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Abdul Kadir, Ph D Deputy Chief Executive Officer
Malaysian Rubber Export Promotion Council
Know yourKnow yourmedical gloves for medical gloves for better protection better protection and patient careand patient care
Outline
�What are medical gloves?� How gloves prevent contamination� Glove material comparisons� Hazards of vinyl gloves� Latex protein allergy� Standard Malaysian Glove (SMG)
What are medical gloves?
Medical gloves are disposable gloves used during medical procedures
• Medical gloves are single-use items
• Decontamination and reprocessing for reuse should be avoided
Main typesof medical gloves
Surgical
Use for conducting surgical procedures
ExaminationUse in:
• Medical examinations
• Diagnostic & therapeutic procedures
• Handling of contaminated medical materials
How gloves prevent infection� Gloves prevent contamination of the hands of
healthcare personnel when touching blood, body fluids, secretions, mucous membranes, and non-intact skin� Gloves reduce the likelihood that microorganisms
present on the hands of healthcare personnel will be transmitted to patients
Failure to change gloves between patient contacts is an infection control hazard
Wearing gloves does not replace the need for hand rubbing and washing
Gloves can be:• Powdered or powder-free• Sterile or non-sterile
Examination gloves
Powdered or powder-free
Surgical gloves
Powdered or powder-free Sterile
Non-sterile
Sterile • Powdered gloves are coated with corn starch
• Powder-free gloves are chlorinated or have a synthetic coating
Use of sterile exam gloves
Invasive insertion
Sterile dressing changes
End stage renal
disease treatment
Treating immune-
compromised individuals
FDA potential warning on powdered gloves
Warning: Powdered gloves may lead to foreign body reactions and the formation of granulomasin patients. In addition, the powder used on gloves may contribute to the development of irritant dermatitis and Type IV allergy, and on latex gloves may serve as a carrier for airborne natural latex leading to sensitization of glove users.
Glove materials
Material Examination Surgical
Natural rubber √ √Nitrile √ √
Vinyl √
Polyurethane √ √
Polyisoprene √
Polychlorprene √
Styrene butadiene √
Styrene-ethylene-butylene-styrene √
General properties of gloves made from different materials
Natural rubber Nitrile Vinyl
Durability
Puncture & tear resistance
Comfort and fit
Flexibility
Tactile sensitivity
Grip
Detection of holesin gloves� Introduce 1000 cm3
water into the glove
� Observe for leaks immediately
� If the glove does not leak immediately, make a second observation after 2 to 4 minutes
Simulated use conditions
Manipulation Repetition
1. Attach and remove a capped needle to a Luer-Lok syringe 30 times
2. Connect and disconnect a Luer-Lok syringe to intravenous tubing
8 times
3. Manipulate a stopcock 8 times
4. Wrapping, taping and unwrapping a blunt object 2 times
Percentage failure of glovessubject to water leak test
Glove material New After ‘use’
Natural rubber 2.0 1.8
Nitrile 3.0 2.8
Vinyl 4.8 29.8
Failure of vinyl gloves
after simulated use increased by
520%
Rego A and Roley L, American Journal of Infection Control, Volume 27, Number 5, 1999.
Limited useof vinyl gloves
Vinyl gloves are appropriate only for short-term tasks that involve minimum stress on the gloves and low risk of exposure to blood and other infectious materials
DEHP in vinyl gloves
� Used as a plasticizer in vinyl gloves
� Causes abnormal development of the male fetus
� Is a potential endocrine disruptor
� Shown to cause irregular rhythms of cardiac cells in culture
http://www.chemsystems.com/about/cs/news/items/PERP%200708S4_Plasticizers.cfm
Sanctions against DEHP
q US Department of Health and Human Services (DHHS) and Environmental Protection Agency (EPA) label DEHP as potential carcinogen and reproduction toxin
qMany countries have banned DEHP in children’s toys
q Japan and the European Union have banned DEHP in food service gloves
q DEHP is banned in California’s Safe Drinking Water and Toxic Enactment Act of 1986
Latex protein allergy
qNatural rubber latex (NRL) contains proteins
qSome of the proteins are allergens
qSensitization to NRL is caused by direct contact
qPrevalence of latex allergy in the general public is 1% and in healthcare workers from 0.6% to 10%
Symptoms of latex protein allergy
q Local or systemic urticaria
q Hay fever-like symptoms
q Abdominal cramps
q Difficulty in breathing
q Rapid heart rate
q Drop in blood pressure
q Anaphylactic shock
Solution toallergy problem
NR Nitrile
§ A voluntary certification scheme for latex examination gloves
§ Establishes requirements for:ü Freedom from holesü Physical propertiesü Protein contentü Powder content
§ Operated by the Malaysian Rubber Board, an ISO/IEC Guide 65 body, authorized by Standards Malaysia
§ Assurance that SMG gloves comply with the requirements of the SMG specification
Standard Malaysian Glove Scheme
POWDER-FREE POWDERED
SMG meets American and European standards for physical properties
SMG Type StandardType I AmericanType II European
SMG powder contentrequirements (mg/glove)
Powder-free 2
Powdered 150
SMG protein contentrequirements (μg/dm2)
Powder-free 50
Powdered 200
Practical considerations in glove use
Change glove if …
• The integrity of a glove is compromised and complemented with hand hygiene
Use double gloves if …
• There is a need to take precautions against HBV, HCV and HIV for long surgical procedures (>30 minutes)
• Performing procedures in contact with large amounts of blood and other body fluids
• Undertaking high risk orthopaedic procedures
Conclusion
� Gloves prevent contamination and the spread of infection by providing an effective barrier against microorganisms
� There are many different types of gloves and selecting the right ones for use will result in better infection control and protection of the healthcare personnel
Thank you More information on medical gloves
is available at the following websites:
www.latexglove.info
www.smg-gloves.com
www.mrepc.com
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