Wearing test with 2 different types of latex gloves with and without the use of a skin protection cream

Making Glove Decision Less of a White Knuckling Experience: A Systematic Review and Inventory of Glove Accelerator Contents

Background

Accelerators in medical gloves are a common cause of allergic contact dermatitis among healthcare workers.

Objective

A systematic review of medical and nursing literature, patch testing reports, and chemical analyses of gloves was conducted to assess accelerator contents reported in the literature and to identify accelerator-free gloves.

Methods

A systematic literature search was performed in OVID Medline and OVID EMBASE. Hand-searching of reference lists of articles in the field and author input generated the remainder of articles assessed.

Results

We present an inventory of accelerator contents of gloves and accelerator-free glove options as reported in the literature as a clinical reference tool to assist allergen-free glove selection for individuals suffering from allergic contact dermatitis due to rubber accelerators.

Limitations

Pertinent limitations of our review include lack of predefined study exclusion criteria and screening of the studies identified in the search by 1 review author only.

Conclusion

The glove inventory we provide summarizes the available literature regarding medical and surgical glove accelerator content, describing gloves both by brand and manufacturer as well as by accelerators.

Occupational management of type I latex allergy

BACKGROUND

Although the incidence of type 1 latex allergy has decreased in recent years with the introduction of powder-free low-protein (PFLP) latex gloves, type 1 latex allergy is still commonly found among workers who use natural rubber latex (NRL) gloves at work.

AIMS

To elucidate the optimal management of workers with type 1 latex allergy whose work necessitates the use of NRL gloves in the workplace.

METHODS

A sensitive electronic search of relevant bibliographic databases was performed with related search terms for articles from 1 January 1990 to 1 September 2010. Relevant abstracts were reviewed, and studies that furnished data on the management of type 1 latex allergy in the workplace were extracted. Articles for inclusion in the review were appraised using the Scottish Intercollegiate Guideline Network methodology.

RESULTS

A total of 7041 abstracts were retrieved; 12 articles met the inclusion criteria for the review. We found moderately strong and consistent evidence that avoidance of NRL in the workplace reduces both symptoms and markers of sensitization in latex-allergic individuals. There is limited evidence that latex-allergic workers can continue to use PFLP gloves with no worsening of symptoms, provided that their co-workers also use PFLP latex or non-latex gloves.

CONCLUSIONS

Individuals with type 1 latex allergy whose work necessitates them wearing latex gloves may continue in their job provided that adjustments are made to ensure that they are not exposed to powdered latex gloves.

Effectiveness of skin protection creams as a preventive measure in occupational dermatitis: a critical update according to criteria of evidence-based medicine

OBJECTIVES

This study attempts to assess the evidence of the generally recommended three-step programme of skin protection in the prevention of occupational skin disease.

METHODS

The following clinical questions, representative of critical appraisal of this preventive measurement, were generated: (1) Can a skincare regimen effectively reduce or eliminate work-related poor skin conditions? (2) Do protective creams prevent harmful substances from penetrating and adhering to the skin? (3) Is the differentiation between pre-exposure and post-exposure products justified by reliable data? Answers were generated according to the method used in evidence-based medicine by searching the literature, critically appraising the results and applying the results to the clinical questions. For our search we decided to use PubMed as the most convenient access to Medline and because, in contrast to other databases, this access is available free of charge.

RESULTS

To investigate the efficacy of barrier creams as pre-exposure skin protectors various in vitro and in vivo test methods have been developed. Over the past years the test techniques have been improved in order to adopt a real workplace situation. Efforts for standardisation of evaluation criteria have been made, too. Nevertheless, there is a lack of placebo-controlled, randomised clinical trials evaluating the benefit of these products in the prevention of occupational contact dermatitis under real workplace conditions. The literature data are conflicting; some publications report on the positive aspects of skin protection, whereas others stress the negative ones.

CONCLUSION

Not enough data have been accumulated for one to prove the benefit of skin protection measures under real workplace condition. Up to now, it is almost unclear if the various in vitro and in vivo methods used are suitable to simulate real workplace conditions and if these test results can be related to real occupational exposure. For the evidence-based recommendation of skin protection, further studies, especially under daily working conditions evaluating the contribution of each single element of skincare programme (products, frequency of application and education programme) are needed.

Latex sensitization in dental students using powder-free gloves low in latex protein:a cross-sectional study

In Germany, employers must provide low-protein, powder-free gloves. This study was carried out to determine the current prevalence of latex sensitization in dental students using these gloves and to compare our results with a study of the same design dating from 1990/1991 at our university. A cross-sectional study was performed by questionnaire, prick testing and determination of specific IgE antibodies. 226 of 403 dental students underwent prick testing with a panel of 8 aero-allergens, 1 commercially available latex extract and 5 high-ammonia accelerator-free latex fluids. 39 of 226 dental students (17.3%) had a positive prick test response to at least 1 of the 6 latex substances tested. The prick test positivity was similar in preclinical education (semester 1-6) and in clinical education (semester 7-10), at 17.1% and 17.4%, respectively. In 9 of 32 persons with positive prick tests, specific IgE antibodies to latex could be detected. Within the past 10 years, prick test positivity increased from 8.7% to 17.3%. 14 students (6.2%) reported a history of glove intolerance, 3 of them (1.3%) showing a positive prick test to latex. By the use of low-protein, powder-free gloves less students with glove intolerance were observed. The observed reactions to between 1 and 3 of 6 latex substances tested may indicate a decrease in intensity and spectrum of sensitization. Additionally non-occupational sensitization may be of importance.