know your gloves for better infection control · selecting gloves. how gloves prevent infections...

Abdul Kadir, Ph D Deputy Chief Executive Officer

Malaysian Rubber Export Promotion Council

Know your gloves for better

infection control

OutlineHow gloves prevent infectionsWhat are medical gloves?Glove material comparisonsHazards of vinyl glovesLatex protein allergyStandard Malaysian Glove

(SMG)Selecting gloves

How gloves prevent infections 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 washing

What are medical gloves?

Used during medical examinations and procedures, and

surgery

Disposable

Powdered or powder-free

Made of polymer

Prevent contamination

Main typesof medical gloves

Surgical

Use for conducting surgical procedures.

Examination

Use in:Medical examinations

Diagnostic & therapeutic procedures

Handling of contaminated medical materials

Chemotherapy glovesFor safe handling of highly toxic cancer chemotherapeutic drugs

Thicker and longer than surgical or examination gloves

Tested for resistance to permeation of chemo drugs

Worn by:• Oncologists• Oncologic nurses• Hospital pharmacists• Pharmaceutical manufacturers

Gloves can be powdered or powder-free

Powdered gloves are coated with corn starch to make them easier to don

Powder-free gloves are chlorinated or have a synthetic coating for ease of donning

Main glove materials

Natural rubber

Nitrile

Vinyl

General properties of gloves made from different materials

Natural Rubber Nitrile Vinyl

Durability

Puncture & tear resistance

Comfort and fit

Flexibility

Tactile sensitivity

Grip

Barrier protection

The reason for wearing medical gloves is that they provide barrier protection against infectious agents

Percentage failure of new gloves subject to water leak test

Natural Rubber 2.0

Nitrile 3.0

Vinyl 4.8

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-Loksyringe to intravenous tubing 8 times

3. Manipulate a stopcock 8 times

4. Wrapping, taping and unwrapping a blunt object 2 times

Percentage failure of gloves after simulated use

1.8 2.8

29.8

05

101520253035

Natural Rubber Nitrile Vinyl

Rego A and Roley L, American Journal of Infection Control, Volume 27, Number 5, 1999.

Failure of vinyl gloves

after simulated use increased by

520%

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

Use of plasticizersin vinyl gloves

Vinyl or polyvinylchloride (PVC) is a hard plastic

It can be made softer and more flexible by the addition of plasticizers

The most common plasticizer used is di(2-ethylhexyl) phthalate, better known as DEHP

Vinyl gloves can contain up to 40% of DEHP

DEHP is not bound chemically to the PVC and can be leached out when in contact with blood or body fluids

Sanctions against DEHP

US Department of Health and Human Services (DHHS) and Environmental Protection Agency (EPA) label DEHP as potential carcinogen and reproduction toxin

Many countries have banned DEHP in children’s toys

Japan and the European Union have banned DEHP in food service gloves

DEHP is banned in California’s Safe Drinking Water and Toxic Enactment Act of 1986

Latex protein allergy

Natural rubber latex (NRL) contains proteins

Some of the proteins are allergens

Sensitization to NRL is caused by direct contact

Prevalence of latex allergy in the general public is 1% and in healthcare workers from 0.6% to 10%

Symptoms of latex protein allergy Local or systematic urticaria

Hay fever-like symptoms

Abdominal cramps

Difficulty in breathing

Rapid heart rate

Drop in blood pressure

Anaphylactic shock

Solution toallergy problem

NR Nitrile

A voluntary certification scheme for latex examination gloves

Establishes requirements for: Freedom from holes Physical properties Protein content 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

Physical properties of SMG Type I

Property Unit Requirement (min.)

UnagedTensile strength MPa 18Elongation at break % 650

AgedTensile strength MPa 14Elongation at break % 500

Ageing conditions: 7 days at 70 ± 2OC

SMG Protein ContentRequirements (μg/dm2)

Powder-free 50

Powdered 200

Selecting gloves

• NitrileIf allergic to latex

• Powder-freeIf powder

cause irritation

• PowderedIf need to grip

and handle instruments

If comfort important • Powder-free

Malaysia exports rubber gloves to over 180 countries around

the world

Malaysia’s exports of rubber medical gloves

1.712.11 2.03

2.773.24 3.42

0

1

2

3

4

2007 2008 2009 2010 2011 2012

US$ billions

% of world’s exports

48.649.850.7

51.5

52.253.2

Malaysia’s exports of medical gloves to Indonesia

3.50 3.735.06

6.94

9.05

12.39

0

2

4

6

8

10

12

14

2007 2008 2009 2010 2011 2012

US$ millions

CAGR = 28.8%

Thank you

For more information about medical gloves:

www.latexglove.info

www.smg-gloves.com

www.mrepc.com