United States Workers’ Compensation Programs are Becoming Sensitized to Latex

Latex allergy sensitivity claims are becoming a more common phenomenon in workers’ compensation systems throughout the United States. Causal relationship between latex exposure and allergic reactions, including anaphylactic shock, has led to the reporting of 23 deaths to the Federal Drug Administration between 1988 and 1995. Although most commonly associated with latex gloves, natural latex rubber is used in more than 40,000 medical, surgical and household products. It has been estimated that over 950,000 healthcare workers may become sensitized to latex protein during their careers. The purpose of this article is to report developing trends throughout the United States concerning latex allergy. 

For the purpose of this article, three (3) types of diseases were considered in locating reported workers’ compensation decisions. The first type was irritant contact dermatitis involving non-allergic reactions, which amounted to 80% of the disease base. Between 25% and 40% of glove wearers develop a mild irritant reaction. The second type of disease that was considered was Type IV hypersensitivity. This is a delayed reaction involving contact dermatitis producing the first inflammatory reaction in a delayed fashion, occurring at several hours and possibly up to four days after re-exposure to the substance initially. 

The third type of claim, the most serious, was Type I hypersensitivity, which occurs when an antigen interacts with an antibody. This type of allergic reaction produces an immediate response by the immune system that can occur within minutes or at one to two hours after exposure. Type I hypersensitivity usually presents with either localized hives, generalized hives with facial and throat swelling, hives with asthma involvement of the nose, throat, ears, and digestive tract, or a life-threatening systemic reaction, anaphylaxis. For the purpose of this statistical analysis, only Type I hypersensitivity was utilized.

A review of the case law disclosed that 13 states had reported cases: Illinois, Mississippi, Minnesota, Montana, New York, Oregon, Pennsylvania, South Dakota, Texas, Vermont, Virginia, Washington and Wisconsin. Of the 30 reported cases nationally, 21 were deemed to be compensable under the Workers’ Compensation Acts of the various jurisdictions. A growing trend in claims from the period of 1987 through 1999 demonstrates that there has been a significant increase in those seeking benefits because of latex sensitivity. Since the last reported case available for consideration was decided on June 30, 1999, estimated projections for the third and fourth quarters of 1999 were utilized. The projections demonstrate a consistently increasing number of claims for latex allergy sensitivity. The claims seem to be clustered in various jurisdictions including Wisconsin, New York, Texas, Virginia and South Dakota. Both Wisconsin and New York have dramatically demonstrated that a claim for latex sensitivity is extremely serious in nature and is indeed compensable. A significant percentage of the claims resulted in the awarding of total and permanent disability benefits to the claimant.

An orthodontic technician in Wisconsin was determined to be totally and permanently disabled on an “odd-lot” basis as she was unable to secure continuing and gainful employment due to her development of hypersensitivity. Yannaras v. David Stangl, 1996 WL 647561 (Wis.Lab.Ind.Rev.Com.). In another Wisconsin case, the administrative law judge held the applicant to be permanently and totally disabled based upon a physician’s opinion that additional medical treatment might be required in the future and that the individual would be unable to work until such time as there were advances in medical science that resulted in the ability to better control or reverse the injured worker’s sensitivity. A registered nurse at the John Doyne Hospital was required to wear latex surgical gloves and often made frequent glove changes during one operation. Others performed similar glove changes in the operating theater. As a result, the nurse experienced latex allergy symptoms, which included respiratory difficulties. The claimant demonstrated that she was unable to engage in regular, continuous employment anywhere. McMillan v. County Milwaukee, 1996 WL 98882 (Wis.Lab.Ind.Rev.Com.).

In Montana, the court went so far as to award a nurse’s aide total disability benefits and reviewed a need for special housing that she requested. This nurse’s aide worked for the Kalispell Regional Hospital and was required to use latex gloves while working with a patient who was in isolation. During that procedure, her hands swelled up and she developed abdominal pain, nausea and vomiting. The health care worker was subsequently hospitalized, and when physicians conducted both rectal and pelvic examinations with latex gloves, her condition worsened. Finally, as a result of attempting to administer a barium enema utilizing latex equipment for the purpose of diagnosing her unexplained abdominal pain, her blood pressure began to fall and she went into anaphylactic shock. The workers’ compensation hearing official considered the case so unique and the claimant’s disability so severe because of its life-threatening potential that the official stated, “there may well be no equitable solution.” In rendering her totally and permanently disabled, the court also indicated that suitable housing should be located and that a price should be reached which would allow a lump sum advance of benefits. The court encouraged the parties to come to an agreement for housing adaptation. Daniels v. Kalispell Regional Hospital, WL 109850 (Mont.Work.Comp.Ct.). 

In conclusion, it can be stated that reported workers’ compensation claims are increasing throughout the United States at a very rapid rate and that 70% of the reported decisions to date were held to be compensable by the courts. It can further be recognized that the claimants are being awarded disability benefits that are substantial in nature due to the severity of the injury and the resulting inability to return to the labor market. Furthermore, home adaptation is being considered because of the great proliferation of latex containing products which may be present in our everyday lives. Since workers’ compensation remedies may in fact be inadequate to monetarily compensate the petitioners, the victims of latex allergies are also filing products liability claims against the suppliers, manufacturers and distributors of latex products.