HSE banner

Policy for the Prevention and Management of Natural Rubber Latex Allergy

1. Introduction

Over the last 20 years the health risks associated with exposure to natural rubber latex (NRL) have been increasingly recognised. The development of allergy to NRL is associated with a range of reactions including skin rashes (urticaria or 'hives') 'hay-fever' like symptoms and asthma through to anaphylaxis, which has resulted in fatalities.

Allergy to NRL is a concern for Trust staff who will be exposed to NRL in the course of their work, and for patients who may be exposed during treatment.

The risk of developing NRL allergy is associated with the extent of individual exposure to latex proteins. During the 1980's and 1990's the use of Universal Infection Control Precautions in health care led to an increased use of NRL gloves. This increasing demand for NRL products led to changes in the manufacturing process, resulting in materials which allowed a higher level of NRL proteins to be released during use (particularly when combined with powder in gloves). The repeated exposure of patients to certain treatments e.g. repeated catheterisation or surgery also led to increased exposure and an increasing risk of developing allergy (a process referred to as sensitisation).

The purpose of this policy is to detail the responsibilities of all staff in ensuring the effective management of NRL risks.

2. Scope

This policy applies to all levels of employees and to specific organisations within the Trust.

3. Policy Objectives

The ………….NHS Trust Health and Safety Policy defines the means by which the Trust will plan and execute the assessment and control of health and safety risks, and monitor and review progress to that end.

This policy defines the specific organisational arrangements through which………….. NHS Trust will reduce the risk of staff or patients developing NRL allergy, and ensure safe employment or treatment for those who become sensitised. The policy is supported by specific protocols1 relating to the management of staff or patients with known or suspected latex allergy, and for the management of patients considered to be at increased risk.

Note: Generic protocols may be used taking into account local risk assessment

Responsibilities

4. Trust Board

4.1. The general responsibilities of the Trust Board are detailed in the Trust Health and Safety Policy

5. Chief Executive

5.1. The Board vests in the Chief Executive responsibility for ensuring the development of and compliance with this policy.

5.2. The delegated authority for co-ordinating and monitoring implementation of this policy and the associated protocols/procedures will lie with the Latex Allergy Group (LAG), a sub-group of the Trust Health and Safety Committee. A Specialist Adviser to the LAG and the Trust will be identified.

6. Directorate Management Teams

6.1. The Directorate Management Teams have responsibility for ensuring that risks associated with NRL allergy to patients and staff are managed in accordance with this policy and the associated protocols/procedures.

7. Line Managers (Including Consultants)

Line managers are responsible for:

7.1. Ensuring that general NRL risk assessment is undertaken with regard to work and clinical activities within their areas of responsibility. Specific individual risk assessment will be required where patients or staff are identified as allergic to NRL.

7.2. Identifying and implementing any action/control required following the NRL risk assessment, using the NRL Allergy protocols developed by the LAG, but adapting these if necessary for their areas of responsibility (further advice may be sought from LAG, the Specialist Adviser or Occupational Health).

7.3. Ensuring that staff are given the necessary information, instruction and training to enable them to manage NRL allergy and comply with this policy, including the need for reporting:

7.3.1. NRL allergic reactions suffered by patients via the critical incident reporting mechanism.
7.3.2. symptoms suggestive of NRL allergy in staff to the Occupational Health Department.

8. Responsibilities of Staff

8.1. Having been provided with information, instruction and training, staff will comply with this policy and follow the associated protocols/procedures/safe systems of work for their area(s) of work and responsibility.

8.2. Staff are strongly advised to report possible NRL allergy symptoms to the Occupational Health Service.

9. Responsibilities of the Supplies Department

9.1. Monitor all products which have the potential to contain NRL by liaising with manufacturers and advise management of their findings.

9.2. Advise on the availability of alternative products.

10. Responsibilities of the Occupational Health Service

10.1. Ensure staff (or prospective staff) with NRL allergy and their managers, are advised of any necessary adjustments or restrictions to their work activities, using an evidence and risk assessment based approach.

10.2. Provide guidance to staff and managers on suitable and safe working environments for NRL sensitised employees.

10.3. Facilitate investigation of staff suspected of having NRL allergy.

10.4. Provide statistical and other relevant information concerning NRL allergy in staff to the LAG, whilst maintaining individual confidentiality.

11. Responsibility of the Clinical Risk Managers

11.1. Clinical risk managers will provide anonymised summaries of all patient related NRL allergy incidents to the LAG.

12. Responsibilities of the Latex Advisory Group

12.1. Co-ordinating and monitoring implementation of this policy.

12.2. Co-ordinate and monitor the control of cross-directorate NRL risks

12.3. Identifying, with managers, the resources required for staff training and other aspects of the implementation of this policy.

12.4. Providing advice to managers developing protocols/procedures/safe systems of work relating to NRL allergic patients. (Generic protocols/procedures relating to NRL allergy and patient care will be produced by the LAG, but will require revision depending on the outcome of local risk assessment)

12.5. Reviewing reports from Occupational Health Service and Clinical Risk Managers regarding NRL allergy related matters.

12.6. Providing annual reports regarding NRL allergy matters to the Trust Health and Safety Committee and the Clinical Risk Committee. Interim reports will be provided to one or both groups where considered necessary to highlight specific concerns.

13. Responsibilities of the Specialist Adviser

13.1. Maintain an up-to-date knowledge on NRL and related allergy.

13.2. Provide advice about NRL and related allergy to the LAG and to managers.

14. Membership of the Latex Advisory Group

Membership will include:

The group will have access to specialist immunology advice where required.