NORCROSS, Ga. -- Hospitals and surgical centers should opt for latex-safe environment glove choices to decrease the risk of latex allergy as well as assure excellent barrier protection, surgeon and healthcare worker comfort, and cost-effectiveness, says Molnlycke Health Care US, LLC, manufacturer of the Biogel surgical glove line.
"Making informed glove choices to combat latex allergy is paramount," says G.L. Sussman, MD, FRCP, professor of immunology at the University of Toronto. "What's happening now is a latex-safe evolution. The choice is for latex- safe, rather than non-latex. The industry is learning that it doesn't have to be all or nothing. A latex-safe environment allows an individual worker or patient to be less likely to have latex allergy issues."
Additionally, the United States Army Medical Command's latex allergy prevention policy advises "focus on latex-safe rather than latex-free."(1)
A latex-safe environment is one in which every reasonable effort has been made to remove high-allergen and airborne latex sources from coming into direct contact with affected individuals, according to AORN's 2006 Latex Guidelines. The Guidelines go on to state that a latex-free environment (one in which all latex-containing products, not simply gloves, have been removed) is considered unattainable.(2)
To maintain a latex-safe environment, latex-free supplies and policies must be in place to protect patients with suspected or documented latex allergies. Healthcare facilities should use pre-operative screening questionnaires to identify at-risk patients. In addition, use of low-allergen, powder-free latex gloves is recognized by multiple professional and government organizations (including NIOSH, AAAAI, ACAAI) as one of the key components in establishing a latex-safe environment.(3)
There is nothing like latex; its strength, pliability, ability to convey tactile sensation and affordability have made it the gold standard material for medical products. However, its adverse effect on latex allergic and sensitive healthcare workers and patients calls for a safe alternative. It's estimated that latex is used in 40,000 medical and non-medical products; so it is virtually impossible to avoid. While making an entire facility latex-free can be impractical and too costly, it is possible and affordable to make it latex-safe.(4)
Prevalence of Latex Allergy
Reactions associated with latex and synthetic products include irritant contact dermatitis, allergic contact dermatitis (type IV), and immediate IgE hypersensitive reactions (type I). Only type I constitutes a true latex allergy. The prevalence of latex allergy in the general public is low (probably less than 1 percent), while the potential for health care workers to become sensitized due to repeated exposure to latex ranges from 8 percent to
17 percent.(5)
It is unsafe to expose latex-allergic individuals to an environment laden with latex allergens. The AORN Guidelines state that individuals who have been clinically diagnosed as either sensitive or allergic to natural rubber latex should be treated or work in an environment that is latex-safe, with additional measures taken for the immediate vicinity in which the individual receives or provides care.(6)
Why Powder-Free?
Powdered latex gloves should not be used for surgical procedures because it is the starch powder itself that promotes the transfer of allergenic latex proteins.(7) Delayed wound healing and many postoperative complications also are associated with the use of powdered gloves. The risk of postoperative adhesions and accompanying costs of treatment can be decreased with the use of powder-free gloves.(8) Hospitals adopting powder-free latex glove policies experience reductions in glove-related allergy incidence.(9) There is a reported 1 percent annual incidence of sensitization among powdered latex-glove users, whereas users of powder-free, low-protein, latex gloves reported a 0 percent sensitization rate.(10)
Latex-Safe Environment Glove Solutions
Molnlycke recommends the use of latex, non-latex and deproteinised latex glove styles to address both general surgery and specialty needs in a latex- safe environment. "Hospitals and surgical centers should understand gloving choices and intelligently select the best protection for healthcare workers and patients," says Carolyn Twomey, RN, vice president of clinical affairs.
"For 13 years, we have been using Biogel powder-free surgical gloves exclusively. With the help of Biogel, we created a latex-safe environment to help ensure the safety of both patients and healthcare workers at Brigham and Women's Hospital," says Peggy Doyle, director of perioperative nursing, surgical services, at Brigham and Women's Hospital in Boston.
As the only major surgical glove company with an exclusively powder-free surgical glove line, Molnlycke's Biogel surgical gloves are made from high- tech material to which is bonded a thin inner coating of acrylate terpolymer. The smooth inner surface allows Biogel gloves to be easily donned with damp or dry hands without the need for a powder lubricant. This not only eliminates the risk of powder-related postoperative complications, but also reduces the risk of allergic reactions to aerosolized natural rubber latex proteins.
   The Biogel glove line features a deproteinised latex glove, Biogel Eclipse and Biogel Skinsense, a synthetic glove. Biogel Eclipse is a cost-effective safety option for facilities wanting to reduce exposure of healthcare workers and patients to latex antigenic proteins without having to incur the cost of non-latex gloves for those not sensitized to latex proteins.
The Biogel Skinsense glove is the first of the next generation of synthetics, made from a special synthetic elastomer, completely free from natural rubber latex. Competitively priced, the new neutral-tone Biogel Skinsense glove is designed to perform like latex and is a cost-effective alternative to Polyisoprene.
References:Â Â Â
   (1) Department of the Army, Headquarters United States Army Medical
Command, MEDCOM Regulation No. 40-44, 6 June 2002, p. 3.
   (2),(6) AORN 2006 Latex Guidelines, Standards, Recommended Practices,
and Guidelines, pages 199-214.
   (3) "Latex allergy: Protect your self, protect your patients," Work
Place Information Series Brochure, American Nurses Association,
http://www.nursingworld.org/dlwa/osh/wp7.htm (accessed 17 Oct 2003).
National Institute for Occupational Safety and Health, NIOSH Alert:
Preventing Allergic Reactions to Natural Rubber Latex in the Workplace.
DHHS Publ 97-135 (Cincinnati: National Institute for Occupational Safety
and Health, August 1997).
   (4) H D Reines, "4 Tips to Achieve Latex Safety", Outpatient Surgery
Magazine, Aug 2006.
   (5) K T Kim et al, "Implementation Recommendations for Making Health
Care Facilities Latex Safe", AORN Journal, (67, March 1998), pp 615-632.
   (7) Beezhold D, Beck WC, Surgical Glove Powders Bind Latex Antigens,
Archives of Surgery 1992; 127: 1354-1357.
   (8) FDA Medical Glove Powder Report - E, September 1992.
   (9) Allmers H. Et al. J. Allerg. Clin. Immunol. 2004 ; 114 : 347-51.
   (10) G L Sussman et al, "Incidence of latex sensitization among latex
glove users," Journal of Allergy and Clinical Immunology 101 (February
1998) 171-178.
Source: Molnlycke Health Care US, LLC
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