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chapter 12 | Promoting a Healthy Workplace 181 CikguOnline
supervise other employees, regularly review your A midwife initially suffered hives, nasal conges-
agency’s policies and procedures. Seek appropriate tion, and conjunctivitis. Within a year, she devel-
guidance from your Human Resources personnel. oped asthma, and 2 years later she went into shock
If an employee approaches you with a complaint, after a routine gynecological examination during
then a confidential investigation of the charges which latex gloves were used.The midwife also suf-
should be initiated. Above all, do not dismiss any fered respiratory distress in latex-containing envi-
incidents or charges of sexual harassment involving ronments when she had no direct contact with latex
yourself or others as “just having fun” or respond products. She was unable to continue working
that “there is nothing anyone can do.” Responses (Bauer et al., 1993).
such as this can have serious consequences in the A physician with a history of seasonal allergies,
workplace (Outwater, 1994). runny nose, and eczema on his hands suffered
The ANA cites four tactics to fight sexual harass- severe runny nose, shortness of breath, and collapse
ment (nursingworld.org/dlwa/wpr/wp3/htm): minutes after putting on a pair of latex gloves. A
cardiac arrest team successfully resuscitated him
1. Confront. Indicate immediately and clearly to (Rosen et al., 1993).
the harasser that the attention is unwanted. Latex products are manufactured from the
If you are in a union facility, ask the nursing milky fluid of the rubber tree. Latex allergy was
representative to accompany you. first identified in the late 1970s. It has become such
2. Report. Report the incident immediately to a major health problem in the workplace that both
your supervisor. If the harasser is your supervi- the OSHA and the ANA have devoted Web sites
sor, report the incident to a higher authority. to the problem. It is estimated that currently
File a formal complaint, and follow the chain 8%–12% of health-care workers are sensitive to
of command. natural rubber latex products.Table 12-2 lists prod-
3. Document. Document the incident immedi- ucts commonly produced with latex.
ately while it is fresh in your mind—what Since the 1987 CDC recommendations for uni-
happened, when and where it occurred, and versal precautions, use of latex gloves has greatly
how you responded. Name any witnesses. Keep increased exposure of health-care workers to natu-
thorough records, and keep them in a safe place ral rubber latex (NRL). The two major routes of
away from work. exposure to NRL are skin and inhalation, particu-
4. Support. Seek support from friends, relatives, larly when glove powder acts as a carrier for NRL
and organizations such as your state nurses protein (OSHA latex alert: cdc.gov/niosh/latexalt).
association. If you are a student, seek support Reactions range from contact dermatitis, with scal-
from a trusted faculty member or advisor. ing, drying, cracking, and blistering skin, to allergic
Additionally, your employer has a responsibility contact dermatitis in the form of generalized hives.
to maintain a harassment-free workplace. You More serious reactions can progress to generalized
should expect your employer to demonstrate urticaria, rhinitis, wheezing, swelling, shortness of
commitment to creating a harassment-free breath, and anaphylaxis. According to the NIOSH,
workplace, provide strong written policies the most common reaction to latex products is
prohibiting sexual harassment and describing irritant contact dermatitis, the development of
how employees will be protected, and educate dry, itchy, irritated areas on the skin, usually the
all employees verbally and in writing. hands. This reaction is caused by irritation from
wearing gloves and by exposure to the powders
Latex Allergy added to them.
Allergic contact dermatitis (sometimes called
A nurse developed hives in 1987, nasal congestion chemical sensitivity dermatitis) results from the
in 1989, and asthma in 1992. She was diagnosed chemicals added to latex during harvesting, pro-
with latex allergy. Eventually she developed severe cessing, or manufacturing. These chemicals can
respiratory symptoms in the health-care environ- cause a skin rash similar to that of poison ivy.
ment even when she had no direct contact with Neither irritant contact dermatitis nor chemical
latex. The nurse was forced to leave her occupation sensitivity dermatitis is a true allergy (cdc.gov/
because of these health effects (Bauer et al., 1993). niosh/98-113).