When choosing the latex glove you use in your hospital or practice what factors determine your product choice?
Is cost the only consideration; or do you look for quality at a reasonable cost? Is cheapest the best for your practice?
Examination gloves are used to protect you and your staff from the risk of cross infection but the process should involve consideration of the allergens in the glove as a potential threat.
Allergic reactions to the proteins present in natural rubber latex and can have serious long term implications on your lifestyle.
3 Different Types of Allergic Reactions
A dermatitis caused by chemical irritation that does not involve the immune system.
Irritant reactions are local skin reactions, and while they do not involve the immune system they do allow the latex allergens to more easily enter the body, and cause Type I reactions.
Type IV Dermatitis
A chemical contact dermatitis, caused by the chemicals used in latex production but involving the immune system.
Type IV reactions are limited to skin. Clinically they are dermatitis of the hands caused by rubber gloves, oral reactions caused by dental appliances, and penile and vaginal reactions caused by condoms.
These reactions are caused by chemicals added to rubber during processing. While not life threatening, patients with Type IV reactions are much more likely to develop serious Type I symptoms, because of the latex proteins entering the body through the irritated skin.
Type I Systemic Reactions
True allergic reactions caused by protein antibodies in the latex.
It is Type I that cause serious and potentially lethal reactions. Type I reactions are mediated by the immune system. They are caused by an interaction between a foreign protein (antigen) and the body's defensive cells that produce antibodies (IgE antibodies).
This antigen/antibody reaction causes mast cells and basophils to release histamine, leukotrienes, prostaglandins and kinins. It is these chemicals that cause the symptoms of the allergic reaction. Symptoms range from rhinitis to death.
(Authoriser: RCH Policies & Procedures Committee, 2012)
Increasingly, health care workers are developing serious chronic asthma, which can progress to pulmonary fibrosis.
It is not a perfect predicator of allergenic protein content but, if the total levels of proteins in a glove are high, the higher the allergenic protein content and conversely, the lower the total protein content is in a glove the lower the allergen. So it can be anticipated that the lower the level of total protein the latex then the lower the probability of exposure to potential protein allergens.
Chlorination, thanks to its multiple wash cycles, greatly reduces protein content in latex gloves.
Latex powder-free gloves, such as those available from safety gloves specialist MADPAC, are double chlorinated.
Risk management is now very real in the management of businesses. Every prudent practice manager should make a considered decision about purchasing the right type of allergen-free gloves for their staff.
What's practice management responsible for?
They are to ensure all latex gloves provided in clinical areas are non-powdered to reduce the risk of powder proteins responsible for latex allergies being attached to glove powder. When powdered gloves are worn, more latex protein reaches the skin.
Also, when gloves are put on or removed, particles of latex protein powder become aerosolised and can be inhaled, contacting mucous membranes. As a result, allergic health care personnel and patients can experience symptoms related to cutaneous, respiratory, and conjunctival exposure.
If any member of the team is definitively diagnosed with allergy to natural rubber latex (NRL) protein:
- Avoid, as much as possible, subsequent exposure to the protein and only use latex free (e.g. nitrile or vinyl) gloves;
- Make sure that other staff members in the dental practice wear either latex free or reduced protein, powder-free latex gloves;
- Maintain work processes and ensuring the same are reviewed periodically to assess whether opportunities exist to reduce latex exposure for staff;
- Provid staff with appropriate training and instruction relating to latex sensitivity and the use of products made from latex;
- Record any incidents of latex allergy within the team and episodes related to latex allergy.
Where a staff member is identified as having a latex allergy or sensitivity, the ongoing management is documented and the team member is instructed on:
- Appropriate treatment of symptoms;
- Modification to work arrangements to support avoidance of latex exposure;
- Preparedness for serious reaction to latex.
What should employees ensure?
- Powder-free or latex-free gloves are used as provided;
- They keep themselves informed of prescribed work processes to assess whether opportunities exist to reduce latex exposure for staff;
- Hand washing occurs immediately after removing latex gloves – to prevent latex protein transfer to the mucous membranes of the eyes, nose and mouth;
- Any confirmed or suspected latex allergy issues are immediately reported to management;
- Where sensitivity or allergy is identified every effort is made to follow the management strategies outlined above.
What should the workplace OHS manager or responsible staff member ensure?
- Any incident data related to latex sensitivity is reviewed periodically to ensure appropriate preventative strategies are being maintained and implemented;
- Management is kept up to date with cost effective appropriate latex-free alternatives products;
- The flow of current relevant information and education is provided to all staff as part of the continuing workplace health and safety education as required;
- Strategies are in place to meet the requirements of a staff member identified as having a latex allergy or sensitivity.