Posted By Chris Packham This is one aspect of health and safety where there is a great deal of nonsense talked. The "latex allergy" problem was/is confined to the single-use, powdered natural rubber latex gloves. Latex allergy, i.e. a type I reaction to the proteins in natural rubber latex, is extremely rare in unpowdered gloves, as the experience in Germany shows. They banned powdered NRL gloves some years ago, and in the words of one of their experts, Dr. Henning Allmers, at the international skin conference in Stockholm last June: "Latex allergy is history". Their health service has standardised on unpowdered, low protein, NRL gloves for health care workers. The type I reaction to the reusable gauntlets/gloves used by cleaners is virtually unkown, unless that person is so sensitised to NRL than ANY exposure triggers a problem. I have never encountered it in 26 years dealing with skin reactions to gloves. You might encounter a type IV reaction to the chemicals used in the manufacture of NRL gloves of this type, but you will find the same chemicals in other glove materials, e.g. nitrile. You are much more likely to encounter an irritant reaction due to the occlusion. This has been recognised in Germany, where if gloves have to be worn for more than 2 hours in total in an 8 hour shift, this qualifies as a hazardous situation and special precautions have to be taken (Technal Regulation for Hazardous Substances no. 531). Finally, to quote a leading UK dermatologist the other day in an e-mail to me: "The epidemic is over as we now have powder free and low release of NRL protein gloves in the NHS." If anyone wants to know more about this, we have a Technical Bulletin on Latex Allergy available at nominal cost via our website.

Posted By Chris Packham Treat the HSE guidance with some caution! In my view, and that of other experts around Europe that I have discussed this with, the HSE overstates the latex allergy problem. In the vast majority of cases there is absolutely no need to adopt the approach being adopted by many inspectors that employers need to find alternative to natural rubber latex, unless the use of this is unavoidable. All the scientific evidence indicates that this is not necessary and that employers who adopt this approach may (a) be providing inferior protection and thus increasing the risk of damage to health of their workers and (b) increasing their operating costs for no good reason. I have put this to HSE but have you ever tried to get them to admit that anything they put out as guidance is wrong?

Posted By Chris Packham Firstly, there are several studies that show that unless a proper diagnosis has been carried out (prick or RAST test) it is often assumed that there is a latex allergy (i.e. a type I response to the latex protein) when this is not actually the case. (If anyone want the references contact me direct.) I have a client in the pharmaceutical industry who has a large number of workers who wear natural rubber latex gloves all day and have done so for some 15 years without a single case of latex allergy. Of course, what they use is a high quality, unpowdered, low free protein, natural rubber glove. Prof. Turjanmaa in Finland did a study which showed that if low protein, unpowdered natural rubber gloves are used, even many of those with a genuine latex allergy can wear them without a problem. There is at least one other study that shows a similar result. Why change to the more expensive alternatives when there is no real reason to do this? Since no other glove can match natural rubber latex for protection against biological hazards, what are the (legal) implications of changing to a non-latex glove (and thereby increasing the potential for infection of the glove user) when there is no good reason to do this?

Posted By Chris Packham I have had several organisations contact me having changed from natural rubber latex gloves (where they experienced no problems at all) to nitrile gloves and then experiencing cases of type IV allergic reactions to the gloves. Most nitrile gloves contain many of the same chemicals (accelerators etc.) that are used in the manufacture of natural rubber latex gloves.

Posted By Chris Packham Regarding a COSHH risk assessment for natural rubber latex gloves, provided these are unpowdered and low protein, then the risk assessment is very simple. Based on the scientific evidence (and not the masses of 'hype' and non-sense that is being touted around)the risk is so negligible that it can be ignored. I have been collecting the evidence for some time now and it all point one way. Unpowdered, low protein natural rubber gloves are no more a risk than any other types of occlusive glove. In fact, Prof. Turjanmaa and her co-worders at the Finnish National Agency for Medicines conducted a trial and concluded that the unpowdered, low protein gloves "contain such low levels of the main natural rubber allergens that they are suitable not only for non-sllergenic persons but also for most of the sensitized users". I have other studies that have reached the same conclusion. In the words of a leading UK consultant dermatologist, specialising in contact dermatitis: "The allergy is over, now we have powder free and low release of NRL protein gloves in the NHS". Why do so many people continue to ignore the scientific evidence on this topic?

Posted By Paul Durkin Thanks Chris, Your comments are re-assuring,however as long as the HSE put in the bogie of COSHH and H.S. for latex gloves(ipso facto) ,it will be avoided. After the responses,HSE have got about textured coatings,they probably will be very reluctant to make any decision about latex !!! How about an IOSH pressure group(NHS/PS)support???(Is there an interest in HEALTH issues !!)OOPs just seem a dying swan fly past. Regards,Paul

Posted By Chris Packham The statement that you changed to vinyl gloves concerns me. There is evidence to support the view that vinyl gloves offer less effective protection against biological hazards, in particular viruses. Thus, by changing from NRL to vinyl you may be reducing the level of protection for the users. This could result in an interesting legal situation, were a user to suffer an infection that could be traced to glove failure! There is also concern about reactions to the plasticisers used in vinyl gloves. Some of these are chemicals called pthalates, known to be toxic. One further point. Care is needed in disposing of vinyl gloves. If incinerated they can release chlorine monomers and dioxins, both highly toxic. Unless the incinerator is able to remove these, then the emissions would not be acceptable and an alternative method of disposal will be needed.

Posted By jackw. Hi Charlie, you are making assumptions without knowledge. The work undertaken is not high risk and did not need the level of protection afforded by latex gloves. It was just historical that they were used. Yes I am aware that other gloves, not only vinyl, are also causing some alergic reactions, as i stated in my first post Cheers.

Posted By Diane Thomason Chris, Regarding your posting above about HSE guidance: it doesn't say that you should ONLY do a risk assessment if the substance has a risk phrase or ONLY use risk phrases to do your assessmment. Surely you can assess the risks from wet work any way you want - in the COSHH manner if you want, or by means of a normal "5 steps" type RA if it makes better sense than the COSHH approach?

Posted By Charlie Gunter Since my orginal posting on 22 Feb lots of useful stuff has been generated. My thanks to all who have contributed Charlie