We have a new member of staff starting with us next week working on the Deli Counter within our Farm Shop and she has declared to us, by completing a health questionnaire, that she has a severe nut allergy (Brazil nuts). I asked whether there were any adjustments or precautions we should take? She stated there was not apart from perhaps gloves (I've checked that she doesn't have a latex allergy). She is happy for the team to know about her allergy. She said that she carries an epi pen and that if she has come into contact and starts to have a reaction she knows the warning signs to look out for. She said that she has only had one medical episode. My question is - should we put a risk assessment in place and if so should it be specific to this individual case or a general risk assessment covering all potential allergens? does anyone have anymore information they can share on this? Thoughts please?

You are dealing here with a type I immune response (allergic contact urticaria). For this to occur there must be sufficient contact with the allergen. This can occur due to both airborne and skin exposure. With Brazil nuts I would anticipate that airborne exposure is unlikely, so we are concerned primarily with skin exposure. Gloves can provide an adequate level of protection. I would choose single use gloves manufactured from natural rubber latex. However, these must be unpowdered, low free protein. Any risk from wearing this type of latex glove causing development of latex allergy is miniscule. If these gloves are to be worn for an extended period (i.e. in excess of two hours in total in an eight hour shift) then precautions should be taken to avoid irritant contact dermatitis due to the effect of the hyperhydration that will occur in the occluded skin inside the gloves. This actually worse than having hands in water for the same length of time as the nature of the hyperhydration actually increases the effect on the skin. The way to avoid this is for her to wear separate cotton gloves inside the rubber gloves. These will need to be changed regularly as they become saturated. They can be rinsed, dried and reused. You will need to introduce a process for skin health surveillance, but this should be done for any workers wearing occlusive gloves for any length of time. You will also need to train her so that she can remove her gloves without contaminating her hands with whatever in on the outside of the gloves. The HSE have posters on how to do this that can be downloaded for free.

Latex (NRL) gives greater dexterity, less wearer fatigue and is usually less expensive. Single use nitrile gloves represent a greater risk of developing type IV allergic contact dermatitis than NRL as they use many of the same chemicals in their manufacture but these cannot be 'bound' into the finished glove in nitrile as they can be with latex. I had a client (large pharmaceutical company) where up to 500 workers wore single use NRL gloves all day. Since we persuaded the company to insist on low free protein, unpowdered NRL gloves in 1991 until early 2000 they had not had a single case of latex allergy. When taken over the new owners insisted on nitrile with the result that with two months they had an outbreak of allergic contact dermatitis! In the German state health care sector NRL gloves are the standard, but always unpowdered, low free protein, and as my colleague there put it, 'latex allergy is history' You might also check the study done by the Royal College of Physicians on latex allergy. You can find this on the NHS Plus website. Chris

Chris Thanks for the information We user nitrile gloves as they give better protection against occasional chemical splash risk than latex gloves, so I was concerned about the dermatitis risk from nitrile gloves. We have had a nitrile policy for nearly 10 years and not had any problems but now I know that there could be problem. Thanks