Severe anaphylaxis induced by latex as a contaminant of plastic balls in play pits

Alessandro Fiocchi, Patrizia Restani, Cinzia Ballabio, Gabriel R. Bouygue, Annalisa Serra, Marta Travaini, Luigi Terracciano

Research output: Contribution to journalArticlepeer-review


Background: Latex causes anaphylaxis in specific contexts among children. We present 2 cases that show that severe reactions may occur in everyday circumstances with latex as a contaminant. Objective: Because 2 cases of severe reactions to latex suggested similar circumstances of exposure, we investigated the immediate environment in which episodes occurred. Methods: A 5-year-old girl presented to our casualty department with anaphylaxis after playing in a ball pit filled with approximately 10-cm diameter plastic balls in an American-style fast-food outlet. Two months later, a 9-year-old boy had severe anaphylaxis followed by an asthma attack with loss of consciousness while playing in the playpen of a different outlet belonging to the same company. Latex sensitization was confirmed in both cases by means of skin prick testing, latex glove skin prick testing, and 1-glove finger testing. Immunoblotting of elutions from a ball, the natural rubber latex foam pit lining, and its polyvinyl chloride sheet were performed. Results: In the girl's immunoblot high levels of IgE specific to Hev b 4, Hev b 7, and Hev b 2 were found, The boy's immunoblot showed positivity to Hev b 7. The polyvinyl chloride ball sample showed a high concentration of specific Hevea species allergen similar to that of the foam layer sample. Conclusion: Severe anaphylaxis can result from contact with latex proteins as a contaminant, rather than as a component, of play area ball pits and therefore outside the reported settings. Emergency health cate workers should be aware of this kind of risk, A latex-reduced environment might prevent potentially severe reactions in young customers of fast-food outlets.

Original languageEnglish
Pages (from-to)298-300
Number of pages3
JournalJournal of Allergy and Clinical Immunology
Issue number2
Publication statusPublished - 2001


  • Anaphylaxis
  • Ball pits
  • Children
  • Natural rubber latex

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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