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PubMed1984

Permeability of latex and polyvinyl chloride gloves to 20 antineoplastic drugs.

Permeability of latex and polyvinyl chloride (PVC) gloves to 20 injectable antineoplastic drugs was studied. Four types of gloves were evaluated: latex surgical gloves, latex examination gloves, and PVC gloves in two thicknesses. Each glove material was exposed to each drug for 90 minutes, and permeation was tested using a mutagenicity assay. Individual fingertips of thin PVC gloves and latex surgical gloves were tested for permeability at five time points (2-30 minutes) using a doxorubicin coloration assay. All drugs permeated the thin PVC gloves. Latex surgical gloves were definitely permeable to two drugs (carmustine and thiotepa) and exhibited borderline permeability to mechlorethamine hydrochloride. The thick PVC gloves were definitely permeable to four drugs (carmustine, thiotepa, mechlorethamine hydrochloride, and daunorubicin hydrochloride) and exhibited borderline permeability to two drugs (doxorubicin and mercaptopurine). The latex examination gloves were permeable to carmustine, thiotepa, mechlorethamine hydrochloride, and cyclophosphamide. Doxorubicin permeation of individual fingertips of thin PVC gloves varied in time and amount. Doxorubicin did not permeate the latex surgical glove material, but testing with thiotepa showed that individual fingertips of this material also varied in permeability. Glove thickness was a major determinant of permeability; latex surgical gloves were the least permeable and thin PVC gloves the most permeable to the antineoplastic drugs tested. Within individual gloves and glove types, time and amount of permeation were not uniform.

Antineoplastic Agents↗
PubMed2000

Glove leakage rates as a function of latex content and brand: caveat emptor.

HYPOTHESIS: That water leakage rates and protection against blood-borne pathogens should not vary as a function of latex content among Food and Drug Administration-approved gloves, allowing avoidance of unnecessary latex exposure. DESIGN AND METHODS: Eighteen different glove types were purchased and tested using the American Society for Testing Methods Standard Test for Detecting Holes in medical gloves, which involves mounting the glove on a plastic tube, pouring a liter of tap water into the glove, and visually inspecting the glove initially and after 2 minutes. Half of the gloves were tested straight from the package and half after a standardized manipulation. SETTING: A university hospital. RESULTS: Eleven sterile glove types (5 high latex content, 4 low latex content, and 2 nonlatex content), and 7 nonsterile examination glove types (2 high latex content, 2 low latex content, and 3 nonlatex content) were tested (total tested, 3720 gloves). Leakage rates were greater for examination than for surgical gloves (relative risk [RR], 1.41, 95% confidence interval [CI], 1.01-1.96), for manipulated than for unused gloves (RR, 2.89, 5% CI, 1.98-4.22), and for low latex content surgical gloves (RR, 2.58, 95% CI, 1.35-4.92) or nonlatex content surgical gloves (RR, 4.93, 95% CI, 2.35-10.32) than for high latex content surgical gloves. Significant differences were observed among low latex content surgical gloves (P</=.001) and all types of examination gloves (P =.0015) especially after the standardized manipulation (leakage rates ranging from 0%-30%). CONCLUSIONS: Food and Drug Administration approval should not be interpreted as suggesting equality of different manufacturers' products. Some low latex and nonlatex content gloves are very resistant to leakage and should provide an effective barrier for preventing exposure to blood-borne pathogens, while others may not.

Blood-Borne Pathogens↗
PubMed2003

A preliminary report on the incidence of pre-existing pinhole defects in nitrile dental gloves.

INTRODUCTION: Examination gloves manufactured from natural latex have been the predominant glove choice to date in dental practice. However, concerns over hypersensitivity have resulted in the use of alternatives such as nitrile gloves. The aim of the current study was to assess the incidence of pre-existing pinhole defects in nitrile examination gloves. METHODS: Air inflation, followed by water submersion, was used to assess the incidence of pre-existing pinhole defects in five nitrile and two latex glove types. The gloves were filled with a constant volume of air and submerged in 3 litres of water for 10 seconds while being observed for air bubbles which would indicate pinhole defects. The position and number of pinholes were noted for 100 gloves of each type investigated. RESULTS: The incidence of pre-existing pinholes for latex gloves was 0% for the non-sterile surgical latex glove type and 3% for the powdered latex examination glove type, with pinholes located on the thumb, middle finger and ring finger. Of the nitrile gloves evaluated, three types were assessed to have no pre-existing pinhole defects. One type had a 2% incidence of pre-existing pinhole defects--one pinhole located on the thumb region of the glove and one on the ring finger portion of the glove. The fifth nitrile glove type had one pre-existing pinhole defect located on the middle finger. SIGNIFICANCE: All glove types examined met the European Standard (EN 455-1) and there was no statistically significant difference between glove types. However, the nitrile gloves generally exhibited less pre-existing pinhole defects than the latex examination gloves.

Analysis of Variance↗
PubMed2003

Reliability and performance of innovative surgical double-glove hole puncture indication systems.

During operative procedures, operating room personnel wear sterile surgical gloves designed to protect them and their patients against transmissible infections. The Food and Drug Administration (FDA) has set compliance policy guides for manufacturers of gloves. The FDA allows surgeons' gloves whose leakage defect rates do not exceed 1.5 acceptable quality level (AQL) to be used in operating rooms. The implications of this policy are potentially enormous to operating room personnel and patients. This unacceptable risk to the personnel and patient could be significantly reduced by the use of sterile double surgical gloves. Because double-gloves are also susceptible to needle puncture, a double-glove hole indication system is urgently needed to immediately detect surgical needle glove punctures. This warning would allow surgeons to remove the double-gloves, wash their hands, and then don a sterile set of double-gloves with an indication system. During the last decade, Regent Medical has devised non-latex and latex double-glove hole puncture indication systems. The purpose of this comprehensive study is to detect the accuracy of the non-latex and latex double-glove hole puncture indication systems using five commonly used sterile surgical needles: the taper point surgical needle, tapercut surgical needle, reverse cutting edge surgical needle, taper cardiopoint surgical needle, and spatula surgical needle. After subjecting both the non-latex and latex double-glove hole puncture indication systems to surgical needle puncture in each glove fingertip, these double-glove systems were immersed in a sterile basin of saline, after which the double-gloved hands manipulated surgical instruments. Within two minutes, both the non-latex and latex hole puncture indication systems accurately detected needle punctures in all of the surgical gloves, regardless of the dimensions of the surgical needles. In addition, the size of the color change visualized through the translucent outer glove did not correlate with needle diameter. On the basis of this extensive experimental evaluation, both the non-latex and latex double-glove hole puncture indication systems should be used in all operative procedures by all operating room personnel.

Equipment Design↗
PubMed1993

Physical and microbiological quality of five different examination and surgical gloves before and after use in dental practice.

The purpose of the present study was to compare five different types of examination and surgical gloves physically and microbiologically before and after use in clinical dentistry. The prevalence of perforations was examined by the water inflation technique, and adhesion of bacteria to the glove surfaces was determined by use of a standard procedure with Streptococcus salivarius ATCC 13419. The effect of handwashing with a non-medicated soap and disinfectant soaps was finally examined. About 3% of the unused latex--and Elastyren gloves had perforations, while 6-7% of the unused vinyl gloves showed pinholes. Ten handwashes with a non-medicated soap did not affect the physical integrity of any of the glove types, while the disinfectant soap BLIX deteriorates about one third of the Elastyren gloves after 10 washes. In contrast, another disinfectant soap Hibiscrub did not affect these gloves. After use in clinical dentistry all vinyl gloves had perforations, while the other four types seemed unchanged. S. salivarius adhered to unused gloves of all types except for the hypoallergenic latex glove Biogel D. Highest numbers of cultivable bacteria were found for the non-sterile latex gloves and Elastyren gloves. The bacterial contamination was easily removed from all types by handwashing. Repeated handwashing decreased the adherence of S. salivarius to the non-sterile latex gloves and Elastyren gloves. After use in dental practice the adherence of S. salivarius seemed to be unchanged in relation to the situation, when the gloves were only washed up to 10 times. For the Biogel D gloves an increase in adherence of S. salivarius from zero before clinical use to a level comparable with the other glove types after clinical use was observed. Based on the findings in this study and compared with previous studies general recommendations for use of gloves in dental practice are formulated.

Bacterial Adhesion↗
PubMed1996

Subjective effects of double gloves on surgical performance.

This randomised trial compared single gloves with combinations of double gloves to determine the subjective effects on comfort, sensitivity and dexterity in 32 surgeons. Glove perforation rates were also compared. Single gloves of the surgeon's normal size (method A) were used as control. Double gloves were worn in three different ways, selected randomly: normal gloves inside and gloves one-half size larger outside (method B); the larger gloves inside and the normal gloves outside (method C); and lastly, two pairs of gloves of normal size (method D). Double gloves by all three methods significantly protected against needle perforation of the inner gloves when compared with single gloves, but also significantly impaired comfort, sensitivity and dexterity. When the three types of double gloving were compared, there appeared to be advantages for method C for all modalities, but the differences did not reach statistical significance; also, more surgeons expressed a preference for method C. Perforation of the inner gloves was significantly less for double gloves than for single gloves. We conclude that double gloves often protect the surgeon against needle perforations, but are felt to impair comfort, sensitivity and dexterity.

Attitude of Health Personnel↗
PubMed2004

Testing for viral penetration of non-latex surgical and examination gloves: a comparison of three methods.

Currently, there are no international standards based on microbiological methodology for testing the ability of medical examination or surgical gloves to prevent the passage of viruses. Three protocols for the direct examination of the viral barrier properties of non-latex gloves were compared with 1080 gloves (270 gloves from each of two surgical brands and two medical examination brands). In two of the methods, gloves were filled with and suspended in a nutrient broth solution, and bacteriophage phiX174 was placed either inside or outside the glove, while the entire test vessel was agitated. Gloves tested using the third method were filled with a suspension of bacteriophage and allowed to rest in a vessel containing nutrient broth. Gloves were tested directly from the manufacturer's packaging, or after being punctured intentionally or subjected to a stress protocol. The passage of bacteriophage was detected with plaque assays. Significant differences in failure rates between glove brands were apparent only among gloves that had been subjected to the stress protocol. Overall, the two methods in which bacteriophage were placed inside the gloves provided more sensitivity than the method in which bacteriophage was spiked into broth outside the gloves. Thus the placement of bacteriophage inside test gloves (or the use of pressure across the glove barrier during testing), and the use of a standardised stress protocol, will improve significantly the ability of a glove test protocol to determine the relative quality of the barrier offered by medical examination and surgical gloves. Further research is needed to provide test methods that can incorporate reproducibly both the use of bacteriophage and simulated glove use in an industrial quality control setting.

Bacteriophage phi X 174↗
PubMedDate not supplied

The integrity of latex gloves in clinical dental practice.

BACKGROUND: The aim of the study was to assess the integrity of non-sterile latex gloves (Biogel Diagnostic (A), Biogel Dental (B), Gentle Skin (C) and Manufix (D)) in clinical dental practice. MATERIALS AND METHODS: After use, the gloves were collected and examined for perforations using the water inflation test according to the EN 455-1 Standard. Over a 12-month period 847 used gloves were collected and assessed. The mean duration of use for gloves A/B/C/D was 175/112/78/79 min respectively. In spite of these differences favoring gloves C and D, 16% of glove A, 14% of glove B, 21% of glove C and 29% of glove D were found to leak. The proportion of perforated gloves increased slightly if a hygienic handrub using an alcoholic hand disinfectant had been carried out immediately prior to gloving. CONCLUSION: The results indicate striking differences between the quality of medical gloves. As all the gloves comply with the European regulations in terms of integrity, it is very difficult for the user to distinguish between gloves of superior or inferior quality. In a clinical setting it is therefore recommended that the appropriate glove should be determined for each situation. Hands must be thoroughly dry if they are disinfected prior to gloving, since hands still wet with alcoholic disinfectant may increase the risk of glove perforation.

Dental Care↗
PubMed1994

Extractable latex allergens and proteins in disposable medical gloves and other rubber products.

BACKGROUND: IgE-mediated sensitization to rubber proteins is being reported with increasing frequency in health care workers. To explore the relative importance of various sources of allergen exposure, we measured the total rubber allergen and protein levels in extracts of disposable rubber gloves and compared the allergen levels with those in extracts of other medical and consumer rubber products. METHODS: Rubber allergens were measured by inhibition immunoassay with a rubber glove extract as the solid-phase allergen and pooled plasma from five rubber-sensitized health care workers as the IgE antibody source. Proteins were measured by Ninhydrin assay. RESULTS: Among 71 lots of gloves tested, the extractable allergen and protein levels were significantly correlated and were appreciably higher in powdered gloves than in powder-free gloves. Allergen levels varied 3000-fold among gloves from different manufacturers and were higher in examination gloves than in surgical or chemotherapy gloves. Measurable allergen was found in 11 of 24 lots of "hypoallergenic" gloves tested. Allergen levels in toy balloons were comparable to those in powdered gloves; much lower allergen levels were measured in condoms and anesthesia rebreathing bags. CONCLUSIONS: The allergen content of disposable rubber gloves varies widely and is higher in powdered gloves than in powder-free gloves and higher in examination gloves than in surgical gloves. Hypoallergenic gloves may contain substantial amounts of IgE-binding proteins. Gloves and toy balloons appear to be more important sources of rubber allergens than the other rubber products tested.

Allergens↗
PubMed1993

Permeability of latex and thermoplastic elastomer gloves to the bacteriophage phi X174.

BACKGROUND: Most studies challenging the integrity of the glove barrier have compared the permeability of vinyl and latex gloves. However, no studies of a new nonlatex, nonvinyl thermoplastic elastomer have been reported. This pilot study therefore compared the protective barriers provided by latex and thermoplastic elastomer surgical gloves against penetration of the bacteriophage phi X174. METHODS: Twenty thermoplastic elastomer gloves and 25 commercially available latex gloves (20 brand 1, 5 brand 2) were filled with a sterile serum surrogate and exposed to the phi X174 virus in a flask, with shaking for 180 minutes at 37 degrees C. Aliquots of 5 ml were withdrawn at baseline, 30, 60, 120, and 180 minutes and assayed by a standard plaque assay. The remaining contents of the gloves were then tested by an extremely sensitive qualitative assay (plaque assay without dilution of the sample). RESULTS: With the standard plaque assay, virus was detected in 30% of the brand 1 latex gloves, in 80% of the brand 2 latex gloves, but in none of the thermoplastic elastomer gloves. The qualitative assay, which can detect even a single virus in the entire glove contents, had positive results for 30% of the thermoplastic elastomer gloves, 70% of the brand 1 gloves, and 100% of the brand 2 gloves. CONCLUSIONS: Despite the small sample, the results of this stringent assay suggest that the mechanical barrier offered by thermoplastic elastomer gloves is equal to or better than that provided by the latex gloves tested. Clinical studies are needed to evaluate thermoplastic elastomer gloves, which may withstand mechanical stress better than latex or vinyl. Thermoplastic elastomer gloves may therefore be a desirable alternative for health care workers in high-risk settings or for individuals with latex allergies.

Bacteriophages↗
PubMed1999

The development and evaluation of an ergonomic glove.

The primary intent of this study was to determine if a hand glove could be designed on a criterion of selective protection. Force distribution patterns on the palmar side of hand were obtained from various studies to develop zones of hand that needed protection. A new design for gloves was developed based on the principle of selective protection, where protective material is introduced in varying levels over different parts of the glove, in order to provide protection where it is most needed, and at the same time preserve the desirable dexterity and strength capabilities of the barehand, optimizing the trade-off between protection and performance. Two pairs of prototype gloves incorporating different levels of protection were fabricated and tested using a battery of performance tests and an algometer test for pressure sensitivity. The test battery comprising four dexterity tasks and a maximal voluntary grip strength task was used to assess a number of glove conditions, including the two prototype gloves developed. The results indicate that the performance of the prototype gloves are comparable, and that the performance times for the double glove and the two prototype gloves tested were not significantly different. For the grip strength, the two prototype gloves were better than the double glove. The assembly task performance for the prototype II (laminar glove) was significantly lower than that of the other glove types tested. It appears that gloves of variable thickness can be developed to afford adequate protection at zones of most need. Glove manufacturers are recommended to use an ergonomic approach in the design of gloves. Such an approach, besides protecting the safety objective of gloves, could enhance productivity considerably.

Accidents, Occupational↗
PubMed2003

Double gloving: a risk reduction strategy.

BACKGROUND: The use of sterile surgical gloves has become the international standard of care in the perioperative environment. Yet the potential for barrier failure exists, with the subsequent potential for the transfer of pathogens to both the patient and the surgical team. The practice of double gloving (wearing two pairs of sterile surgical gloves) is often considered a mechanism for managing the potential risk of exposure during surgery. LITERATURE ON DOUBLE GLOVING: In the 2002 Cochrane review of double gloving, findings were summarized from 18 studies. The review, which covers a variety of surgical environments and addresses several double gloving options, indicates that double gloving significantly reduced perforations to the innermost glove. Other studies report a risk reduction of 70%-78% attributed to double gloving. OVERCOMING PRACTITIONER OBJECTIONS: Practitioners, in voicing objections to double gloving, cite poor fit, loss of tactile sensitivity, and increased costs. An important issue is how the two gloves work together, especially when they are powder free. Several studies have reported good acceptance of double gloving without loss of tactile sensitivity, two-point discrimination, or loss of dexterity. Although double gloving increases the glove cost per practitioner, the reduction of bloodborne pathogen exposure and possible seroconversion of practitioners represents a significant savings. Strategies that may help to facilitate the process include sharing the data on double gloving to build justification for the implementation, enlisting the support of the champions of the change at hand, and providing a glove-fitting station. SUMMARY: The stresses placed on a surgical glove today--the length of cases, heavy and/or sharp instrumentation, and chemicals used in the surgical field--make it imperative that barrier protection be ensured.

Blood-Borne Pathogens↗
PubMed2001

Protective gloves in Swedish dentistry: use and side-effects.

BACKGROUND: During the 1980s routine wearing of gloves in dentistry was recommended by health authorities in several countries. However, prolonged glove use is associated with side-effects of irritant and allergic origin. OBJECTIVES: To investigate the extent of glove use and self-reported glove intolerance reactions among Swedish dentists, and to examine how far IgE-mediated allergy to natural rubber latex (NRL) occurs in subjects who report rapid itching when in contact with protective gloves. SUBJECTS/METHODS: A postal questionnaire was answered by 3083 of 3500 licensed dentists, a response rate of 88%. Of the dentists who reported rapidly occurring itching of the hands from gloves, 131 of 170 attended a clinical examination including a skin prick test (SPT) and a serological examination (RAST) for IgE-mediated allergy. RESULTS: Seventy-three per cent of the dentists reported daily glove use of more than 2 h, 48% more than 6 h a day, and 6% reported no use. NRL gloves were used most frequently (P < 0.001) and were the main material that elicited symptoms (P < 0.001). Female dentists reported more frequent glove use than males, as did young dentists (P < 0.001) compared with older ones. Females also preferred vinyl gloves. Glove intolerance reactions were reported by 723 (23%) dentists, [females 28%, males 21% (P < 0.001)] and were more common in younger dentists. Of the 417 dentists with reported hand eczema during the previous year, 54% reported glove intolerance, compared with 20% of the dentists without hand eczema (P < 0.001). A logistic regression analysis including hand eczema, age, sex and atopy showed that all these factors contributed significantly to the risk of glove intolerance, and that hand eczema was a stronger factor than atopy. In 15 of 131 (11%) dentists examined for reported glove-related itch, latex allergy was verified by SPT and/or RAST. Glove-related conjunctivitis, rhinitis and asthma, in contrast to skin symptoms, showed a significant association with IgE-mediated allergy to NRL. CONCLUSIONS: Swedish dentists show good compliance with the recommendations for routine glove use. Intolerance reactions are frequently reported, especially by dentists with hand eczema, which emphasizes the need for preventive skin care programmes. Glove-related symptoms from mucous membranes showed a higher association with IgE-mediated allergy to NRL than reported itching of the skin, a fact that should be considered when composing screening questionnaires for NRL sensitization

Adult↗
PubMed2001

Powder-free, non-sterile gloves assessed in a wound healing centre.

OBJECTIVE: To investigate the relative importance of features of gloves for medical staff working with problem wounds. DESIGN: Prospective, consecutive, crossover, open questionnaire investigation. SETTING: University hospital, Copenhagen, Denmark. SUBJECTS: 38 doctors, nurses, and podiatrists. INTERVENTIONS: Two types of powder-free, non-sterile gloves (No powder Ansell Medical and Skinsense Biogel coated examination glove) were evaluated in the outpatient clinic and the ward of the Copenhagen Wound Healing Center. MAIN OUTCOME MEASURES: Features of gloves regarded as important in the treatment of wounds and a comparison of the features based on the following criteria: much better = 2, better = 1, no difference = 0, worse = -1, much worse = -2. RESULTS: The first questionnaire showed that 84% of the respondents needed a new type of non-sterile glove, and for 66% the price of the glove was a main feature. The study of individual features of gloves showed that "protection" was ranked highest followed by "durability" and "sensitivity". Least important was the "length of the gloves" (p <0.01). The gloves were tested in two different time periods. The Skinsense Biogel glove was evaluated better or much better for "durability" (82%-92% (period 1, 2), p <0.001), "protection" (76%-80%, p <0.001) and "ease of donning" (68%-71%, p <0.001). The Ansell Medical glove was evaluated as better or much better for "tactile sensitivity" (77%-79%, p <0.001). The Skinsense Biogel glove showed more positive changes in skin condition than the Ansell Medical glove. The quality of packing of the Ansell Medical glove in the containers also resulted in more gloves being unusable when unpacked. CONCLUSION: The powder-free, non-sterile gloves were useful in a wound healing department. The Skinsense Biogel glove showed more advantageous features, less changes for the worse in the skin condition, and was better packed in the containers.

Ambulatory Care Facilities↗
PubMed1994

Influence of dental glove type on the penetration of liquid through experimental perforation: a spectrophotometric analysis.

This study was made to assess whether the physical structure or the commercial make of a glove has any influence on the penetration of liquid through perforations in the glove during work. A comparison was made between three types of gloves (10 for each brand name and type): vinyl (Peha Fit, Paul Hartmann), latex (without ASTM certification), and Biogel D (Regent Dental Division) for a total of 30 gloves. Of the 10 gloves for each type, five were worn tightly adhering to the operator's hand and five were worn relatively loosely. Holes of a predetermined size (0.40 mm) were made in each glove on the index, middle, and ring fingers, for a total of 90 holes. A randomized preprogrammed list ensured a perfect balance of the three variables: type of glove, adherence to the hand, and fingers having holes. The amount of liquid that penetrated the gloves through the holes was determined by placing the gloved hand in a tank containing a colored substance for 3 minutes and then analyzing the colored substance that had penetrated the glove with an ultraviolet (UV) spectrophotometer. The results clearly showed that the amount of liquid that penetrated through the holes varied significantly (p < 0.001) according to the type of glove tested. The mean quantity of liquid penetrating the vinyl gloves (6.24 microL) was approximately five times higher than that of the latex gloves (1.20 microL), and 100 times higher than that of the Biogel D gloves (0.05 microL). The statistical differences between the three types of gloves were even more significant in the cases in which the glove adhered closely to the hand (12.44 microL in vinyl, 2.37 microL in latex, and 0.09 microL in Biogel D), whereas no significant difference was found when the gloves were loose (0.03 microL in vinyl, 0.04 microL in latex, and 0.00 microL in Biogel D).

Analysis of Variance↗
PubMed1994

Double gloving might predispose to injury by blunting temperature perception.

Double gloving may blunt perception of excessively warm instruments. We describe a case where this might have contributed to a cutaneous burn in a patient undergoing laparoscopic cholecystectomy. To test the role of two gloves in blunting temperature perception, we performed two experiments. In the first, 250 ml of water at 70 degrees C were placed in one glove or two gloves, and the rate of change of temperature after submersion in a bath at 18 degrees C was measured. The use of two gloves was associated with a marked decrease in rate of change in temperature (temperature at 5 min 37 +/- 2.3 degrees C [double gloves] versus 24 +/- 2.6 degrees C [single glove]; p < 0.001). In the second experiment, a thermometer covered with no gloves, one glove, or two gloves (group 5; n = 5) was submerged in a water bath at 90 degrees C. After 5 s, the temperature without gloves was 85.2 +/- 2.2 degrees C compared with 61.3 +/- 0.8 degrees C with one glove and 45.6 +/- 1.1 degree C with two gloves (p < 0.001). After 15 s, the temperature without gloves was 90.2 +/- 1.6 degrees C compared with 76.5 +/- 0.5 degrees C with one glove, and 64.4 +/- 0.8 degrees C with two gloves (p < 0.001). We conclude that the use of two gloves significantly decreases heat transmission, thus altering temperature perception.

Aged↗
PubMed2005

A study of natural rubber latex allergens in gloves used by healthcare workers in Singapore.

BACKGROUND: Allergy to natural rubber latex (NRL) proteins is a well-recognized health problem among subjects using protective gloves and products made of NRL. There is currently no information on NRL allergen levels in gloves used in Singapore. OBJECTIVES: This study aims to quantify the amount of specific allergens (Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02) found in rubber gloves used in Singapore. It also aims to determine if these levels are above thresholds that may cause NRL allergy. It also compares the levels of these specific allergens in gloves used for different purposes, namely gloves used for examination purposes or for surgical procedures. METHODS: Forty-nine rubber gloves were obtained from major hospitals and healthcare departments in Singapore and were analysed for their NRL allergen levels. FITkit, based on the enzyme immunometric assay technique, was used to determine the specific allergen levels of Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02 in the gloves. RESULTS: Examination gloves had higher NRL allergen content compared with surgical gloves, and powdered gloves had higher allergen content compared with nonpowdered gloves. Among the various allergens, Hev b 5 and Hev b 6.02 were present in larger quantities than Hev b 1 and Hev b 3. Only two of 19 (11%) surgical gloves had the sum of the four allergens (Hev b 1, Hev b 3, Hev b 5, Hev b 6.02) in excess of 1 microg g(-1), which is believed to be a clinically relevant threshold. Among the examination gloves, 25 of 30 (83%) exceeded this level. CONCLUSIONS: This study shows that NRL allergen levels are present in the majority of examination gloves used by healthcare workers in Singapore at levels high enough to cause NRL allergy among sensitized persons. The information can serve as evidence for a possible requirement for manufacturers to produce gloves with low NRL allergen levels and to state the allergen level in gloves in the product information.

Allergens↗
PubMed1999

Failure of a new double glove hole detection system in the Emergency Department.

The purpose of this study was to evaluate the performance of a new double glove hole detection system in the Emergency Department. First, the frequency of holes in both gloves of the double glove hole detection system was determined using a watertight test method. Second, the frequency of glove puncture was determined first by searching for the optical color change that occurs with the ingress of fluid in the double glove hole detection system. These same gloves were then removed and also checked for holes by the watertight test method. After removal from the package, no holes were detected in the two gloves of the system using the watertight test method. In 50 consecutive patients, there was no color change in the inner glove indicating glove puncture. When these same gloves were then tested with the watertight test method, 14 of the 50 double glove hole detection systems failed; all 14 outer gloves were punctured, and three of the inner gloves had holes without demonstrable injury to the skin. This double glove hole detection system is not a reliable system to detect holes in relatively dry clinical settings because the ingress of fluid by capillary action between the gloves is necessary to cause a color change in the inner glove that signals the presence of a hole.

Arthroplasty↗