Posted By holmezy
Alan,

me thinks not..

but what do I know?

Holmezy

Tired and want to go to the pub...

Posted By Chris Packham
Alan

Extensive use of occlusive gloves is equivalent to wet work. (In Germany a special rule applies if gloves are worn for a total of more than 2 hours in an 8 hour shift.) What happens is that moisture that would otherwise be lost from the skin surface (trans-epidermal water loss, not just sweating!) cannot escape and is absorbed by skin cells. This can affect the skin cell and eventually lead to irritant contact dermatitis.

So . . .
1. Anyone wearing occlusive gloves for more than a short period and only occasionally should, if possible, wear separate cotton gloves underneath to minimise the hyperhydration of the skin. Studies have shown that this can play a major role in minimising the risk of dermatitis.
2. Where gloves are worn for anything other than infrequent and short periods, then skin health surveillance will be mandatory under COSHH.

Incidentally the powder in nitrile gloves will be an irritant but is unlikely to be a cause of allergic skin reactions.

Chris

Posted By Chris Packham
Colin

There is now abundant evidence that changing from single-use latex to nitrile can result in significant increase in cases of dermatitis. Mostly the reaction to nitrile will be a type IV allergic contact dermatitis to the chemicals used in the glove manufacture. The same reaction can occur with natural rubber latex gloves. However, the reaction to the latter material that has caused such concern in the past is a type I reaction (contact urticaria) to the proteins in these gloves. There are now also two reports of type I reactions to nitrile gloves.

Unfortunately, the approach by the HSE does not accord with the scientific and epidemiological evidence. Provided you use only low free protein, unpowdered natural rubber latex gloves (and I am assuming you are using the thin, single use type) then any risk of these causing someone to become allergic is so minimal that you can safely ignore it. ALl the problems, i.e. the "latex allergy epidemic" were associated with the high free protein, powdered type.

If you need more on this contact me direct (chris.packham@enviroderm.co.uk/01386 832 311).

Posted By Chris Packham
Jay

Two items that may be of interest:

“The gloves in categories ‘very low’ and ‘low’ contain such low levels of the main natural rubber allergens that they are suitable not only for non-allergenic persons but also for most of the sensitized users.”
Turjanmaa K, Kanto M, Kautiainen H, Reunala T, Palosuo T; Long-term follow-up of 160 adult patients with natural rubber latex allergy; J Allergy Clin Immunol 2002, 110, 70-74

In February, 2006, a supplement appeared to The Journal of Hospital Infection. “epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England” (ISBN 0195-6701)states:
“NHS Trusts need to provide gloves that conform to European Standard, and which are acceptable to health care providers. Gloves are available in a variety of materials, the most common being natural rubber latex (NRL) and synthetic materials. NRL remains the material of choice due to its efficacy in protecting against bloodborne viruses and properties that enable the wearer to maintain dexterity. The problem of wearer sensitivity to NRL proteins must be considered when deciding on glove materials.”

The German experience, which I can e-mail to anyone interested, is clear. Unpowdered, low free protein gloves should be the preferred glove where optimum protection against biological hazards is required. There are some exceptions, e.g. those known to have a genuine allergy to natural rubber latex, papa-medics and those in A+E who may have to deal with unconscious people with open wounds who may be allergic to natural rubber latex.

Chris