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Identification of causative chemicals of allergic contact dermatitis using a combination of patch testing in patients and chemical analysis. Application to cases from rubber gloves.

5 cases of allergic contact dermatitis from rubber gloves were investigated by our recommended procedures using a combination of patch testing in patients and chemical analysis of causative rubber products by gas chromatography (GC) and high-performance liquid chromatography (HPLC). We previously confirmed that zinc ethylphenyldithiocarbamate (ZEPC), a dithiocarbamae-type accelerator (DTC), was causative in a case of allergic contact dermatitis from rubber work gloves. Subsequently, we have clarified that DTCs such as zinc dimethyldithiocarbamate (ZDMC), zinc diethyldithiocarbamate (ZDEC) and zinc dibutyldithiocarbamate (ZDBC) and amines such as dimethylamine (DMA), diethylamine (DEA) and piperidine (PIP) were also causative in cases from surgical rubber gloves. Thus, our investigative studies revealed that, although thiurams have been taken much more notice of as allergenic compounds than their corresponding DTCs and amines, not only DTCs such as ZDMC, ZDEC, ZDBC and ZEPC, but also amines such as DMA, DEA and PIP were noteworthy causative candidates of allergic contact dermatitis from rubber gloves.

Adult↗

Isolation of anaerobic bacteria from human gingiva and mouse cecum by means of a simplified glove box procedure.

An anaerobic glove box constructed of clear flexible vinyl plastic is described. It is sufficiently inexpensive and simple in operation to be used not only in research but also in a clinical laboratory by technicians without special training. Conventional bacteriological techniques may be used inside the glove box for culturing and transferring anaerobic bacteria. The box may be heated to 37 C and thus serve as an anaerobic incubator as well, permitting inspection of cultures at any time. Media may be prepared and agar plates may be poured on the laboratory bench in the conventional manner. An overlay of trace amounts of palladium black catalyst over plated agar media reduces the medium to an oxidation-reduction (O-R) potential of - 300 mv within 2 days after introduction into the glove box. In spite of its greater simplicity, the system matched or excelled the roll tube method with respect to all parameters tested, including O-R potential obtainable in the media, O(2) concentration in the gas phase, and efficiency in isolating anaerobic bacteria from the mouse cecum. Comparative studies indicate that the conventional anaerobic jar method was inadequate for the isolation of strict anaerobes from human gingival specimens and from the mouse cecum. This was due to the exposure of specimens and media to air during plating on the open laboratory bench. Anaerobic jars were adequate for maintaining the proper conditions for growth of anaerobic bacteria once these had been established in the glove box.

Animals↗

Manual performance in the cold with gloves and bare hands.

Previous research aimed at quantifying and reducing the decrements encountered in performing manual tasks in cold weather has not described the relationships between task characteristics and cold-induced impairments. The amount of decrement and, often times, the optimal means for reducing the decrement, appear to be task-specific. The research reported here is one in a series of studies formulated to explore those relationships. The strategy is to use tasks from the battery developed by Fleishman (1967) to measure the factorially 'pure' abilities needed to perform all manual tasks. 24 U.S. Marines performed this battery of nine tasks across a range of cold temperatures. To determine if the decrement due to wearing gloves might be less than the decrement due to cold hands as the air temperature decreased, performance on the battery of tasks was measured with and without gloves. Only three of the tasks (abilities) were affected by cold temperatures, and the amount of decrement increased as the air temperature decreased. Three tasks deteriorated due to wearing of gloves, two of those affected by cold and one other. Temperature affected performance independently of the glove effect. Half of the subjects did not complete bare-handed testing at -18 degrees C (approximately 20 min.), indicating this is the lower end of the temperature range in which bare-handed performance for more than a few minutes is practical.

Adolescent↗

A topical cream containing a zinc gel (allergy guard) as a prophylactic against latex glove-related contact dermatitis.

BACKGROUND: Many health care workers are sensitized to the proteins in natural rubber latex and get contact dermatitis as a result of wearing latex gloves. OBJECTIVE: The aim of the study was to evaluate a topical formulation containing a zinc gel (Allergy Guard) as a prophylactic against latex glove-related contact dermatitis. METHODS: The study was carried out with volunteers who exhibited mild to moderate contact dermatitis (type IV) after wearing latex gloves as per the protocol. RESULTS: Allergy Guard significantly reduced skin irritation in volunteers who exhibited type IV hypersensitivity when exposed to latex gloves. Allergy Guard also exhibited a barrier effect as shown by the permeation of chlorophyllin dye into the skin of volunteers. Allergy Guard prevented dermal irritation induced by sodium lauryl sulfate. CONCLUSION: Topical formulations containing a zinc gel may be used to delay or prevent latex sensitivity, especially among health care professionals.

Administration, Topical↗

Dermatoses in the canning industry--the roles of glove use and non-occupational exposures.

Primary prevention is the mainstay of management of occupational dermatoses. Despite the high rates of dermatoses found in a study of 686 female workers in a canning factory in March 1990, use of protective gloves was extremely low, even though there was evidence that they prevented acute paronychia and intertrigo. Reasons associated with low glove use were unavailability, discomfort and workers' failure to perceive a protective role for gloves. Difficulties with replacement of damaged gloves were an important cause of unavailability. Domestic and other non-occupational exposure at the workplace appeared to be unimportant in the development of dermatoses. Important preventive interventions are possible in the industry to reduce the rates of dermatoses among the workforce.

Adolescent↗

The effect of starch glove powder on joint and other tissues.

The purpose of this research was to establish the possible role of starch glove powder in complications following orthopaedic surgery using in vivo and in vitro techniques. Exposure of primary mouse peritoneal macrophages to starch glove powder caused 10% release of prostaglandin E2 (0.1 mg/ml, 16 h) but no increased release of lactate dehydrogenase, demonstrating that cell integrity had not been compromised. Long-term tissue reaction to starch glove powder was investigated in vivo by injection into mouse knee joints. Over a period of 52 weeks no inflammatory response was elicited, no starch was observed in the regional lymph nodes and none was found in joints after the 8th week. Starch glove powder appeared to be innocuous in the joint and although prostaglandin E2 release was stimulated in vitro, this had no apparent effect on joints in vivo.

Animals↗

[Construction and operation of an anaerobic glove box (author's transl)].

Construction and operation of an anaerobic glove box is described mainly built of commercially available material. The box is made of refined steel and has the dimensions of 150 cm in length, 62 cm in height and 68 cm in depth. It is equipped with one round vacuum tight steel airlock for transfer of material. Three Neopren gloves and an oblique glass window are installed into the frontside. The anaerobic box is continuously perfused by 35 l/h of O2-free gas. In the box the atmosphere is whirled round by a fan and hereby led over a layer of catalyst. The O2-content of the anaerobic atmosphere is less than 1 ppm-3 ppm to 4 ppm on a yearly average - measured by an oxygen trace analysor. All bacteriological work as cultivation and isolation of strictly anaerobic bacteria can be done within a continuous O2-free atmosphere by conventional technics. The anaerobic glove box described was used for three years without any failure. In glove boxes built in the same manner as above mentioned similar O2-values will be achievable.

Anaerobiosis↗

In situ localization of latex allergens in 3 different brands of latex gloves by means of immunogold field emission scanning and transmission electron microscopy.

BACKGROUND: Latex proteins represent relevant allergens, particularly for those persons who are frequently exposed to latex products (eg, health care workers and patients with chronic disorders). Although several latex allergens have been characterized by biochemical and molecular biologic techniques, little information is available concerning the in situ localization of allergenic proteins in latex products. OBJECTIVE: The objective of the present study was the in situ localization of latex allergens. METHODS: Serum IgE from patients with latex allergy reacting with a broad range (5-200 kd) of latex allergens was used for the in situ localization of latex allergens. One surgical and 2 examination latex glove brands were investigated by using immunogold field emission scanning and transmission electron microscopy. RESULTS: Allergens were detected on the inner and outer surface of the gloves, particularly near the edges, crests, or folds of the bleb-like structures visible on the surface of the latex material at high magnifications. In ultrathin cross-sections, latex allergens were found throughout the sections. CONCLUSIONS: Latex allergens were localized on the outer and inner surface but also in the interior of latex gloves. The occurrence of latex allergens on the surface of latex products may be related to their potential to induce local reactions and, perhaps, to sensitize individuals by means of contact.

Allergens↗

Suture contamination by surface powders on surgical gloves.

Recent studies have shown that many glove manufacturers still are using talc as a glove-mold release agent. The removal of talc particles from the patient-contact side of the gloves is difficult and incomplete with the use of recommended washing and wiping procedures. As a result, a shedding hazard exists that may ultimately be related to granulomatous reactions. In our study, shedding was demonstrated to be hazardous because of suture contamination with talc particles.

Gloves, Surgical↗

Surgical glove powders bind latex antigens.

Latex surgical gloves have recently been identified as a potential source of allergens. Much of the current information suggests that the soluble proteins in latex may cause significant reactions in sensitive individuals. The starch powders used as a lubricant on some latex gloves have also been identified as potential allergens in some patients. In this study, we determined these powders to act as potential carriers of latex allergens. We have produced a polyclonal antiserum to be used as a reagent to study latex proteins. By Western blot analysis, we identified a significant interaction between latex proteins and starch powders. The binding of latex proteins to starch particles results in a glove particle that may have an increased potential to act as an allergen. The latex protein-starch particles represent a potential mechanism for exposure and sensitization of health care workers to latex allergens. Elimination of these particles from the operating room should reduce the route of sensitization and the potential for adverse reactions to latex.

Adsorption↗

The immunogenicity of starch glove powder and talc.

An antigen responsible for cutaneous delayed hypersensitivity to starch glove powder in guinea-pigs was found to be associated with starch grains. Talc was not immunogenic in this system, and did not cross-react in skin tests with starch glove powder. Additives and protein components in the glove powder did not appear to be antigenic.

Animals↗

Tumor necrosis factor-alpha, interleukin 1, eicosanoid, and hydrogen peroxide release from macrophages exposed to glove starch particles.

The inflammatory mechanisms leading to glove starch powder peritonitis are still unclear. This study was designed to examine the secretory potential of macrophages exposed to starch powder particles. Rat peritoneal macrophages and human monocytes were incubated in vitro with starch particles obtained from three commonly used surgical gloves. It was found that macrophages and monocytes released large amounts of tumor necrosis factor-alpha, interleukin 1, prostaglandin E2, thromboxane B2, and hydrogen peroxide. Release of these inflammatory mediators was associated with progressive cell death of macrophages. These data indicate that postoperative peritonitis and subsequent granuloma formation initiated by glove powder particles may be mediated and maintained, at least in part, by macrophage-derived cytokines, eicosanoids, and reactive oxygen intermediates.

Animals↗

Incidence of glove perforation during episiotomy repair.

A total of 416 gloves were tested for punctures after 200 episiotomy repairs. Evidence of perforation was found in 34 (8%) of the gloves used and in only half the cases did the surgeon actually realise that a perforation had occurred. The left index finger and thumb were more often perforated than other parts of the gloves. The implications of the findings, especially as regards spread of infections to surgeons, are discussed.

Episiotomy↗

Cleanup of gloves contaminated with granular terbufos and tefluthrin.

Chemical-resistant gloves are used for protection from pesticides in farming operations. Cleanup of gloves after pesticide contamination was the focus of this research. Nitrile, neoprene, and barrier laminate glove specimens were exposed to 300 mg terbufos or tefluthrin granules for 3 or 30 min in petri dishes in a laboratory. Specimens were cleaned by flush with running water or LaunderOmeter washing with detergent. Following the cleanup treatments, specimens were dried and placed in test tubes with solvents to extract pesticide residue. Levels of contamination remaining were determined by gas chromatography. The residue remaining varied with exposure time, material type, cleanup method, and pesticide. Flush was more effective with the shorter exposure time. Tefluthrin was more effectively removed than terbufos. Barrier laminate was confirmed as a single-use material. Cleanup procedures reduced contamination in nitrile and neoprene, but findings show that these materials retained residue after cleanup.

Agriculture↗

Cotton liners to mediate glove comfort for greenhouse applicators.

Greenhouse applicators' acceptance of cotton knit gloves worn as liners under nitrile chemical-resistant gloves (CRG) for pesticide application was investigated through a wear study in Iowa and New York. Comfort was assessed by questionnaires and interviews with 10 applicators. Contamination levels of four pesticides on CRG and liners at thumb, forefinger, palm, and cuff locations were determined by chemical analysis using high-performance liquid chromatography or gas chromatography. Applicators reported feeling more comfortable with cotton liners under their CRG than without and that cotton liners were easy to manage. Contamination was significantly greater on nitrile CRG than on cotton liners underneath, but a few liner specimens had measurable contamination. No significant contamination differences were found between right- and left-hand gloves. Contamination varied significantly by hand location, with cuffs least, and by pesticide, with chlorpyrifos most. These results support the Environmental Protection Agency's recommendation that liners should be disposable, but further work on liners and their laundering feasibility seems indicated.

Agriculture↗

Effects of exposure time, material type, and granular pesticide on glove contamination.

Chemical-resistant gloves are recommended for pesticide applicators to reduce their exposure to agricultural chemicals. In this research, three chemical-resistant glove materials-nitrile, neoprene, and barrier laminate-were studied in relation to contamination with granular terbufos and tefluthrin. Surfaces of specimens backed with alpha cellulose were contaminated with 300 mg of either granular terbufos or tefluthrin for 1-, 2-, 4-, 8-, 16-, and 24-h time periods in petri dishes in the laboratory. Residues were extracted using ethyl acetate for terbufos and iso-octane for tefluthrin in test tubes for 24 h. Analysis of extracts by gas chromatograph and statistical analysis of the data showed that contamination levels varied with the time of exposure, material type, and pesticide used. Pesticide was not detected in the alpha cellulose even after 24 h contamination time. A linear relationship was found between contamination level and exposure time for terbufos in the three materials, with longer exposure times causing higher contamination levels. Contamination of nitrile was significantly less than neoprene or barrier laminate. Exposed glove materials contained higher levels of contamination of terbufos than tefluthrin.

Chromatography, Gas↗

A study of the incidence and recognition of surgical glove perforation during obstetric and gynecological procedures.

OBJECTIVES: The purpose of this study was to compare the frequency of surgical glove perforation among obstetric and gynecological surgical procedures, and to evaluate surgeons' perceptions. MATERIALS AND METHODS: A cross-sectional study was conducted in which nursing personnel examined the gloves used in obstetric and gynecological procedures, immediately after the surgery, in order to detect perforations. RESULTS: Surgical glove perforation occurred in 20.8% of 817 obstetrics procedures and 24.4% of 131 gynecology procedures. The observed difference between groups was not statistically significant (p=0.35). Obstetricians perceived the occurrence of perforation in 30.6% of the events, and gynecologists in 37.5%. This difference was not statistically significant (p=0.44).

Brazil↗