Tuesday, September 25, 2007

Types of Gloves

Types of Gloves
by Denise M. Korniewicz, DNSc, RN, FA


In an effort to reduce occupational exposure to Hepatitis B Virus (HBV), Human Immunodeficiency Virus (HIV), and other bloodborne pathogens, the Occupational Safety and Health Administration (OSHA) established a mandate related to protective attire. Specifically for gloves, it stated that "Gloves shall be worn when the employee has the potential for hands to have direct skin contact with blood, other potentially infectious material, mucous membranes, non-intact skin, and when handling items or surfaces soiled with blood or other potentially infectious materials.

Disposable (single use) gloves, such as surgical or examination gloves, shall be replaced as soon as possible when visibly soiled, torn, punctured or when their ability to function as a barrier is compromised." [Federal register: Part II, CFR Part 1910].
As a result of this mandate and the implementation of universal precautions (Centers of Disease Control and Prevention, 1987), glove usage grew from 1.4 billion in 1988 to 8.3 billion in 1993 (NIOSH, 1997). Healthcare workers are concerned, confused, and often times, unsure about the types of gloves available for their use in healthcare settings. Often they find that the information available depends on cost versus the quality of the product.

Today, there are a variety of gloves available for medical use ranging from sterile to non-sterile, from latex to non-latex products, and gloves marketed for "special use" to gloves that are labeled as procedure gloves. Additionally, there are a variety of gloves color coded and used in clinical settings that are marketed as more effective than others; however, there is little or no evidence as to the barrier quality of most gloves and how each differs from the other. In an effort to provide information to product managers about the selection of gloves for clinical use, most manufacturers are beginning to differentiate their product based on the standards developed by the Food and Drug Administration (FDA) and the American Standards of Tests and Materials (ASTM).

A variety of gloves can be found in most healthcare settings. These include latex (sterile, non-sterile), neoprene (chloroprene), nitrile, vinyl, polyurethane, and a variety of copolymers. Depending on which vendors supply your institution, the availability and variety of gloves used in your institution may vary. In order to provide healthcare workers with the best quality of gloves used for clinical practice, gloves (surgical or non-surgical) should be evaluated for their barrier quality, strength and durability, puncture resistance, fit and comfort, elasticity, and their allergen content or ability to cause an allergy. Listed below is a simple glove selection guide to assist product managers with the differences in the types of gloves available for clinical use.

Denise M. Korniewicz, DNSc, RN, FAAN, is a Professor at the University of Maryland School of Nursing (Baltimore, Maryland).

References
1. Federal Register (Part II, CFR Part 1910). Occupation Exposure to bloodborne pathogens: Proposed Rules and Notice of Hearing. May 30, 1989.
2. Centers for Disease Control: Recommendations for prevention of HIV transmission in healthcare setting. Morbidity and Mortality Weekly Report. 1987;36:IS-12S,(suppl II).
3. National Institute for Occupational Safety and Health, Department of Health and Human Services: NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace, publ. No. 97:135, 1997.



Selection Guide for Gloves Used in Health Care Settings

Barrier
Protection
Strength & Durability
Puncture Resistance
Fit & Comfort
Elasticity
Allergenicity
Latex
Long-standing barrier qualities
Strong, natural rubber is durable
Has Re-seal qualities
Provides comfortable fit
Natural ability due to elastic quality rubber
Contains protein & chemical allergens low powder is preferred
Neoprene (Chloroprene)
Good but tear resistance Is marginal
Strong
Has some puncture resistant qualities
Provides a good fit, has some elastic ability that enhances fit
Close to latex & allows for flexibility
Contains no latex proteins but has some accelerator chemicals
Nitrile
Resistant to punctures & tears, flexes & does not develop holes
Strong has puncture resistant qualities
Has puncture resistant qualities
Slightly tighter fit
Less than latex over time tends to shape to wearer's hand
Contains no proteins but contains some accelerator chemicals
Vinyl
Easily breaks during use, Baggy
Weak, breaks easily & punctures easily in use
Punctures with sharps
Fit limited baggy
Dexterity compromised
Contains no proteins but chemical accelerators
Polyurethane
Durable & high puncture resistance
Excellent tear, puncture & abrasion resistance
Superior to latex for puncture resistance; mimics nitrile in performance
Good comfort & fit; has latex - like qualities
Elasticity is apparent
Contains no latex proteins & no chemical accelerators
Copolymer (block polymers)
Good resistance to tears
Stronger than vinyl; puncture resistance is fair
Easy to puncture
Latex like fit and comfortable
Elasticity superior to vinyl but below latex
Contains no latex proteins but some chemical accelerators

(message copied from a milist in yahoogroups)

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