Primary Care Trust (PCT)

Sensitisation and reactions to Natural Rubber Latex (NRL) affects the PCT because:

  • They have a statutory responsibility to take all necessary precautions to reduce the risk of sensitisation and allergic reaction in staff.
  • They have a statutory responsibility to take all necessary precautions to reduce the risk of sensitisation and allergic reaction in patients.

Ensure that your PCT has, and that all workers within the PCT (eg dentists, GPs, community/residential care workers) are familiar with:

  • A local glove policy which only supports the use of powder-free/low-protein NRL glove where a risk assessment has identified them as necessary, and wherever possible NRL-free equipment and product purchasing.
  • A written policy on action to protect staff from developing NRL allergy.
  • A (Policy) on action to protect staff who are allergic to NRL.
  • A (Policy) on action to protect patients who are allergic to NRL.
  • An Education programme to inform all new and existing staff.
  • Posters for patient and staff information on file.
  • An auditing system to ensure that policies for protection of staff and patients are taken up across all sectors of primary care.
  • A named person responsible for Health and Safety.

Specialty specific polices and guidance (e.g. for General Practice, Dental Practice, Residential Care etc) are likely to be better understood by the end-user rather than a general document.

The PCT team responsible for developing local policies and ensuring that these are implemented by all workers in the PCT may include:

  • Named person responsible for Health and Safety 
  • Occupational Health representative
  • Infection Control Nurse
  • Public Health and communicable diseases representative
  • Clinical Governance representative
  • Other (e.g. acute trust representatives responsible for their Trust’s NRL allergy policy development)

Prevention of NRL allergies

Staff

  • Assessment of all new staff should be encouraged using a pre-employment screening tool.
  • If staff are identified as sensitised to NRL, employers must undertake risk-assessment to ensure that the working environment is safe for the employment of the prospective member of staff.
  • In line with the Disability Discrimination Act 1995, individuals who are sensitised to NRL should stop using NRL medical gloves and be provided with gloves made from an alternative material. They should also avoid areas where NRL glove powder particles are likely to be airborne, (Health Service Circular HSC 1999/186).

Reporting
Reporting of work-related incidences should be encouraged. Employers have a duty to report incidences of occupational dermatitis and asthma attributable to NRL to the Health and Safety Executive under the RIDDOR  (or Reporting of Injuries, Disease and Dangerous Occurrences Regulations 1995 requirements).

Sensitised patients
The 1996 Medical Devices Agency (MDA) Device Bulletin entitled “Latex in the Health Care Setting DB9601 set out many of the problems surrounding NRL allergy, offered guidance and recommended that all healthcare establishments implement local policies to address glove use and the management of staff and patients with known or suspected NRL allergy.

Ensure local healthcare providers are familiar with and implement policies and protocols for managing NRL allergy in patients in NRL-safe environments and treating allergic reactions.

Reporting agencies for adverse reactions to Natural Rubber Latex products
The National Patient Safety Agency (NPSA) is a Special Health Authority charged with improving patient safety in the NHS.  It was created in 2001, following the publication of two reports addressing patient safety incidents in the NHS (An Organisation with a Memory and its follow-up, Building a Safer NHS for Patients).

The Medicines and Healthcare Products Regulatory Agency (MHRA) has a voluntary reporting system for reporting cases of NRL sensitisation in both patients and staff.