US_Infectious_Yip.qxp 14/5/08 5:24 pm Page 70
Infection Control and Prevention
that involve minimal stress, and are not appropriate for tasks that involve • for the majority of healthcare personnel who are not latex-allergic to
exposure to blood and other potentially infectious materials. Synthetic continue to rely on the best possible barrier protection offered by
alternatives such as nitrile and polychloroprene gloves have much better latex gloves;
barrier properties than vinyl and are suitable for latex-allergic individuals,
although these gloves are more expensive. Overall, natural rubber latex • to avoid latex protein sensitization among healthcare personnel; and
gloves remain the gold standard owing to their cost-effectiveness, excellent
barrier performance, durability, comfort, fit, tactile sensitivity, and ease of • to allow many latex-allergic individuals to wear gloves to work in
hospitals without heightened allergy concerns.
Because healthcare professionals
The above factors are consistent with the latest recommendations of the
frequently come into direct contact with
Occupational Safety and Health Administration (OSHA), published on
February 28, 2008 (‘Safety and Health Information Bulletin Updates of
blood and other bodily fluids, wearing
TIB 99–04–2’). These recommendations state that employees should be
suitable medical gloves for effective
given the choice of using low-protein/low-allergen natural rubber latex
gloves for protection from infectious agents, and that alternative suitable
barrier protection is of great importance.
non-latex gloves should be provided for employees who are latex-
allergic. The importance of using gloves made of material that provides
putting them on; these characteristics are primarily due to the combination proper barrier protection is much emphasized throughout. The OSHA
of superior molecular structural attributes in the rubber polymer. Their ability also recommends safety measures such as periodic screening
to re-seal when punctured by tiny needles is yet another beneficial barrier questionnaires and testing for employees who have experienced
feature not observed in either vinyl or nitrile gloves. significant latex protein exposure to further protect them.
The advent of low-protein-latex gloves has provided hospitals with an In conclusion, gloves—when selected and worn properly—can greatly
option that not only is cost-effective, but also offers a safety-oriented reduce the daily risk of cross-infection experienced by both patients and
work environment. This makes it possible: healthcare personnel. ■
1. Korniewicz DM, Laughon BE, Cyr WH, et al., Leakage of Virus Rubber Latex, J Allergy Clin Immunol, 2002;110:S3–14. Care Workers Parallels With a Decreasing Percentage of Highly
through Used Vinyl and Latex Examination Gloves, J Clinical 15. Allmers H, Brehler R, Chen Z, et al., Reduction of Latex Allergenic Latex Gloves in the Market in Finland. 60th Annual
Microbiology, 1990;28:787–8. Aeroallergens and Latex-specific IgE Antibodies in Sensitized Meeting of the American Academy of Asthma, Allergy and
2. Korniewicz DM, El-Masri M, Broyles JM, et al., Performance of Workers After Removal of Powdered Natural Rubber Latex Immunology (AAAAI), 2004, abstract #140.
Latex and Non-latex Medical Examination Gloves During Gloves in a Hospital, J Allergy Clin Immunol, 1998;102:841–6. 24. Korniewicz DM, Chookaew N, El-Masri M, et al., Conversion to
Simulated Use, Am J Infect Control, 2002;30:133–8. 16. Rueff F, Schopf P, Przybilla B, Parameters of Natural Rubber Low-Protein, Powder-free Surgical Gloves – Is it Worth the
3. Korniewicz DM, Garzon L, Plitcha S, Health Care Workers: Risk Latex [NRL] Sensitization Decrease in Healthcare Workers Cost?, AAOHN J, 2005;53:388–93.
Factors for Nonlatex and Latex Gloves During Surgery, AIHA (HCW) Following Reduction of NRL Exposure. Klinik und 25. ECRI Guidance Article, Lower-Protein Gloves: A Way to Reduce
Journal, 2003;64:851–5. Poliklinik fur Dermatologie und Allergologie, Ludwig- Allergic Reactions in Hospital Staff, Health Devices, 2004;33(5):
4. Korniewicz DM, Seltzer J, Veinieb M, Failure Rates in Nonlatex Maximilians-Universitat, Munich, Germany. Presented at the 169–74.
Surgical Gloves, Am J Infect Control, 2004;32:268–73. 56th annual meeting of the American American Academy of 26. Tsumura Y, Ishimitsu S, Kaihara A, et al., Di(2-ethylhexyl)
5. Klein RC, Party E, Gershey EL, Virus Penetration of Examination Asthma, Allergy and Immunology (AAAAI), 2000. Phthalate Contamination of Retail Packed Lunches Caused by
Gloves, Biotechniques, 1990;9:196–9. 17. Tarlo SM, Easty A, Dubanks K, et al., Outcomes of a Natural PVC Gloves Used in the Preparation of Foods, Food Addit Contam,
6. Olsen RJ, Lynch P, Coyle MB, et al., Examination Gloves as Rubber Latex Control Program in an Ontario Teaching Hospital, 2001;18(6):569–79.
Barriers to Hand Contamination in Clinical Practice, JAMA, J Allergy Clin Immunol, 2001;108:628–33. 27. Doull J, et al., A Cancer Risk Assessment of Di(2-ethylhexyl)
1993;270:350–53. 18. Turjanmaa K, Kanto M, Kautiainen H, et al., Long-term Outcome Phthalate; Application of the New US EPA Risk Assessment
7. Douglas A, Simon T, Goddard M, Barrier Durability of Latex and of 160 Adult Patients with Natural Rubber Latex Allergy, Guidelines, Regul Toxicol Pharmacol, 1999;29:327–57.
Vinyl Medical Gloves in Clinical Settings, Am Ind Hyg Assoc J, J Allergy Clin Immunol, 2002;110:70–74. 28. Arcadi RA, et al., Oral Toxicity of DEHP During Pregnancy and
1997;58:672–6. 19. Hunt LW, Kalker P, Reed CE, Yunginger JW, Management of Suckling in the Long Evan Rat, Food Chem Toxicol, 1998;36:
8. Rego A, Roley L, In-use Barrier Integrity of Gloves: Latex and Occupational Allergy to Natural Rubber Latex in a Medical 963–70.
Nitrile Superior to Vinyl, Am J Infect Control, 1999;27(5): Center: The Importance of Quantitative Latex Allergen 29. Davis BJ, et al., Di(2-ethylhexyl) Phthalate Suppresses Estradiol
405–10. Measurement and Objective Follow-Up, J Allergy Clin Immunol, and Ovulation in Cycling Rats, Toxicol Appl Pharmacol,
9. Kerr LN, Chaput MP, Cash LD, et al., Assessment of the 2002;110:94–106. 1994;128:216–23.
Durability of Medical Examination Gloves, J Occup Environ Hyg, 20. Allmers H, Schmengler J, Skudlik C, Primary Prevention of 30. Ward JM, et al., Receptor and Non-Receptor Mediated Organ
2004;1:607–12. Natural Rubber Latex Allergy in the German Health Care System Specific Toxicity of DEHP in Peroxisome Proliferator-Activated
10. Broyles JM, O’Connell KP, Korniewicz DM, A PCR-Based Method Through Education and Intervention, J Allergy Clin Immunol, Receptor Alpha-null Mice, Toxicol Pathol, 1998;26:240–46.
for Detecting Viral Penetration of Medical Exam Gloves, J Clin 2002;110:318–23. 31. Kevy S, Jacobson M, Hepatic Effects of a Phthalate Ester
Microbiol, 2002;52:965–99. 21. Kelly KJ, Klancnik M, Kurup V, et al., A Four-Year Prospective Plasticizer Leached From Poly(vinyl chloride) Blood Bags
11. Hasma H, Othman AB, Barrier Integrity of Punctured Gloves: Study to Evaluate the Efficacy of Glove Interventions in Following Transfusion, Environ Health Perspect, 1982;45:
NR Superior To Vinyl and Nitrile, J Rubber Research, 2003;6(4): Preventing Natural Latex Sensitization in Healthcare Workers at 57–64.
231–40. Two Hospitals, J Allergy Clin Immunol, 2003;111(2 Pt 2):426. 32. Roth B, et al., DEHP as Plasticizer in PVC Respiratory Tubing
12. Liss GM, Sussman GL, Latex Sensitization: Occupational Versus 22. Allmers H, Beezhold D, Hamilton RG, Sutherland ER, Challenge Systems: Indications of Hazardous Effects on Pulmonary
General Population Prevalence Rates, Am J Ind Med, 1999;35: Tests With Powder-free Natural Rubber Latex (NRL) Gloves in Function in Mechanically Ventilated, Preterm Infants, Eur J Pediatr,
196–200. Health Care Workers With a History of NRL-Induced Asthma, 1998;147:41–6.
13. Kevin Kelly, Chair of the Latex Allergy Committee for the 60th Annual Meeting of the American Academy of Asthma, 33. Morris MD, Health Considerations of Synthetic Alternatives to
American Academy of Asthma, Allergy & Immunology, Health Allergy and Immunology (AAAAI), 2004, abstract #138. Natural Rubber Latex, J Natural Rubber Research, 1994;9(2):
Link, Medical College of Wisconsin, August 2005. 23. Turjanmaa K, Alenius H, Reinikka-Railo H, Palosuo T, A 121.
14. Yip ES, Cacioli P, The Manufacture of Gloves from Natural Significant Decrease in the Incidence of Latex Allergic Health
70 US INFECTIOUS DISEASE
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76