Durability of gloves can vary considerably
Durability of gloves can vary considerably
All of the materials currently used to produce examination and surgical gloves (natural rubber latex and synthetics) offer users equal protection against pathogens — at least when they’re first removed from the box, according to the Food and Drug Admini stra tion (FDA), which regulates medical gloves. But according to some research, the quality of barrier protection can change significantly during use.
Mel Stratmeyer, chief of the Health Sciences Branch, Office of Science and Technology at the FDA’s Center for Devices and Radiological Health in Rockville, MD, says examination and surgical gloves must meet criteria of the Ameri can Society for Testing and Materials (ASTM), which sets standards for the various glove materials. "Any glove that meets ASTM standards would at the time it’s taken out of the box meet the FDA barrier requirements," he explains.
The Centers for Disease Control and Preven tion concurs: "There is no difference in barrier effectiveness as long as the glove is intact," says Sarah Critchley, RN, in the CDC’s Hospital Infections Program.
However, neither the FDA nor the CDC has investigated how glove use affects barrier integrity for various glove materials. "It doesn’t appear that all of the materials are equal with respect to that. We’re looking at what comes out of the box, not after use, but we’re in the process of exploring the whole issue," Stratmeyer says.
So are other researchers, who have compared the strength and durability of natural rubber latex with some common nonlatex alternatives. Their findings reveal some notable differences. "It is the in-use barrier performance that separates gloves of various material composition in regard to on-the-job barrier protection," says Wava M. Truscott, PhD, vice president of scientific affairs for Safeskin Corp. in San Diego.
One group of investigators compared the barrier integrity of exam gloves made of latex, vinyl, and nitrile under controlled conditions that simulated common patient-care activities.1 The study concluded that the barrier integrity of vinyl gloves was violated more quickly and more often than natural rubber latex and nitrile gloves.
Researchers tested 800 latex gloves, 800 vinyl gloves, and 400 nitrile gloves. To determine baseline leakage before use, gloves were taken directly from their boxes without manipulation and subjected to a water leak test.
Glove use simulations were designed to mimic rigorous patient care activities for approximately 20 minutes. Simulated use conditions were: attach and remove a capped needle to a Luer-Lok syringe 30 times; connect and disconnect a Luer-Lok syringe with intravenous tubing eight times; manipulate a stopcock eight times; and wrap, tape, and unwrap a blunt object two times (to simulate bandaging an amputation stump). Gloves either "passed" or "failed" based on the ASTM Standard Test method for detecting holes in medical gloves.
Vinyl gloves failed more often than others
Overall, the investigators found no significant differences in failure rates for gloves when tested, unused, directly out of the box. But after manipulation that simulated patient care activities, vinyl gloves failed 12%-61% of the time; latex failed 0%-4% of the time; and nitrile failed 1%-3% of the time. Failure rates for stretch vinyl, while still relatively high, were lower than those for standard vinyl. All of the latex gloves, with one exception, were low-protein gloves containing less than 50 [gm]g/g of latex allergen as determined by the Lowry test.
"Careful consideration to the degree of barrier effectiveness should be given prior to glove selection where the potential exposure to bloodborne pathogens or biohazard risk is a concern," concluded the investigators.
Reference
1. Rego A, Roley L. In-use barrier integrity of gloves: Latex and nitrile superior to vinyl. Amer J Infect Control. In press.
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