Summary
The organizational issue is allergy and hypersensitivity to latex-containing products and supplies in dental facility staff and patients. The first solution is the use of health surveillance and testing in staff members for timely diagnosis of allergies. The second solution is the development and implementation of policies to limit all staff members’ and patients’ exposure to potential allergens.
Articles Supporting Solution 1 (Testing and Health Surveillance for Staff)
Bakiri, A., Skenderaj, S., Kraja, D., Petrela, E., & Mingomataj, E. Ç. (2017). Hypersensitivity to latex gloves among dental students: Is the pre-matriculation evaluation and periodic health surveillance necessary? International Journal of Clinical and Medical Allergy, 5(1), 52-61. Web.
The article is a prospective study that demonstrates the helpfulness of diagnostic tools, including self-report questionnaires, for the identification of professionals and students that have the highest risks of developing latex hypersensitivity or allergy. The source has been written by four qualified allergology and dental health professionals from Albanian hospitals and medical universities. The authors’ levels of expertise and experiences probably vary greatly, but obviously biased attitudes are absent. The study’s primary purpose is to assess the prevalence of allergic reactions to latex gloves in dental students by means of various diagnostic efforts. The intended audience is comprised of subject matter experts involved in the education of dental health specialists. Among the main ideas are the varying prevalence of allergy in dental professionals and self-assessment tests’ and history-taking interventions’ predictive value in identifying high-risk populations for latex allergy. Using the quantitative methodology, the authors implemented self-report questionnaires in three groups of participants totaling 240 individuals and proceeded with objective diagnostic interventions, such as skin prick tests and challenge tests. The authors refer to links between allergies and medical history findings to argue for the necessity of periodic health surveillance for those exposed to latex in educational or workplace settings (solution one).
Bakiri, A., Skenderaj, S., Kraja, D., Petrela, E., Mingomataj, C. E., & Mingomataj, D. (2017). Questionnaire’s and diagnostic tests’ reliability on natural rubber latex allergy among Albanian dental students. The Open Access Journal of Science and Technology, 5(3), 1-8. Web.
The article has been created to report the evaluation of a self-administered questionnaire for future dental health practitioners exposed to latex-containing products as a result of educational endeavors. It is targeted at professional audiences interested in dental hygiene education and clinical practice. The authors are six Albanian researchers affiliated with eight professional institutions, including Logos University, diverse departments at the Medicine University of Tirana, and Mother Theresa School of Medicine. The researchers have expertise in different fields, such as allergology, medical laboratory science, epidemiology and statistics, stomatology, dermatology, and venereology, which supports an unbiased and multi-sided approach to research. The methodology included administering a multi-item self-report questionnaire and allergy tests in a sample of dental students with subsequent correlation analysis. The main arguments and ideas revolve around the unique role of respiratory exposure in allergy processes. Also, based on the questionnaire’s positive predictive power, the authors argue that it could be used together with diagnostic tests for the timely identification of allergic professionals to develop individualized latex-containing product use recommendations. By appreciating the idea of regular health checks for latex allergy prevention, the authors support the first solution proposed in the previous assignment. However, they acknowledge that the effectiveness of self-report questionnaires for the staff in dental facilities has not been thoroughly evaluated.
Articles Supporting Solution 2 (Limiting Exposure to Latex-Containing Supplies)
Tabary, M., Araghi, F., Nasiri, S., & Dadkhahfar, S. (2021). Dealing with skin reactions to gloves during the COVID-19 pandemic. Infection Control & Hospital Epidemiology, 42(2), 247-248. Web.
This brief article has been created to summarize the risk factors for latex allergy and provide allergy prevention recommendations for healthcare facilities to be used during the COVID-19 pandemic. The authors specialize in dermatology and general medicine, and the source is intended for researchers and those influencing occupational safety decision-making in clinical contexts. Biases are unlikely due to the absence of conflicts of interest. Moreover, there are no recommendations that would refer to specific brands or supply types offered by very few manufacturers. The researchers do not report particular methodologies, and their data come from the review of previous scholarly experimental studies and dermatology guidebooks. The main idea pertaining to latex allergy is that hypersensitivity to latex gloves in healthcare professionals has increased recently. The situation requires the minimization of exposure to potential allergens for the safety of both direct care providers and patients. The source offers explicit support for the second solution since the use of hypoallergic gloves is cited as the first-line allergy prevention measure that trumps H1 and H2 blockers before contact with latex-containing supplies. Notably, the researchers give preference to powder-free hypoallergic gloves that could, however, be inferior to their latex counterparts in terms of various protective properties.
Critchley, E., & Pemberton, M. N. (2020). Latex and synthetic rubber glove usage in UK general dental practice: Changing trends. Heliyon, 6(5), e03889. Web.
The source was created by two specialists in dental health affiliated with the University Dental Hospital of Manchester to assess trends in a latex glove and latex-containing dam use in dental practice. A quantitative questionnaire and statistical analysis techniques represent the utilized methodology, and the source is clearly intended for dental health practitioners and decision-makers. The main ideas and findings include the growing trend for non-sterile non-latex gloves in dental clinical contexts, especially nitrile gloves, and the increasing popularity of dental dams containing no latex. There are no definitive sources of bias, but the findings’ generalizability might be limited since all participants are from only two regions of the UK. The authors support the practice of restricting the use of latex-containing products as an anti-allergy measure. They state that the strategy addresses service providers’ continuing exposure to natural rubber latex, thus addressing the increasing issue of hypersensitivity to latex in diverse medical professions. Although nitrile gloves can still cause dermatological symptoms, their use is cited as a safer practice compared to the routine use of powdered or non-powdered NRL gloves. Moreover, NRL gloves’ advantage in manual dexterity is called into question, which also supports the strategy of minimizing the routine use of latex-containing dental supplies.
Raulf, M. (2020). The current state of occupational latex allergy. Current Opinion in Allergy and Clinical Immunology, 20(2), 112-116. Web.
The article is intended for researchers and specialists in occupational health. Its purpose is to review and summarize the most recent knowledge pertaining to natural rubber latex allergies in professional settings, including dental facilities. The author specializes in occupational medicine and works for the Ruhr-University Bochum in Germany. The sources of biased attitudes are not obvious even though the author collaborated with ThermoFisher Scientific, a manufacturer of medical consumables, in the past. This, however, does not affect the contents of the article since there are no recommendations that would be based on commercial studies or involve brand names. Using the unstructured literature review method, the author conceptualizes latex allergy as an ongoing concern and presents exposure minimization as a practice that is central to allergy prevention. Particularly, the banning of powdered NRL gloves or NRL gloves with high protein content in Germany and similar measures in the United States are cited as examples of evidence-based risk minimization strategies. The source supports the second solution by demonstrating the effectiveness of allergen exposure minimization strategies in reducing hypersensitivity and allergy cases among professionals and patients. Aside from minimizing latex exposure, the source argues for further chemistry research to find safer alternatives to Hevea brasiliensis latex.
Articles Supporting No Change
Japundžić, I., Vodanović, M., & Lugović-Mihić, L. (2018). An analysis of skin prick tests to latex and patch tests to rubber additives and other causative factors among dental professionals and students with contact dermatoses. International Archives of Allergy and Immunology, 177(3), 238-244. Web.
This cross-sectional study has been conducted to examine non-allergic and allergic contact dermatosis cases in current and future dental professionals in Croatia. The source is intended for allergy and immunology professionals and utilizes the quantitative methodology with the survey and patch tests for latex allergy. The authors specialize in dermatology, venerology, and dental anthropologic studies and work for the Sisters of Charity, which is a teaching hospital in Zagreb, and the University of Zagreb. They are unlikely to be biased since they have no interest in misinterpreting data on the causes of dermatosis in the dental profession. Also, they actually came to conclusions that differed from their expectations. Based on the data from more than four hundred dental professionals and students, the authors argue that the prevalence of latex allergy may be overstated. Particularly, in more than 66% of cases, the actual clinical picture of what is attributed to latex hypersensitivity turns out to be linked with erythema and skin dryness. The article supports neither of the solutions since it states that contact dermatosis and skin irritation instances stem from latex exposure relatively rarely. In particular, they highlight that changing glove manufacturing practices and natural rubber protein content standards have already minimized the risks of immediate and severe allergic reactions in clinical settings.
Lajolo, C., Leso, V., Gioco, G., Patini, R., Fedele, M., Giuliani, M., & Iavicoli, I. (2019). Chemical hazard for dental hygienists: A systematic review. European Review for Medical and Pharmacological Sciences, 23(18), 7713-7721. Web.
Created by four professionals in dentistry, clinical medicine, and occupational medicine, the source aims to review current knowledge pertaining to chemical risks in the dental profession. The chosen article is intended for a vast array of researchers interested in occupational hazards, utilizes the PRISMA methodology for systematic reviews, and summarizes findings from ten carefully selected studies. Data for review come from methodologically sound sources, but the authors highlight that the absence of selection bias in these studies’ samples cannot be guaranteed. The key takeaway pertaining to latex allergy is that the prevalence of this issue among dental hygienists continues to decline, especially when it comes to type I NRL hypersensitivity. Additionally, it is concluded that glove brand selection affects hypersensitivity and allergy rates aside from glove type, and the status of latex as the key irritant might be overemphasized. Being focused on the review, the authors do not give preference to solution one or solution two and insist on the continuation of chemical risk studies in dental hygienists and dentists. They argue that the development of a comprehensive method of minimizing skin problems in dental professionals should start from longitudinal research and tools for the accurate assessment of exposure levels.