studies of latex extract would be useful in further characterizing the immune response to natural rubber.

With recent increases in the production and use of latex gloves and other rubber products, clinical sensitivity may be more common than in previous years, and the regulatory, research, and medical communities are responding accordingly. A current regulatory review by the FDA may result in relabeling of latex products—including latex gloves, condoms, catheters, dental dams, and enema kits—to highlight the risks of latex hypersensitivity. The FDA has already issued a Medical Alert (MDA91-1, March 29, 1991) containing recommendations to health professionals regarding the use of latex products. The American College of Allergy and Immunology has also issued interim guidelines on latex allergy.

As noted by Slater (1989), and others, and described in the medical alert and guidelines, patients with a history of rubber-induced allergic reactions, as with all life-threatening allergy, should practice avoidance as the main form of treatment. Health care workers should use nonrubber gloves when treating these patients, and appropriate care should be taken to avoid exposing latex-sensitive patients to either direct or aerosolized contact (e.g., from the cornstarch dust used in packaging latex gloves). It has also been suggested that latex allergen may be carried on syringe needles from the rubber stoppers of multiuse vials (Silverman, 1989).

Finally, it is important that sensitive individuals be recognized prior to surgery so that proper precautions can be taken to avoid latex exposure and minimize the potential for experiencing the associated adverse reactions. In addition to allergen avoidance strategies, some authors believe that latex-sensitive patients should be premedicated according to protocols for the prevention of anaphylactic reactions in surgery (Bielory and Kaliner, 1985; Greenberger et al., 1985; Lasser et al., 1987).

CONCLUSIONS AND RECOMMENDATIONS

Indoor plants are commonly found in offices, schools, and the home. Although most indoor plants do not produce aerosols of allergen-containing particles, as more plants are used indoors, especially in large numbers in office settings, the risk of exposure to plant allergens increases.

Research Agenda Item: Assess the significance of workplace exposures to indoor plants, including the contribution to the overall magnitude of indoor allergic disease.

Latex allergy has recently received substantial attention because of increasing reports of its occurrence and its potential, in certain individuals, to produce life-threatening anaphylactic reactions. In addition to health care



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