Screening for latex sensitization by questionnaire: diagnostic performance in health care workers.

Abstract

BACKGROUND: Latex allergy has emerged as a major cause of allergic reactions in health care workers. However, information is limited regarding the diagnostic methods available. OBJECTIVE: The aim of this study was to investigate diagnostic performance (sensitivity, specificity, and predictive values) of screening for natural rubber latex sensitization by questionnaire among health care workers, using skin prick test (SPT) as the gold standard for diagnosis. METHODS: The study population consisted of 260 randomly selected health care workers from the public health units in the city of Florianopolis, Brazil. The subjects were recruited from 2 groups: those who used latex gloves in their work (140) and those who were not exposed to latex (120). The mean (SD) age of the study population was 38.6 (0.6) years. Logistic regression analysis was used to predict SPT result from the questionnaire on previous symptoms of latex sensitization. RESULTS: Symptoms of (1) dryness, fissuring, swelling, pruritus, or cutaneous rash on the hands, and (2) pruritus of the oral mucosa or local redness after eating certain fruits (avocados, bananas, kiwis, chestnuts, mango, melons, or peaches) were the most sensitive and specific questionnaire items, respectively. The combination of these items with a cutoff point derived from the logistic regression led to 100% sensitivity and specificity for the prediction of SPT results in the population studied, with 95% confidence intervals of 51.7% to 100% for sensitivity and 98.1% to 100% for specificity. CONCLUSION: A questionnaire applied in a group of health care workers displayed excellent screening performance for latex sensitization.