Protecting the Hands of Healthcare Providers: Latex & Nitrile Examination Glove
LacerdaCare Journal Newsletter
Author:
Micheal Cardozo, Regd. Pharmacist - (HPOS)-Head of Pharmaceutical Operations & Strategy, LacerdaCare Pvt Ltd.
Product reviewed: Gloves
Protecting the Hands of Healthcare Providers: Latex & Nitrile Examination Gloves
Gloves form the primary barrier to protect the patient and a care-giver from various pathogenic & non-pathogenic micro-organisms, thereby also keeping the hands clean by avoiding direct contact with the elements.Hence gloves are very critical in the functioning of the healthcare industry. Apart from physician-patient protection, gloves are also a key item when handling biological fluids and corrosive chemicals at diagnostic laboratories, testing laboratory and pharmaceutical manufacturing units, wherein the analyst/operator is protected.
In addition to the healthcare industry gloves are also used in the food handling, tattoo studios, spa & salons to maintain hygienic conditions and in handling of chemicals where prolonged skin contact can be detrimental by protecting the service provider.
All-in-all gloves are an essential component across various industries. Therefore it is important to get to know about the product that we use, that may look insignificant and one might overlook but is crucial in maintaining hygiene and protecting the protector of health.
Types of Gloves
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Vinyl/Plastic Gloves:
These gloves are manufactured using synthetic materials mainly PVC, which stands for Polyvinyl chloride, which by itself is a hard polymer but are made pliable by incorporating plasticizers. But these types of gloves are not suitable as medical examination gloves as they do not provide the dexterity required to handle medical instruments precisely and lack the grip strength to hold the instruments firmly. Also in a study conducted by Rego et al, who’s aim was compare the in-use barrier integrity of various types of gloves, it was found that out of 800 PVC gloves tested, 12% to 61% of them failed the barrier integrity test while the other types of gloves had a failure rate of 0.4% to 4%. Hence it was concluded that vinyl gloves had a significantly less durability, thereby compromising the effectiveness of the gloves as a barrier against pathogens which in turn may compromise the the health of the caregiver and their patients. Therefore we can safely say that vinyl gloves should not be used in a medical setting.
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Latex Examination Gloves:
These gloves are made by collecting and processing the sap/latex obtained from various latex producing trees like Hevea brasiliensis (belonging to family Euphorbiaceae, which is native to the Amazon basin of South America but now can be found all over the tropical regions of the world. Rubber obtained from this tree is known as Amazonian rubber), Ficus elastica (belonging to the family Moraceae. Commonly known as Rubber tree, Indian Rubber bush, rubber plant is native to eastern parts of South and Southeast Asia. They can also be found in Central America and the Caribbean. Rubber obtained from this tree is called Indian rubber).
Gloves manufactured using NRL (Natural Rubber Latex) are the most versatile single use gloves in the healthcare industry, as they can be used during examination of patients where physical contact is required, also as a protective barrier while handling biological fluids during its analysis similarly to avoid direct contact with analytical chemical agents which may be problematic in the long run when there is frequent exposure. Also they can be used during collection and disposal of biomedical waste as they may contain pathogenic organisms. As a secondary function they promote hygiene and gives the patient confidence and a sense of safety & relief in the healthcare provider that proper hygienic standards are maintained in their practice.
As mentioned before in the study conducted by Rego et al, it was found that out of the 800 latex gloves tested for in-use barrier integrity, there was a failure rate of 0.4% to 4% across various brands of latex gloves. Hence proving their effectiveness as a reliable protective barrier against micro-organisms and also against the elements.
Latex gloves are usually powdered using cornstarch USP, which plays a role as a glident which makes it easier for donning. Non-powdered latex gloves are also available commercially but due to absence of a glident it is difficult to donn and may stick to one another compromising on its usability and there is a risk of tearing while wearing them. A secondary reason for powdered gloves is that when using the gloves the user tends to perspire, which is subjective and may vary from person to person, the powder used in the gloves also helps in absorbing the sweat produced decreasing the discomfort.
Allergy concerns when using latex gloves: Since Latex is a natural substance it contains various types of phytoconstituents like alkaloids, glycosides and glycoproteins etc. Therefore, due to the presence of residual extractable proteins in the latex gloves it is possible that a very low percentage of the population in the world could be sensitive to the said proteins thereby causing allergic reactions. The reactions may include but not limited to hives, itching, stuffy and runny nose, it may also cause asthma like symptoms such as difficulty in breathing, wheezing etc.The majority of the population need not worry as it affects a very small proportion of the population as latex gloves are still considered the very best in providing barrier protection. Those showing signs of sensitivity towards latex gloves may use alternative synthetic materials such as nitrile gloves which are just as good or even better compared to latex gloves.
Nitrile Examination Gloves:
Nitrile rubber, chemically known as Acrylonitrile Butadiene rubber, is a polymer formed by cross linking molecules of acrylonitrile and butadiene. It was first developed in 1931 by Erich Konrad and Eduard Tschunkur at Bayer a subsidiary of a chemical conglomerate IG Farben industeries in Germany. Commercial production of Nitrile rubber started in 1935.Nitrile rubber is made by cross linking acrylonitrile and butadiene by the process of polymerisation. It was found that nitrile rubber had good resistance to mineral oils and non-polar solvents, but was not able to withstand higher temperatures like latex.
Similar to latex, gloves made from nitrile rubber has excellent barrier integrity. The same study as discussed before conducted by Rego et al, it was found that nitrile gloves had a failure rate of 1% to 3% which is very slightly better than latex gloves. Which means that just like latex gloves, nitrile gloves are just as good as latex gloves in acting as a barrier towards pathogens in a medical setting.
Nitrile gloves have a significant advantage over latex gloves in-terms of the allergic concerns. Since nitrile is a synthetic material it is devoid any phyotoconstituent found in latex, hence there is no antigenic protein present to cause any allergic reactions.Therefore nitrile gloves are an excellent alternative for those having sensitivity reactions towards latex gloves. Additionally nitrile gloves are very lightly to non-powdered as they are easier to donn, which gives them another edge over the powdered latex gloves.
Allergy Concerns and Dexterity
It is common knowledge that carrying out task feels more comfortable barehanded as a reduction in dexterity is seen by wearing protective gloves, but barehanded practices especially in a medical setting is a big no as it compromises on the safety of both the patients and the healthcare providers. But handling of instruments by the doctors, especially when precision is required there grip is more important as at such a point an error can cause an unwanted injury which could be fatal. Since there cannot be any compromise with hygienic standards in the healthcare industry there is a compromise made with regards to the grip in handling of instruments. As a middle ground the gloves available at LacerdaCare have textured finger tips which helps in improving the grip while handling instruments.
Conclusion
Examination gloves are a very critical component of the healthcare industry as they promote hygiene and reduces the spread of diseases caused by human contact thereby protecting healthcare professionals and patients from pathogens. As we could see that vinyl gloves gave poor results when compared to latex and nitrile examination gloves in terms of barrier protection, hence vinyl gloves should be avoided as it could be a health risk to both patients and the doctors. Gloves also protects an analyst from direct contact with biological fluids and harsh chemicals during analysis of the said fluids. Similarly operators involved in manufacture of medications and chemicals are also protected from long term skin exposure of the same.
Both Latex and Nitrile gloves are time tested and are excellent in-terms of barrier protection as they have a very low failure rate. Latex gloves are manufactured by processing the sap collected from various varieties of rubber trees, while nitrile gloves are manufactured from nitrile rubber which is made by cross linking molecules of acrylonitrile and butadiene by subjecting them to polymerisation.
Latex gloves being produced from natural rubber contains other phytoconstituents which can cause sensitivity reactions in some individuals while nitrile being synthetic are devoid of unwanted compounds hence reducing the incidence of sensitivity reactions, therefore can be considered as an alternative material for those presenting signs of latex sensitivity.