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