PubMed · 10734875
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D May. Guidelines on using gloves.. https://doi.org/10.7748/ns.14.1.31.s54
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BACKGROUND: Allergy to natural rubber latex (NRL) has been frequently reported in health care workers. However, there is little published evidence of the outcome of hospital intervention programs to reduce exposure and detect cases of sensitization early. OBJECTIVE: This study assesses the effects of intervention to reduce NRL allergy in an Ontario teaching hospital with approximately 8000 employees. METHODS: A retrospective review assessed annual numbers of employees visiting the occupational health clinic, allergy clinic, or both for manifestations of NRL allergy compared with the timing of introduction of intervention strategies, such as worker education, voluntary medical surveillance, and hospital conversion to low-protein, powder-free NRL gloves. RESULTS: The number of workers identified with NRL allergy rose annually, from 1 in 1988 to 6 in 1993. When worker education and voluntary medical surveillance were introduced in 1994, a further 25 workers were identified. Nonsterile gloves were changed to low-protein, powder-free NRL gloves in 1995: Diagnoses fell to 8 workers that year, and 2 of the 3 nurses who had been off work because of asthma-anaphylaxis were able to return to work with personal avoidance of NRL products. With a change to lower protein, powder-free NRL sterile gloves in 1997, allergy diagnoses fell to 3, and only 1 new case was identified subsequently up to May 1999. No increased glove costs were incurred as a result of consolidated glove purchases. CONCLUSIONS: This program to reduce NRL allergy in employees was effectively achieved without additional glove costs while reducing expenses from time off work and workers' compensation claims.
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Personal protective equipment (PPE) should only be used as a control measure when other measures are inappropriate or are inadequate by themselves. The person undertaking a risk assessment must exercise his or her judgment to take into account the protection afforded by the PPE. There is, therefore, considerable scope for differences in approach and it would seem sensible to eliminate these differences and ensure consistency, where possible, by reaching agreement on the attenuating effect of PPE. However, there is growing evidence that the levels of protection indicated by laboratory-based tests may not be achieved in real use situations. Studies of workplace protection suggest that the spread of contaminants inside protective clothing, including gloves, is commonplace and significant. Insufficient attention may have been paid to the effect of factors such as temperature differentials on the permeation of chemical agents through protective materials. To investigate this, a test cell was designed and built to measure the breakthrough times and subsequent permeation rate of solvents through glove materials where the temperature inside and outside the glove was representative of those that can occur in the workplace. Two chemical solvents were tested against two different glove materials at three different temperature conditions. The differences between the breakthrough times and permeation rates were measured and compared to manufacturer's test data. The practical implications are considered for risk of health and safety to the wearer.