MUH solves latex problem for healthcare workers

by Catherine Fahey, Charleston Regional Business Journal

For Amy Romanczuk, the solution is clear. Latex removal benefits hospital patients, employees, and the bottom line.

Romanczuk is a registered nurse at MUSC. Her life took an unexpected turn this year when she also developed a life-threatening allergic reaction to latex, a common product material derived from the tropical rubber tree, hevea brasiliensis. Like most healthcare providers around the country, Charleston area hospitals have become extremely dependent upon this inexpensive and reliable substance, which is used in everything from catheters to chest drains and bandages to blood pressure cuffs. Fortunately for Romanczuk, an 18-year veteran nurse, MUSC took immediate steps to latex-proof her work area. Six weeks after taking disability leave, Romanczuk was back at work. “I am really indebted to MUSC for tackling this problem,” she said. “It is phenomenal what they did so rapidly.” Years ago, the occurrence of latex allergy was infrequent, limited mostly to adults with compromised immune systems and children with congenital anomalies such as spina bifida. But 10 years ago, OSHA mandated that healthcare workers use gloves for better barrier protection against HIV and other infectious disease. Nationwide, the demand for hospital gloves increased from several hundred million per year to 22 billion in 1997. American manufacturers, swamped by the demand, purchased latex from countries whose production standards were inferior. Because foreign businesses reduced the standard number of latex washings, the latex-protein content was increased. Hospitals in the United States stocked their warehouses with protein-rich latex products, unaware that frequent and potent exposure can trigger latex allergy. Latex allergies begin steady rise Latex-allergic individuals can be nearly symptom-free and unaware of their allergies, then suffer a deadly reaction without warning. In July 1993, five operating rooms were closed at Boston's Brigham and Women's Hospital after the staff experienced an epidemic of headaches, rashes, hives and respiratory irritation. An internal investigation revealed “sick building syndrome” caused by allergic reactions to powdered latex. The hospital paid millions to clean up the operating rooms and settled millions more in liability lawsuits brought by disabled workers. Clyde E. Daffin, a registered nurse and operating room supervisor at Bon-Secours St. Francis Xavier Hospital, believes that hospitals must act soon to dramatically reduce latex product use, especially gloves. “All the local hospitals have made progress in identifying and treating latex-allergic patients,” Daffin states, but he believes the health risk to employees has been perilously under-recognized. National surveys bear him out, with estimates that 20 percent of all healthcare workers are latex sensitive or latex allergic. Then there's the problem of the powder. Most medical latex gloves are coated with cornstarch powder to keep them sticking. Unfortunately, cornstarch enables latex to be absorbed more potently into the skin. In addition, when workers remove their gloves and the powder becomes airborne, latex protein particles can be breathed in, increasing the overexposure that could trigger allergic reaction. Providing alternatives Is it expensive to switch to non-latex/powder-free products? The answer depends on who you ask. For Sally Fosberry, R.N., vice-president for surgical services with Trident Health System, providing non-latex products for sensitive patients and staff is part of the hospital's mission. “There are some products that are more expensive that we've had to make available. But we feel that's part of our obligation,” she said. Still, Fosberry does not believe that latex allergy is a huge problem in the Trident system and that a wholesale switch to non-latex products is neither necessary nor financially practicable. Daffin agrees that medical facilities can become “latex safe” without becoming completely latex-free. “But hospitals should act now to eliminate unnecessary latex and choose nonallergenic vinyl, neoprene, or polypropylene items,” he said. While working as an MUSC product evaluation coordinator, he discovered that many non-latex products, when bought in bulk, cost the same as latex, or even less. For instance, “We are now able to save two to five dollars on each foley catheter kit that is non-latex.” However, the most popular powdered latex surgical gloves today cost less than 40 cents per pair while non-latex/powder-free gloves cost seven to nine times more. “Not only are they expensive,” said Fosberry, “but from a tactical standpoint, they are not what the physicians are used to. So unless they have a reason to change, they wouldn't want to.” Daffin concedes that savings in other non-latex products will have to offset the cost of switching to non-latex gloves or powder-free gloves. Nevertheless, in recent years the Mayo Clinic has limited glove choices for physicians to non-latex/powder-free gloves or powder-free, low allergen gloves. As a result it has saved more than $250,000 annually. Another hospital study showed that 73 out of 74 latex-allergic employees were able to return to work once the switch was made to powder-free, low allergen latex gloves. “Look at my situation,“ concludes Romanczuk. “I thought I was going to be unable to work, which meant the university would have to pay my disability, plus hire someone to do my job. By reducing the use of latex, the hospital allowed me to come back to work.” Editor's note: Article reprinted with permission from the Charleston Regional Business Journal.

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