PubMed · 14730525
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Ellen E Sullivan. 2003. Off with her nails.. https://doi.org/10.1016/j.jopan.2003.09.002
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There are standardized laboratory tests for chemical protective gloves that provide estimates of breakthrough time and steady-state permeation flux. However, there is evidence to suggest that these tests may not be completely relevant to glove usage in the workplace. There is no consensus about how glove workplace effectiveness should be assessed, although a few studies have attempted to measure the effectiveness of chemical protective gloves. We have used a conceptual model of dermal exposure to help analyse how workers' skin may become exposed while wearing gloves, and propose a new glove workplace protection factor (PFgloves), which is based on the ratio of the estimated uptake of chemicals through the hands without gloves to the uptake through the hands while wearing protective gloves. Mathematical simulations demonstrate that glove protection factor is unlikely to be constant for a glove type, but will be strongly influenced by the work situation and the duration of the exposure. This has important consequences for the selection of protective gloves.
Due to the increasing demand for nonlatex medical gloves in the health-care community, there is a need to assess the durability of alternative glove materials. This study examines durability characteristics of various glove materials by abrasion resistance testing. Natural rubber latex (latex), polyvinyl chloride (vinyl), acrylonitrile butadiene (nitrile), polychloroprene (neoprene), and a styrene-ethylene/butylene-styrene block copolymer (SEBS) were tested. All test specimens, with the exception of the vinyl, were obtained from surgical gloves. Unaged out-of-the-box specimens as well as those subjected to various degrees of artificial aging were included in the study. After the abrasion sequence, the barrier integrity of the material was assessed through the use of a static leak test. Other traditional tests performed on these materials were viral penetration to validate the abrasion data and tear testing for comparative purposes. The results indicate that specific glove-material performance is dependent upon the particular test under consideration. Most notably, abrasion, even in controlled nonsevere conditions, may compromise to varying degrees the barrier integrity of latex, vinyl, SEBS, nitrile, and neoprene glove materials. However, as evidenced by the results of testing three brands of neoprene gloves, the abrasion resistance of any one glove material may be significantly affected by variations in production processes.
In spite of its importance, handwashing frequency in healthcare workers is generally low. The rebuilding and relocation of an 800-bed tertiary referral hospital on the same campus allowed assessment of the impact of easy accessibility to sinks on handwashing compliance. The new hospital design ensured that no clinical activity could occur more than 5 m (usually much less) from a sink. In the old hospital, clinical staff were often up to 30 m from a sink. Covert observation of nursing staff was undertaken in intensive care, infectious diseases, internal medicine and urology wards, over a total of 24 h during three consecutive days, two months before and one and 10 months after relocation to the new hospital. In all areas, handwashing compliance was greater before than after-patient contact. Initial increases (9-24%) in after-patient contact handwashing frequency following patient contact were demonstrated in units of both high and low clinical care activity one month after relocation. However, no sustained clinically significant improvement could be demonstrated nine months later. Glove use was shown to diminish compliance with handwashing protocols by as much as 25%. Improved accessibility to sinks does not lead to an improvement in healthcare workers' handwashing compliance.