potency using a histamine standard and RAST score which supports the continued use of histamine as a standard in skin prick testing; and (e) important associations between certain allergens and clinical diagnosis emerged (e.g. positive skin test reactions to house dust mites and epithelia but not pollens were associated with asthma).     

Sheepskins and bedding in childhood, and the risk of development of bronchial asthma

Background: Sheepskin bedding might increase house dust mite exposure and so explain some of the increasing prevalence or severity of childhood asthma.
Methods: Relationships between use of different types of bedding, and diagnoses of asthma, symptoms of wheezing, skin prick test evidence of house dust mite sensitivity, and airway responsiveness to methacholine, were examined retrospectively in a birth cohort of children followed longitudinally to age 15 years.
Results: In the whole cohort, no associations were identified to suggest a causal relationship between use of any type of bedding and development of features of asthma. Although not an a priori hypothesis, we noted that among children with a family history of atopic disease, those who were house dust mite sensitive were more likely to have used an innerspring mattress (29.6% vs 10.2% who had not used an innerspring mattress, ρ= 0.005).
Conclusion: In this subgroup, increased airway responsiveness and mite sensitivity were significantly associated with use of innerspring mattresses, although whether this is a causal or secondary association is not certain. Use of a sheepskin in the bed in early childhood was not an additional risk factor for the development of asthma. (Aust NZ J Med 1994; 24: 687–692.)     

Latex allergy and fruit cross-reaction in subjects who are nonatopic.

Since the first case reported in 1927, latex allergy has attracted the attention of allergists including its capacity to cross-react with fruits. To evaluate the frequency of sensitivity to some fruit allergens shown to cross-react with latex, we evaluated 82 patients (43 men and 39 women, aged between 18 and 45 years) with latex allergy. All patients underwent skin tests with various fruit extracts that potentially cross-react with latex. Only patients with negative prick tests successively underwent prick-by-prick tests with fresh fruits. Thirty-nine of 82 patients (47.5%) were found to have positive skin tests. Prick tests with fruit extracts were positive in 28 patients (kiwi, 21 patients; banana, 17 patients; avocado, 8 patients; and papaya, 3 patients), and the prick-by-prick test had positive results in 11 patients (kiwi, 7 patients; banana, 4 patients; and avocado, 3 patients). In our experience patients with latex allergy are at a high risk of sensitization to some fruits and they often develop allergic reactions, even severe ones, after eating them; for this reason fruit sensitization should be taken into consideration when investigating patients allergic to natural rubber latex.     

蟑螂过敏患者对蚕蛾与尘螨过敏原体外检测研究

目的探讨对蟑螂变态反应性疾病患者血清中蚕蛾与尘螨过敏原特异性免疫球蛋白E（SIgE）的情况以及它们的相互关系。方法采用荧光酶联免疫吸附试验,对本院呼吸科和变态反应科门诊,经变应原皮试和体外血清SIgE检测,德国小蠊（Blatella germanica）变应原结果均为阳性的33例患者,继续给予检测美洲大蠊（Periplaneta Americana）、蚕蛾（Bombyx）和屋尘螨（Dermatophagoides pteronyssinus）3种常见昆虫变应原SIgE的测定。结果在变态反应性疾病的患者中,对这4种昆虫变应原同时过敏的患者,对蟑螂和蚕蛾的过敏程度均为弱阳性（4级以下）,其SIgE值显著低于屋尘螨（P〈0．001）;通过线性回归分析,显示两种蟑螂与蚕蛾两两之间存在显著的正相关关系（P〈0．001）,而蟑螂、蚕蛾与屋尘螨之间均不存在相关关系。结论对于蟑螂、蚕蛾和屋尘螨同时过敏的患者,屋尘螨的过敏程度最高;德国小蠊、美洲大蠊与蚕蛾之间可能具有共同的IgE结合成分。     

Latex allergen sensitization and risk factors due to glove use by health care workers at public health units in Florianopolis, Brazil.

BACKGROUND: Natural rubber latex allergy is a "new" illness whose prevalence has reached epidemic proportions in highly exposed populations such as health care professionals. OBJECTIVE: The aim of the study was to evaluate the frequency of reactions to latex and risk factors due to glove use in health care workers (HCW) in Florianopolis, Santa Catarina, Brazil. METHODS: We evaluated latex-related allergy in 260 HCW by means of a questionnaire, skin prick tests (SPT) and serum latex specific IgE antibody levels. The subjects were divided into two groups depending on level of exposure to latex gloves. Comparisons were made between the different variables and a risk score was calculated using logistic regression analysis. RESULTS: Glove-related symptoms were observed in 57% of 140 HCW. Significant differences between HCW and control groups were found for the following symptoms: contact dermatitis (P < .0001), cutaneous rash (P < .0001), asthma or allergic rhinitis (P < .0001), symptoms associated with toy balloons (P < .0001), airborne glove powder causing latex allergen reaction (P < .0001), food allergy (P < .0001), fruit allergy (P < .0001) and multiple surgical interventions (P = .0052). Contact dermatitis and anaphylaxis were the main problems, with a high risk factor for the development of latex allergy. Logistic regression analysis showed a significant positive association between the risk of latex allergy and those subjects who reported more than 4 positive answers on the questionnaire (including SPT) (odds ratio 6.8; 95% confidence interval 0.7-60.3). No latex-related allergy symptoms were reported by the control group. Serological latex specific immunoglobulin (Ig) E antibody levels were negative for both groups. CONCLUSION: It is essential to recognize which professionals are sensitized to latex in order to provide appropriate treatment and to establish adequate prevention.     

Latex-vegetable syndrome due to custard apple and aubergine: new variations of the hevein symphony.

An increasing number of vegetables with crossreactions to latex are being described in patients with latex-vegetable syndrome. We present two of these vegetables, custard apple linked in two previous cases with latex sensitisation, and aubergine, that had not been described up to now in patients with latex sensitisation. The diagnosis of both cases was based on the clinical history, positive skin prick test (SPT) and specific IgE to the offending vegetables, as well as to positive SPT and specific IgE levels to latex and the major fruits involved in the latex-fruit syndrome (avocado, banana, and chestnut). Further, crude extracts from latex, custard apple and aubergine, as well as the purified allergens Hev b 6.02 and Prs a 1 were used in in vitro and in vivo assays: IgE immunodetection, histamine release (HRT) and basophil activation (BAT) tests and skin prick tests. In case 1, both purified Hev b 6.02 and Prs a 1 induced positive responses in skin prick tests, high levels of basophil activation and histamine release. Specific IgE immunodetection uncovered a reactive band of 45 kd in the crude custard apple extract, which was also recognized by anti-chitinase monospecific antibodies. The serum from patient 1 also detected Prs a 1 in immunodetection. Hev b 6.02 produced positive skin responses and showed high biological activity in HRT and BAT in the case of patient 2. However, Prs a 1 was reactive neither in SPT nor in IgE immunodetection. In fact, no band was detected using the serum of patient 2 in avocado or aubergine extracts. By contrast, Prs a 1 reached high values of basophil activation and over 10% of histamine release in case 2.     

Prevalence of latex sensitization in health care workers of a general hospital in Palermo, Sicily.

STUDY OBJECTIVE: To assess the prevalence of latex sensitization in a group of hospital employees in a general hospital. DESIGN: Cross-sectional study on hypersensitivity to latex gloves among health-care workers. SETTING: A general hospital in Palermo, Sicily. PATIENTS: 196 health-care workers answered a questionnaire about their case history of allergic diseases (i. e., rhinitis and/or asthma) and about symptoms after wearing latex gloves. All subjects were tested by skin prick test (SPT) with commercial latex extract and aeroallergens and had blood draw for total serum IgE and latex-specific IgE testing and glove-use test. MAIN RESULTS: 42% of the subjects who answered the questionnaire reported at least one symptom after wearing latex gloves. All symptoms were local, and none of the subjects reported systemic reactions. The most common symptom was itching, but none of subjects with only itching presented a positive SPT or specific serum IgE to latex. The SPT to latex was positive in 19 of 196 subjects (9.7%). Specific IgE to latex were found in 15/196 subjects (7.6%). Glove-use test was positive in 14/196 (7.1%). CONCLUSIONS: The overall prevalence of latex sensitivity in health-care workers in our epidemiological setting is 7.1%. An accurate diagnosis must take in account the integration of in vivo and in vitro tests with previous history of allergic disease.     

Risk factors for asthma among young adults in Melbourne, Australia

Abstract Asthma is more prevalent in Australia than in Europe or North America. As part of the European Community Respiratory Health Survey (ECRHS), we investigated exposure to risk factors for asthma among young adults in Melbourne. During this study, 553 randomly selected and 204 symptomatic participants aged between 20 and 44 years completed a detailed respiratory questionnaire, of whom 675 underwent measurement of bronchial hyperreactivity (BHR) by methacholine challenge and 745 had skin prick tests for atopy. Current asthma, defined as BHR and wheeze in the preceding 12 months, was present in 25.5% of those tested. A family history of asthma was a risk factor for current asthma (maternal asthma odds ratio [OR] 2.4, paternal asthma OR 2.1). Current smokers were 1.7 times more likely to have current asthma. A serious respiratory infection before 5 years of age increased the risk of current asthma 2.3-fold. Atopy on skin testing was also strongly associated with current asthma (OR 5.9). The greatest risks were associated with positive skin tests to Cladosporium , house dust mite, cat and rye grass pollen. We conclude that female gender, maternal asthma, smoking, hayfever, early respiratory infection, occupational exposure and atopy are important risk factors for asthma in young adults.     

Allergic contact dermatitis to synthetic rubber following breast augmentation

Allergic reactions associated with silicone injection and implant were examined in a 50-year-old woman with a granulomatous reaction following breast silicone-gel prosthesis rupture who developed a delayed hypersensitivity to rubber compounds. Patch tests with SIDAPA, dental, and rubber series as well as open tests with latex, silicone and non silicone tubes, open application test with silicone gel, and skin prick test for aero and food-allergens were performed. Total and specific serum IgE measured by CAP-FEIA. Skin tests revealed a delayed-type hypersensitivity to thioureas, thiuram mixture and platinum. Specific IgE to natural rubber latex were found. Allergic contact dermatitis from thioureas, thiurams and platinum might be under-diagnosed, as they are not tested as part of the standard patch test series. Clinicians should consider this diagnosis in patients submitted to several cosmetic treatments.     

Prevalence of latex sensitivity in patients with malignancies.

An increased frequency of allergic reactions to latex have been reported in specific populations with chronic latex exposure (e. g., children with spina bifida, health-care workers, rubber and doll-manufacturing workers). However, latex sensitization occurs in adult patients with no known risk factors. This study investigated hypersensitivity to latex in patients with malignancies. MATERIAL AND METHODS: We studied 70 adult patients (40 females, 30 males) with a standard questionnaire, skin prick tests (SPTs) with latex, common aeroallergens and fruits to all of the subjects. In addition, specific IgE concentrations for all of these allergens were measured in serum with the Pharmacia UniCAP system. RESULTS: The prevalence of latex sensitization was found to be 11.4% (n = 8). Both SPTs and anti-latex IgE antibodies of these patients were positive in the sera. Latex sensitization was related to the personal history of allergic diseases (p = 0.02), the duration of disease (p = 0.01), and the number of invasive procedures (p = 0.04). DISCUSSION: This study shows that latex hypersensitivity is present in patients with malignancies. From our results latex sensitization must be kept in mind while dealing with this susceptible patient group.     

Food hypersensitivity reactions visualised by ultrasonography and magnetic resonance imaging in a patient lacking systemic food-specific IgE

BACKGROUND: Abdominal complaints related to food intake might be due to hypersensitivity. A firm diagnosis of food allergy is often difficult to establish, particularly in the absence of systemic food-specific IgE. Using ultrasonography and magnetic resonance imaging (MRI) we were able to visualise the intestinal response in one such case. METHODS: A 24-year-old female presented with self-reported food hypersensitivity, particularly related to the intake of egg. Nausea and diarrhoea were predominant symptoms. Double-blind placebo-controlled food challenge with raw egg was positive, but all other conventional tests of food hypersensitivity, including skin prick test, total and food-specific IgE in serum, were negative. A thorough investigation programme could not reveal any organic disease of the gastrointestinal tract. We extended the evaluation to include two new provocation tests, where intestinal wall thickening and the amount of luminal liquid were monitored by external abdominal ultrasound and MRI. RESULTS: Both ultrasound and MRI investigations indicated intestinal wall thickening and influx of large amounts of fluid into the proximal small intestines within 10 min of duodenal challenge with egg. The response was associated with abdominal pain and bloating. CONCLUSIONS: The response to provocation was typical of an immediate allergic reaction. Our results indicate that local food-induced hypersensitivity reactions can occur in the gut in the absence of systemic indications of IgE-mediated allergy. Abdominal ultrasonography and MRI might become valuable tools for documenting such responses.     

Sensitization to different mite species in German farmers: clinical aspects.

Various mite species referred to collectively as house dust and storage mites are recognized worldwide as a cause of allergic airway disease. Our study aimed to investigate the frequency of sensitization and potential importance of mite species in farmers using a broad mite spectrum. A total of 86 German farmers with rhinitis and/or asthma were studied by skin prick testing and/or enzyme allergosorbent test (EAST) with the following mites: Blomia tjibodas, Blomia tropicalis, Blomia kulagini, Glycyphagus domesticus, Thyreophagus entomophagus, Euroglyphus maynei, Chortoglyphus arcuatus, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae, Acarus farris and Cheyletus eruditus. Sensitization to at least one mite species was detected in 51 patients (59%) by skin prick testing, and in 31 patients (36%) by EAST. The most frequent sensitizations determined by skin tests were found for the three Blomia species, E. maynei and G. domesticus. Twelve patients (14%) gave a positive EAST with the predator mite C. eruditus. A total of 22 patients gave positive EAST results with the Dermatophagoides species. We were able to document sensitization to C. arcuatus, E. maynei and T. entomophagus for the first time in Germany. A considerable proportion of the German farmers tested were sensitized to storage mites. The allergological potential of various mite species has been recognized, some for the first time. It was concluded that B. tjibodas, G. domesticus, C. arcuatus and C. eruditus in particular should be included in an allergy diagnosis. Further investigations into the clinical relevance of the sensitizations and possible cross-reactivity between the mite species are necessary.     

Latex gloves use and symptoms in health care workers 1 year after implementation of a policy restricting the use of powdered gloves

BACKGROUND: Latex sensitization related to glove use is a complex problem, and glove use policies that restrict exposure to powdered latex gloves alone may not provide adequate safety. This study explored health care workers' (HCWs') latex glove use and reports of related health symptoms 1 year after implementation of the latex glove replacement policy. METHODS: Two cross-sectional surveys. One was a population-based survey of HCWs at the institution (National Surveillance System for Hospital Health Care Workers); the second, a detailed survey of HCWs stratified by exposure to latex gloves (Latex Symptom Survey). RESULTS: The prevalence of symptoms of dermatitis reported by latex glove users was 40.3% (National Surveillance System for Hospital Health Care Workers) and 50.0% (Latex Symptom Survey). Symptom reports increased as exposure to latex gloves increased (pairs used per day, occupations with more glove use, working in higher exposure areas, more tenure, and more hours of use per day). Aerosol symptoms and urticaria related to latex glove use were reported much less frequently than were rash, chapping, itching, or redness. HCWs, even those with skin symptoms, continued to choose latex gloves in more than 80% of the cases. CONCLUSIONS: Stepwise preplacement evaluation at employee health clinics is recommended to identify and protect employees sensitized to latex. The medical community needs more understanding and education about latex gloves, latex sensitization, and available alternatives.     

Fixed drug eruption due to loratadine

We present the clinical case of a 8-years-old boy suffering a fixed drug reaction attributed to the oral intake of loratadine. He is an atopic child with perennial rhinitis and asthma and marked hypersensitivity to the house-dust mite Dermatophagoides pteronyssinus who is receiving inhaled corticosteroids and b2-agonists ad libitum plus specific immunotherapy with the mite. When the boy received loratadine to alleviate his nasal symptoms he suffered a well-defined erythematous and oedematous plaque in his right elbow that disappeared without treatment in one week. Several methods such as the patch-tests, the UBCT or ultra-brief-challenge test (our version of the peroral provocation one) and the skin biopsy were applied. The UBCT and the skin histopathology were the most important techniques to assure the suspected diagnosis. Other antihistamines such as ebastine and cetirizine as well as some excipients used as controls were all negative. Conventional prick or intradermal skin tests with the drug were not performed because we considered that they were useless in this case.     

Vasculitis during immunotherapy treatment in a patient with allergy to Cupressus arizonica

Allergen immunotherapy dates back to 1911 and has been used successfully to treat large numbers of patients throughout the last century. CASE REPORT: a 66-year-old woman presented with symptoms of allergic rhinitis and asthma due to sensitization to Cupressus arizonica. Specific immunotherapy was prescribed as a continuous 2-year treatment with a depot preparation of standarized and characterized allergen extracts of Cupressus arizonica pollen. Forty-eight hours after one maintenance dose of 0.8 cc, the patient presented palpable violaceous purpuric lesions and pruritus on both legs. We performed skin prick and intradermal tests with Cupressus arizonica. Twenty-four hours later, the 1/1 dilution intradermal skin test was positive. Biopsy showed leukocytoclastic vasculitis. CONCLUSIONS: A middle-aged woman experienced cutaneous non-necrotizing vasculitis after 2 years of maintenance immunotherapy. The interval between injections and the first appearance of cutaneous lesions suggests a type III hypersensitivity immune reaction. Skin biopsy of the positive intradermal test also supports this hypothesis.     

Skin test positivity to aeroallergens in the patients with chronic urticaria without allergic respiratory disease.

The etiology of chronic urticaria and angioedema remains uncertain in most of the patients. There are several agents and factors including medications, foods and food additives, infections, contactants, inhalants, physical factors and autoimmunity that implicated in provoking urticaria symptoms. In addition, the possible role of house dust mites has been considered in a few reports. We investigated skin test positivity to house dust mites and other inhalants in 259 patients with chronic idiopathic urticaria and angioedema but without allergic rhinitis and/or asthma. Results were compared with both 300 healthy controls and 300 atopic patients. Immediate cutaneous reactivity to one or more allergens was detected in 71 patients in the study group (27.4%). The most common allergens were house dust mites (24.7%). Skin prick test sensitivity to other inhalant allergens including pollens, molds and cockroach were 7.7%, 0.4% and 0.8%, respectively. In the healthy control group 7% of patients were found as atopic with respect to skin prick test results. The most common allergens in healthy controls were pollens (6%), and house dust mites (4.7%). In atopic control group, pollens and mites are also the most common allergens detected in skin prick test (62% and 50.3%, respectively). The difference between study and healthy control group was statistically significant with respect to presence of atopy and mite sensitivity (p < 0.001). Similar differences were not established in other inhalant allergens. Significant mite sensitivity in the study group is not a coincidence. Because, ratio of skin test positivity to house dust mites in the study group was higher than the healthy controls, but was not as high as atopic patients. Furthermore, the rate of skin reactivity to other aeroallergens was not different from healthy controls. Urticaria as a sole clinical manifestation in mite sensitive patients was unusual.     

Minimum prevalence of latex hypersensitivity in health care workers.

Health care workers (HCW) have been shown to be at significant risk for developing latex allergy. Natural rubber latex hypersensitivity has been reported in 2.9 to 17% of health care workers in previously published studies. This study describes the prevalence of latex hypersensitivity in a large cohort of medical center employees. A screening questionnaire was distributed to 1967 employees in six job categories exposed to latex, and 1331 questionnaires were returned (68%) between March and November 1995. Skin and serologic testing was performed on 156 volunteers. Of the 1331 HCWs who completed the screening questionnaire, 290 (21.8%) self-reported contact dermatitis to latex, 67 (5.0%) self-reported urticaria to latex, 163 (12.2%) self-reported rhinoconjunctivitis to latex, and 17 (1.3%) self-reported asthmatic symptoms to latex. Of the total population of 1967 employees, 38 (1.9%) were either skin test or blood test positive and 30 (1.5%) of these 38 were symptomatic around latex. This study suggests a minimum prevalence of IgE-mediated hypersensitivity to latex of 1.5% among medical center employees. Our reported prevalence figures are lower than previously reported, reflecting, in part, reporting methods using a denominator more consistent with the total population at risk. Our study also illustrates the pitfall of relying on self-reporting in making the diagnosis of latex allergy.