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Natural Rubber Latex (NRL) allergy in Health and Social Care 

Natural Rubber Latex (NRL) can be found in many products in health and social care settings. NRL is widely used in single-use medical gloves (non-sterile examination gloves). It is also found in many other medical products, such as medical devices, elasticised bandages, dressings etc.

NRL contains proteins to which some individuals may develop an allergy. The NRL proteins have the potential to cause occupational asthma and occupational dermatitis and, in some cases, more serious allergic reactions such as anaphylaxis. Allergy to certain latex proteins has emerged as an occupational disease and continues to be an important occupational health problem as NRL products are used increasingly worldwide, particularly in healthcare. The use of gloves is an important element of infection prevention and control in healthcare.

Effects of Latex Allergy

Typical skin and respiratory issues associated with the use of NRL particularly in single-use gloves includes skin rash, occupational dermatitis, itchy or runny eyes or nose, sneezing, coughing, chest tightness, shortness of breath, occupational asthma and in more serious reactions, may result in anaphylactic shock. The symptoms experienced depend on the route of exposure, which can be by direct contact with skin or mucosa, or by inhalation.

Exposure to NRL can occur in the following ways:

  • through direct skin contact such as gloves and tape,
  • inhalation of powder in NRL gloves.
  • mucous membranes via dental treatment, internal examinations with NRL gloves,
  • intravascular- injection from NRL parts in IV tubing, rubber bungs on medication vials and other NRL device parts.

The Law

The most relevant sections of Irish health and safety legislation dealing with occupational exposures to NRL products are:

  • the Safety, Health and Welfare at Work (Chemical Agents) Regulations 2001-2026, particularly Regulations 4 – 6,
  • the Safety, Health and Welfare at Work Act 2005 (S.I. No. 10 of 2005), particularly Parts 2 & 3 and Schedule 3,
  • the Safety, Health and Welfare at Work (General Application) Regulations 2007-2023, particularly Chapter 3 Personal Protective Equipment.
  • European Union (Personal Protective Equipment) Regulations 2018 S.I. No. 136/2018 (as amended).

Relevant European legislation and European Standards

  • EU Medical Device Regulation (MDR) 2017/745, 93/42/EEC- manufacturers must state when a product contains latex.
  • EN 455-3:2023 Medical gloves for single use.
  • BS EN ISO 374 and EN 16523-1: Protective gloves against dangerous chemicals and microorganisms.

Employer requirements

  • The employer must complete a risk assessment to determine the NRL products in use. A risk assessment should identify ‘at risk groups’ and take into consideration those who are known to be sensitised to latex, have a history of allergy to latex and a history of anaphylaxis to latex. The risk assessment must also identify employees who may develop a sensitivity to NRL.
  • The employer must reduce the exposure to NRL products so far as is reasonably practicable and provide articles that are safe and without risk to the safety, health and welfare of the employee.
  • In the selection of protective gloves, the employer needs to take account of the material of the glove and comply with the appropriate EN standards. Where reasonably practicable, consider latex-free and latex power-free solutions. Synthetic products may be considered for example, nitrile, neoprene gloves based on the risk assessment.
  • If NRL products are selected for use, the employer must provide suitable information, instruction, training and supervision.
  • The employer must make arrangements to periodically review the effectiveness of control measures to protect employees from exposure to NRL products.
  • The employer must make available appropriate health surveillance to employees where required in the risk assessment. Refer to the HSA ‘A Short Guide to Health Surveillance’.
  • All incidents regarding the use of NRL products must be reported to the employer in accordance with local incident procedures.

Further Information