Know your gloves for better infection control

Transcription

1 Know your gloves for better infection control Abdul Kadir, Ph D Deputy Chief Executive Officer Malaysian Rubber Export Promotion Council

2 Outline How gloves prevent infections What are medical gloves? Glove material comparisons Hazards of vinyl gloves Latex protein allergy Standard Malaysian Glove (SMG) Selecting gloves

3 How gloves prevent infections Gloves prevent contamination of the hands of healthcare personnel when touching blood, body fluids, secretions, mucous membranes, and nonintact 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

4 Wearing gloves does not replace the need for hand washing

5 What are medical gloves? Prevent contamination Disposable Made of polymer Used during medical examinations and procedures, and surgery Powdered or powder-free

6 Main types of medical gloves Examination Use in: Medical examinations Surgical Use for conducting surgical procedures. Diagnostic & therapeutic procedures Handling of contaminated medical materials

7 Chemotherapy gloves For 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

8 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

9 Main glove materials Natural rubber Nitrile Vinyl

10 General properties of gloves made from different materials Durability Puncture & tear resistance Comfort and fit Flexibility Tactile sensitivity Grip Natural Rubber Nitrile Vinyl

11 Barrier protection The reason for wearing medical gloves is that they provide barrier protection against infectious agents

12 Percentage failure of new gloves subject to water leak test Natural Rubber 2.0 Nitrile 3.0 Vinyl 4.8

13 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-Lok syringe to intravenous tubing 8 times 3. Manipulate a stopcock 8 times 4. Wrapping, taping and unwrapping a blunt object 2 times

14 Percentage failure of gloves after simulated use Natural Rubber Nitrile Vinyl Failure of vinyl gloves after simulated use increased by 520% Rego A and Roley L, American Journal of Infection Control, Volume 27, Number 5, 1999.

15 Limited use of 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

16 Use of plasticizers in 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

17 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

18 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%

19 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

20 Solution to allergy problem NR Nitrile

21 Standard Malaysian Glove Scheme A voluntary certification scheme for latex examination gloves Establishes requirements for: Freedom from holes Physical properties Protein content Powder content POWDER-FREE POWDERED 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

22 Physical properties of SMG Type I Unaged Aged Property Unit Requirement (min.) Tensile strength MPa 18 Elongation at break % 650 Tensile strength MPa 14 Elongation at break % 500 Ageing conditions: 7 days at 70 ± 2 O C

23 SMG Protein Content Requirements (μg/dm 2 ) Powder-free 50 Powdered 200

24 Selecting gloves If allergic to latex If powder cause irritation If need to grip and handle instruments If comfort important Nitrile Powder-free Powdered Powder-free

25 Malaysia exports rubber gloves to over 180 countries around the world

26 Malaysia s exports of rubber medical gloves US$ billions % of world s exports

27 Malaysia s exports of medical gloves to Indonesia US$ millions CAGR = 28.8%

28 Thank you

29 For more information about medical gloves: