Ten things to know about glove materials

by Noel Kelsch, RDHAP
[email protected]

Gloves were introduced to the medical profession in 1889, yet in 1976 I never wore a pair. It was not until the AIDS scare of the 1980s — almost a hundred years after the introduction of gloves to health care — that the awareness of just what a simple pair of gloves could mean to the clinician (and their patients) came to light. It is sad that it took such a devastating disease to wake us all up. Gloves are such a vital part of our personal protective equipment but how many of us even know what they are made of? Here are some interesting and vital facts about glove materials.

1) Medical grade gloves: Not all gloves are the same. You cannot just buy gloves off the store shelf for medical procedures. They must be medical grade and are considered a medical device. Medical gloves are regulated by the Food and Drug Administration (FDA)1 in harmony with the consensus standards of the International Organization for Standardization (ISO) and the American Society for Medical Testing (ASMT). The FDA makes sure the manufacturers meet performance criteria such as leak resistance, tear resistance, etc.

2) Glove materials: A variety of glove materials are available. Last week, I took the four main types of gloves to my private practice and tried them so I could experience the difference on my own hands. It is important for you to try gloves yourself to see what works best for you. Many companies will send you samples to try.

3) Quality: The quality of medical gloves can differ from manufacturer to manufacturer, as well as batch to batch.4 It is vital to always check your gloves for signs of imperfections before and during their use.

4) Breakdowns: Do not use lotions that contain oils if using a latex glove. Use water–based hand lotion. Do not allow patients to use products on their lips that contain oils, such as mineral oil or petroleum–based products. Studies have shown they can break down latex.5 Lubricoat from Dux Dental is a great product for lubricating patients' lips and does not break down latex.

5) Alcohol–based hand rubs: If using an alcohol–based hand rub, allow the rub to completely dry before donning your gloves. Alcohol can break down many of the materials in a glove.

6) Washing: Do not wash your glove or reuse your glove. The glove will break down from both of these actions. Wash your hands before and after using gloves to prevent disease transmission. Bacteria thrive in the moist, warm environment inside the glove. Dry your hands completely before putting the gloves on. This will limit the moisture inside the glove.

7) Stretch: Do not stretch the gloves.This can affect the integrity. Work the glove down to the base of the finger. Make sure the glove fits comfortably and is not too loose or tight on the fingertips. This will affect tactile sensitivity.

8) Rings and nails: Do not wear rings or artificial nails under your gloves.6,7 Rings and artificial nails have been shown to severely affect the gloves' integrity. They can also harbor bacteria and viruses.8,9

9) Shelf life and storage: Rotate your gloves so the oldest supplies are used first. Gloves do have a shelf life. Shelf life is affected by many things. Store them in a cool, dry place. They break down from light, moisture, and heat. Do not store near a motor, air conditioner, X–ray machine, or circulating fan motor. Keep them in their original box until they are used, so you will know the type, size, etc.

10) Powder: The National Institute of Occupational Safety and Health reported that glove powder in latex gloves appears to be contributing to the role in natural rubber latex allergies.10 Glove powder acts as an airborne carrier of the proteins. Look for gloves that have limited amounts or no powder.11,12 Powder has also been shown as a source of cross contamination.13

Gloves are an amazing part of personal protective equipment. Having knowledge about the materials they are made of, as well as their strengths and weaknesses, will assure we maximum safety for our patients and ourselves.

References

1. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/MedicalToolsandSupplies/PersonalProtectiveEquipment/ucm056077.htm#1 Accessed November 11th, 2009.
2. Kerr L, Chaput M, Cash L, O'Malley L, Sarhrani E, Teixeira J, Boivin W, and Mailhot S. Assessment of the Durability of Medical Examination Gloves U.S. Food and Drug Administration, Winchester, Massachusetts.
3. Journal of Occupational and Environmental Hygiene, 1: 607–612 ISSN: 1545–9624 print / 1545–9632 online DOI: 10.1080/15459620490491803.
4. Hwang K, Kou S, Lu Y, Yang N. Evaluation of the Quality of Surgical Gloves Among Four Different Manufacturers, Feb, 1999.
5. Best M. CDC – “Draft Guideline for Hand Hygiene in Healthcare Settings,” American Biological Safety Association (7 December 2001).
6. Larson E. “Hand Washing and Skin Preparation for Invasive Procedures,” APIC Infection Control and Applied Epidemiology, Principles and Practice, Chapter 19, Mosby–Tear Book, Inc., 1996.
7. Hansen K, Korniewicz D, Hexter D, Kornilow J, and Kelen G. Loss of glove integrity during emergency department procedures. Ann. Emerg. Med. 31:65–72 (1998).
8. IDSA Hand Hygiene Task Force. Guideline for hand hygiene in health–care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep. 2002;51.
9. Organization for Safety & Asepsis Procedures. Hand hygiene, new CDC guidelines expand option to healthcare facilities. Infection Control in Practice. 2003.
10. www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/HIVandAIDSActivities/ucm126383.htm Accessed 12/1/09.
11. Heilman D, Jones R, Swanson M, and Yunginger J. A prospective, controlled study showing that rubber gloves are the major contributor to latex aeroallergen levels in the operating room. J Allergy Clin Immunol, 98:325–330, 1996.
12. Beezhold D, Beck W. Surgical glove powders bind latex antigens. Arch Surg, 127:1354–1357, 1992.
13. Dave J, Wilcox M, Kellet M. Glove powder: implications for infection control. Journal of Hospital Infection, Volume 42, Issue 4, August 1999, Pages 283–285