Accommodating latex allergy concerns in surgical settings

AORN Journal, Oct, 2003 by Esah S. Yip

Effectiveness of gloves in providing protection against virus leakage when they are punctured with small-diameter needles also was studied. Both PVC and nitrile gloves were found to have high leakage rates (ie, 78% and 53%, respectively) compared to negligible or undetectable leakage by natural rubber latex gloves. (26) The resealing property of natural rubber latex has been confirmed by another study, which reported that the amount of viral penetration in PVC and nitrile gloves was significantly greater than in natural rubber latex gloves. (27)

The capability of synthetic surgical gloves, including neoprene, nitrile, copolymer, and polyisoprene gloves, to provide effective barrier protection also has been studied, (28-31) although not as frequently. Unlike PVC gloves, neoprene and nitrile gloves showed leakage rates comparable to latex gloves. Co-polymer had a viral leakage rate 1.5 to 2.7 times that of neoprene, (28) and polyisoprene had a viral leakage rate about five times higher than natural rubber latex and neoprene. (30)

Findings of these studies were summed up by Denise Korniewicz, RN, DNSc, FAAN, in her presentation at a recent international glove conference.

   Although non-latex surgical gloves
   provide basic barrier protection, the
   rate at which they break or tear while
   performing routine surgery makes
   them inferior to latex surgical gloves....
   the data clearly supports high
   quality surgical latex gloves as the
   glove material of choice and the use
   of nonlatex gloves for patients and
   health care workers who are allergic
   to latex. (32)

There are many good reasons why health care workers who are not sensitive to latex proteins should use latex gloves that are low-protein, low-allergen, and low-powder or powder-free. The recommendation to use low-protein, low-allergen, powder-free gloves whenever latex gloves are needed is supported by many organizations, such as the National Institute for Occupational Safety and Health; (33) AORN; (34) the American Nurses Association; (35) and the American College of Allergy, Asthma & Immunology. (36) Synthetic gloves also should be stocked, however, and used by health care workers when they care for patients who have been diagnosed with or are at risk for developing a type I allergy and by health care workers who themselves have been diagnosed with a type I allergy to latex proteins.

NOTES

(1.) G M Liss, G L Sussman, "Latex sensitization: Occupational versus general population prevalence rates," American Journal of Industrial Medicine 35 (February 1999) 196-200.

(2.) K Turjanmaa et al, "Natural rubber latex allergy" (Review) Allergy 51 (September 1996) 593-602.

(3.) H Alenius, K Turjanmaa, T Palosuo, "Natural rubber latex allergy," Occupational and Environmental Medicine 59 (June 2002) 419-424.

(4.) E Yip et al, "Allergic responses and levels of extractable proteins in NR latex gloves and dry rubber products," Journal of Natural Rubber Research 9 no 2 (1994) 79-86.

(5.) E Yip, G L Sussman, Allergenicity of latex gloves with reference to latex protein sensitive individuals in a Canadian population," Journal of Natural Rubber Research 3 no 3 (2000) 129-141.