Four common allergens at work—and how nurses can combat them

According to the American Academy of Allergy, Asthma and Immunology (AAAAI), more than half of Americans test positive to at least one allergen. This means that more than half of the individuals in any one occupational group—including nurses, of course—are probably allergic to something.

There’s the biggie of course — latex gloves — but you may be surprised at the other allergens you’ll find in the sterile environment of hospitals and other healthcare settings.

Here’s a look at four major allergens in the nursing environment and how you can deal with them.

1. Natural Rubber Latex
This allergen is the most obvious one, and it’s getting plenty of press these days because an allergy to natural rubber latex (NRL) can be extremely severe. It’s estimated that 5-15% of healthcare workers are allergic to NRL, and nurses comprise the bulk of this group because of their continual exposure to it.

Yes, it’s mainly the NRL gloves that are the problem, and as a nurse, you’re continually donning gloves to perform a variety of tasks. This continued exposure can actually increase your sensitivity to NRL, and you can end up with a full-blown allergy to it. The allergic reaction—generally manifesting as a skin condition such as swelling, peeling or urticaria (hives)—tends to get worse after each exposure. Many nurses reach the point where coming into contact with NRL, even briefly, can have serious consequences.

Fortunately, major brands now carry alternatives to NRL such as Derma Prene and Micro-Touch. Your hospital should provide options for you if you have a NRL allergy. Neoprene, nitrile and polyisoprene are synthetic materials that afford the same protection against infection as latex does.

Note that NRL allergies can lead to far more than skin reactions. Putting on and removing latex rubber gloves releases particles into the air—particles made of protein (the rubber) and starch (from the cornstarch that powdered gloves are typically coated with). These airborne particles are suspected to worsen asthma and even to cause asthma, which explains why the incidence of asthma in OR nurses, who essentially live in a world of NRL gloves, is higher than for nurses in any other area of nursing. If you’re an OR nurse with asthma, you might seriously want to consider moving to another discipline of nursing. Perhaps you don’t have skin reactions to NRL, but being in an NRL environment isn’t doing any favors for your asthma.

The National Institute of Occupational Safety and Health (NIOSH) has identified natural rubber latex as a serious occupational health hazard, and you can find a great deal of information about it on the NIOSH website. Even if you seem to have the mildest reaction to NRL, tell your employer right away, because chances are your reaction will worsen. If you are allergic, wear a medic alert bracelet.

2. Cleaning, disinfecting and sterilizing solutions/substances
As a nurse, you work with a range of harsh solutions and substances every day, and many of them can cause allergic contact dermatitis. Symptoms can include itching, burning, blisters, rashes—any number of skin reactions. Substances such as iodide, formaldehyde and glutaraldehyde are common culprits in the nursing environment. The best protection, of course, is to wear gloves.

3. Perfume
It’s estimated that about four percent of individuals have fragrance allergies. If you’re a nurse with a fragrance allergy, think carefully about what work environment would be best for you. For example, it’s virtually impossible to enforce a “fragrance free” policy in an Emergency Department. After all, Mrs. Smith didn’t expect to get into a car accident when she woke up this morning and put perfume on. In the ICU, however, you’ll likely seldom have to deal with fragrance issues since the patients won’t be wearing perfume, and visitors to ICUs are generally quite conscious that heavy scents aren’t appropriate in this area.

4. Airborne allergens
Allergic reactions can be triggered by airborne allergens such as dust, mold particles and bacteria. The AAAAI has determined that, worldwide, dust is the airborne allergen that causes the most issues for allergy sufferers.

Symptoms of an airborne allergy can include sneezing, coughing, stuffiness, watery eyes, conjunctivitis and “allergic shiners” (dark circles under the eyes). The hallmark symptom of a true allergy to an airborne substance is nasal congestion, due to swelling of the nasal passages.

If you’re allergic to an airborne allergen, you should work in a hospital or facility that has an air purification system, which eliminates those allergens. Ask if your facility has such a system. If it doesn’t, suggest that it look into installing one. There are medications you can take for your allergies, but you don’t necessarily want to take them forever—and you may not want to look for another place to work—so your best bet is to take your air quality concerns to your hospital administration or to your occupational health personnel. Chances are they’re interested in improving air quality for both staff and patients.

You may also be interested in:

• The Scrubs Allergy Tool: Do you know all the allergens you’re exposed to every day?
• The Scrubs Allergy Quiz: Challenge yourself: can you identify these allergy symptoms?