Mysterious skin rashes, watery eyes and laryngitis attacked Susan Sharrock in 1990.
She found the answer to her ailments in the palms of her hands, which were sheathed in powdered latex gloves.
Latex gloves, especially those powdered for easy donning, have increasingly created allergy problems for medical professionals in the past decade. Some people block allergic reactions by using powder-free gloves.
"When you eliminate the powder, you reduce the amount of allergins in the air," said Sarrock, an operating room nurse educator at Dallas Veterans Affairs Medical Center.
Others are more susceptible, and must switch to latex-safe and gloves without powder.
The Dallas VA hospital is joining a growing list of doctors' offices, dental clinics and medical facilities switching to powder-free and latex-safe gloves.Powdered gloves slip on more easily, but also disperse harmful latex proteins in the air. Latex-safe gloves have a minimal amount of latex in them that generally do not affect people with allergies.
An informal survey of medical facilities in Arlington, Fort Worth and Dallas shows most have turned exclusively to the gloves or supply them upon request.
"Almost all facilities that I know of have made latex-safe gloves available," said Joyce Hood, clinical director of occupational health at Harris Methodist Fort Worth.
The switch is occurring as allergic reactions, workers compensation cases and lawsuits increase. Only two court cases have reached verdicts; the others are pending. In 1998, California and Wisconsin courts found manufacturers liable for damages when health care workers suffered reactions to latex gloves. The $1.3 million liability verdict in California is on appeal. The Wisconsin Court of Appeals recently upheld a $1 million verdict against a glove manufacturer.
With hundreds of trials pending nationwide, including in Texas, the health care industry to seeking alternatives to latex and powder. "There are probably 250 to 300 cases out there now, maybe a little more," said Sean Domnick, a West Palm Beach, Fla., attorney. "It is still in its infancy." Domnick is representing two health care workers who suffered anaphylactic shock, or life-threatening allergic reactions, from longtime latex exposure. Both cases are pending.
Attorneys say the number of trial cases could explode if courts begin ruling in favor of plaintiffs.
"A lot of cases haven't gone to trial yet but are poised to go," said New Jersey attorney Jon Gelman, who has focused on latex litigation for three years and on workers compensation cases for 29 years. Workers compensation settlements regarding latex- related lawsuits are becoming common nationwide, with about 70 percent of decisions determined as compensable -- indicating many future lawsuits will also result in settlements, he said.
Latex became popular about 50 years ago, but latex allergies were not recognized until the early 1990s. In the late 1980s, the Centers for Disease Control and Prevention in Atlanta urged health care workers to use latex gloves to prevent the spread of AIDS. Latex, the natural sap of the rubber tree, is used in thousands of industrial products. Gloves, masks, elastic bandages, adhesive tape, catheters, pads and tourniquets are among the hundreds of latex products commonly used in hospitals.
Health care workers routinely don and discard dozens of pairs of gloves a day. Exposure to the allergenic proteins over time can cause hypersensitivity, disability and, in a handful of cases, fatal anaphylactic shock.
About 1 person in 1,000 develops the allergy, which occurs more often in high-risk groups, such as medical professionals, said Colleen Horn, spokesperson for the Washington, D.C.- based Asthma and Allergy Foundation of America.
"The powder carries the latex and it can be inhaled, but it is the latex itself that causes the allergy," she said. "It impacts about 8 to 12 percent of health care workers and others who regularly wear latex gloves."
Dallas VA Medical Center now offers five different types of latex-safe or powder-free gloves, which is good news to Daniel J. Moore, a third-year internal medicine resident at the center and Parkland Memorial Hospital.
"I have had asthma since I was a child that basically went away as I got older," he said. "But I'm prone to allergies."
During medical school in 1990, he was getting rashes that he associated with his powdered latex gloves. For the next few years, he wore cotton gloves beneath his latex gloves.
Still, others around him used powdered gloves. Most days, he would be wheezing by the time his shift ended.
In 1998, he was interning at the VA hospital when a nurse took his breath away -- literally. "She snapped her gloves off, and it generated a cloud of latex powder," he said.
He had trouble breathing and went into spasms.
"It was a work hazard for me," he said. "Since they've gone powder free, I haven't had any problems."
Donetta Terrell, a medical assistant in Arlington, said powder gloves started making her itch, so she switched to powder free.
"They don't go on as easy, but I prefer them," she said.
She works with Dr. Bobby Smith, a family practitioner, and recalls that a dental technician recently came to the office for latex allergies.
"She came in with her hands real red and itchy and some lesions on them," Terrell said. "She changed to another type of glove."
Arlington dentist Jay Baxley said about 10 of his 2,000 patients are latex allergic.
"They come in saying, `Please don't use latex.' " he said. "It is almost imperative to have some vinyl gloves available."
In 1997, Sharrock met her first latex allergic patient.
"He said, `I can tell you whether the druggist who counted my pills was wearing latex gloves,' " she recalled. "It's amazing, isn't it?"
After describing powder and latex issues to her supervisor, Sharrock was told to develop a latex task force. Following her recommendations, the Dallas VA hospital switched gloves a few months ago. The hospital also offers latex-free exams and surgeries.
The Dallas VA's affiliated centers -- the Fort Worth Outpatient Clinic and the Sam Rayburn Memorial Veterans Center in Bonham -- soon will follow suit.
"It's safe for the patients, and it's safe for the employees," Sharrock said.
Monday, Jan. 1, 2001