Spotlight on Spina Bifida
The following Article originally appeared in The ALERT, Summer 2002, Vol. 8, No. 2
Individuals born with spina bifida have an extremely high incidence of natural rubber latex (NRL) 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 NRL-sensitive. Sensitivity was determined by a blood test or by history of an allergic reaction.
It is theorized that the increased sensitization in this population is related to early, frequent exposure to rubber products, such as catheters used in bladder and bowel programs. These children also tend to have frequent surgeries and diagnostic tests, which increases their exposure to NRL gloves.
Frequent surgical intervention is a risk factor even in children who do not have spina bifida; sensitivity to NRL 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 advances in NRL-allergy research related to spina bifida. The specific NRL proteins that are the primary allergens for individuals with spina bifida have been isolated. These are not the same proteins that have been found to be the primary allergens in healthcare workers who have occupational exposure to NRL. 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 water soluble than some of the other latex proteins. Sensitization to these particular proteins may be caused by repeated contact between the NRL and mucus membranes (such as repeated urinary catheterizations).
The SBAA recommends that all individuals with spina bifida should be treated as though they are NRL-sensitive from birth, and they should avoid contact with NRL 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 NRL-safe environment. Sample letters to school personnel are available on the SBAA website.
In addition, individuals who have had allergic reactions to NRL should wear a medic-alert bracelet (http://www.medicalert.org) and should carry auto-injectable epinephrine, non-NRL gloves, and other non-NRL equipment for emergency use.
Source: Brehler, R. & Kutting, B. (2001). Natural rubber latex allergy: A problem of interdisciplinary concern in medicine. Archives of Internal Medicine, 161, 1057-1064.