Managing glove associated reactions in the laboratory

All of us in the laboratory have probably encountered personally or from colleagues skin reactions when wearing gloves. Indeed given the substantial increase in glove usage in the laboratory, the fact that the incidence of glove associated reactions has also risen should come as no surprise. To address these concerns, SHIELD Scientific has recently published an article “If hands could speak” in LABORATORY NEWS.

The key learning points from “If hands could speak” are as follows:

  1. Indentifies the three reactions (Irritant contact dermatitis, allergic contact dermatitis and Natural Rubber Latex allergy) encountered when wearing gloves.
  2. Distinguishes between glove-associated and non-associated-glove reactions.
  3. Provides guidance on action that can be taken to mitigate the occurence of glove-associated reactions.
  4. Gives specific focus to Natural Rubber Latex allergy and highlights the importance of wearing low protein non-powdered natural rubber latex gloves.

At SHIELD Scientific, all gloves are subjected to rigorous controls to minimize the potential for glove associated reactions

If my hands could speak, we might pay more attention to the condition of our hands whilst wearing gloves. With the massive increase in glove usage1)US Department of Health and Human Services Center for Devices and Radiological Health. Medical Glove Powder Report, September 1997, it may not be a surprise that the incidence of glove-associated reactions has also grown. Coupled with increased consumption are the frequency and the duration of glove use in the laboratory, both of which have increased exponentially in the last few years. Also we should not ignore the contribution of powder on gloves, along with constant hand washing towards exacerbating the problem. Whether it is personal protection from chemicals and biohazards or protecting laboratory assays from contamination, gloves are our constant companion. By being aware of the causes and symptoms of glove-associated reactions, we can continue to enjoy the protective properties of disposable gloves and undertake the necessary hand care regime to reduce the risk of such conditions developing.

A common fallacy is that glove wearers can only experience reactions when wearing natural rubber latex gloves. All gloves, whether synthetic or natural rubber latex, have the potential to elicit reactions in some individuals. The most common reaction is non-allergic irritant contact dermatitis and can be experienced with all glove materials. Roughly 40%-60% of all glove wearers experience this condition2)Owenby DR. “Allergies to Natural Rubber Latex”, presentation by Safeskin Corporation (Orlando, Florida, USA, 1998), so if you use gloves regularly in the laboratory the chances are you will be affected by irritant contact dermatitis. The next most common reaction is allergic contact dermatitis, which again can be caused by all glove materials. However, as this is an allergy only those individuals that have the genetic predisposition to be allergic to a certain chemical allergen are vulnerable. It is believed that some 12%3)Gibbon K.L., McFadden J.P., Rycroft R.J. (2001, February) British Journal of Dermatology 144(2):347-350of the population is potentially affected by allergic contact dermatitis. The least common reaction is natural rubber latex allergy, which is specific to the proteins found in natural rubber latex or cross-reactive plant allergens. Between 0.8% and 7% of the general population is reported to be potentially susceptible to natural rubber latex allergy4)Lebenbom-Mansour, M.H., Oesterle J.R., Owenby D.R., et al. (1997) “The of latex sensitivity in ambulatory surgical patients: a correlation of historical factors with positive serum immunoglobin E levels” Anesth Analg 85:44-49. Amongst health care workers the incidence of natural rubber latex allergy appears to be higher, with a recent study in South African hospitals reporting a prevalence of 9% to 20%5)Potter, P.C. (2002) “Latex allergy in South Africa” Allergy Clin Immunol Int 14:10-12.

Causes of glove associated reactions

CauseReactionSource (specific)Glove material
ChemicalsIrritant contact dermatitis & allergic contact dematitisAccelerators, antioxidants, antiozonants, biocides, colorants, processing aidsSynthetic & natural rubber latex
EndotoxinIrritant contact dermatitisWater sources, powder slurry, raw materialsSynthetic & natural rubber latex
PowderIrritant contact dermatitis & occupational asthmaDonning agent & release agentSynthetic & natural rubber latex
Proteins (direct contact or bound to powder)Natural rubber latex allergyLatex proteinsNatural rubber latex

What are the three types of glove reactions?

As we now know, the three glove associated reactions are irritant contact dermatitis, allergic contact dermatitis and natural rubber latex allergy. Each has unique characteristics that allow for distinguishing one from the other.

  1. Irritant contact dermatitis
  2. Allergic contact dermatitis
  3. Natural rubber latex allergy

Conclusion

If my hands could speak, we would be more aware of the potential of our gloves to cause dermal reactions. We would also know that in the laboratory there are external factors such as soaps, disinfectants, skin creams etc that can contribute to the problem. Whilst natural rubber latex allergy is potentially the most serious glove-associated reactions, the risk is restricted to natural rubber gloves and a relatively small proportion of the general population. Allergic contact dermatitis is more frequently encountered and can be triggered by all glove materials. Irritant contact dermatitis is a non-allergic condition that can affect us all and is relatively common to the extent that all of us in the laboratory are likely to experience this dermal reaction. Like allergic contact dermatitis, all glove materials have the potential to elicit irritant contact dermatitis.

Whilst the increase in glove-associated reactions correlates closely with the increase in glove use in the laboratory, there are simple actions that we can take to reduce the risk. As the role of powder is associated with all three reactions, by introducing a powder-free laboratory we have already taken an important step to managing glove-associated reactions. Glove selection on the basis of their suitability for the work we are doing or seeking gloves that have low chemical residues is also important. For natural rubber latex gloves, selecting gloves with low latex protein is crucial.

References   [ + ]

1.US Department of Health and Human Services Center for Devices and Radiological Health. Medical Glove Powder Report, September 1997
2.Owenby DR. “Allergies to Natural Rubber Latex”, presentation by Safeskin Corporation (Orlando, Florida, USA, 1998
3.Gibbon K.L., McFadden J.P., Rycroft R.J. (2001, February) British Journal of Dermatology 144(2):347-350
4.Lebenbom-Mansour, M.H., Oesterle J.R., Owenby D.R., et al. (1997) “The of latex sensitivity in ambulatory surgical patients: a correlation of historical factors with positive serum immunoglobin E levels” Anesth Analg 85:44-49
5.Potter, P.C. (2002) “Latex allergy in South Africa” Allergy Clin Immunol Int 14:10-12

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