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Objectives Latex product manufacturing is an important industry in south-east Asia but has the potential for considerable occupational exposure of workers to latex allergens. Although exposure to latex allergens can result in adverse health reactions, few studies to characterize this exposure have been conducted to date. This study therefore aimed to characterize current airborne inhalable dust and the specific allergen, Hev b 6.02, exposures in this industry in Thailand. Methods Workers were recruited from three factories in the southern part of Thailand. Full-shift inhalable dust personal air sampling was conducted using IOM sampling heads equipped with polytetrafluoroethylene filters at a 2.0 l min(-1) flowrate. After weighing to determine inhalable dust levels, filters were extracted and analysed for Hev b 6.02 using an enzyme immunometric assay. Results Two hundred and seventy-five workers agreed to participate, resulting in a total of 292 measurements. Geometric mean (GM) personal exposure to inhalable dust was 0.88 mg m(-3), but individual exposures up to 12.34 mg m(-3) were measured. The pattern of exposure was similar across factories, with highest exposures in the stripping (GM 2.08-4.05 mg m(-3) for the 3 factories) and tumbling departments (1.11-2.17 mg m(-3)). Within-worker (day-to-day) variability contributed 92% to total variability. The Hev b 6.02 exposure pattern was similar with time-weighted average GM exposure levels in the oldest factory ranging from 8.7 mg m(-3) in the laboratory to 30.2mg m(-3) in the stripping department. In contrast to inhalable dust exposure, total exposure variability was primary driven by variability between workers (67%). Conclusions Workers in these latex product factories get routinely exposed to measurable Hev b 6.02 levels, which may give rise to increased incidence of allergic symptoms and occupational asthma. Also, in this measurement campaign a 10mg m(-3), but not 15 mg m(-3), occupational exposure limit for inhalable dust was occasionally exceeded. Highest Hev b 6.02 exposures were found in the stripping and tumbling departments, which would be natural targets for interventions aimed at reducing exposure.

Background Health care workers (HCWs) who use latex gloves regularly are at a significant risk for developing allergic sensitization to natural rubber latex (NRL) proteins. The airborne route of exposure presents a hazard for sensitization and subsequent allergic symptoms. Objective The purpose of this study was to measure the content of the NRL proteins in the air of work areas (laboratories, treatment rooms, operating rooms, examination rooms, and dentist's treatment rooms) in eight Moscow hospitals where the employees used powdered latex gloves. Methods The air samples were collected by a volumetric filtration method using a static air sampler at a flow rate of 3 L/second. Airborne particles were collected onto polytetrafluoroethylene filters rated 99.9% efficient at 0.3 μm. The NRL allergens were extracted from the air filter samples in phosphate-buffered saline and quantified by an inhibition immunoassay using a five-person pool of sera containing latex-specific human immunoglobulin E. Results The airborne latex allergen concentrations in 11 areas (including positive control) where latex gloves were used varied from 5 to 26 ng/m 3 . Conversely, in 12 areas where latex gloves were seldom used or where powdered-free latex gloves were used allergen levels were not detectable (including two negative controls). The highest concentration of latex allergen (26 ng/m 3 ) was found in an examination room of a gynecology department. Low and moderate concentrations were detected in most operating rooms, and low concentrations in the laboratories and treatment rooms. Conclusions This study indicates that, in general, the airborne NRL concentrations in the work areas of Moscow hospitals are rather low compared with NRL concentrations reported from American hospitals and are dependent on the intensity of latex glove usage.

Frequent latex glove use is a risk factor for the development of latex allergy. With the increase in latex glove use, latex allergy has become more prevalent. There are a number of occupational groups in which the use of latex gloves is both inappropriate and even hazardous, including food handlers, where the hazard relates particularly to their latex-sensitive customers. The aim of this study was to assess both the use of latex gloves by food handlers and the impact of an intervention study on reducing latex glove use. This was done at the Queen Victoria Market in Melbourne, Australia. We found that 10 out of 30 stalls (33%) used latex gloves, and that following a short education program, this was reduced to 1 stall (3%, p=0.006). The potential to reduce latex glove use by using this intervention study was 93% (95% confidence interval of 54% - 100%). We recommend that food handlers be educated during their training, not only about hygiene issues, but also about the appropriate type of glove to wear, in order to prevent both the development of a new occupational group at risk of becoming allergic to latex, but more importantly to protect their latex-sensitive customers.

Background: Barrier creams are important to protect the skin in occupations with chemical exposure. The value of hydrogels in barrier creams has never been studied. Objective: The purpose of this study was to evaluate the current technology in barrier cream formulation and explore the utility of hygrogels in skin protection. Methods: A total of 80 men, women, and children between the ages of newborn to 80 years >were studied with the following dermatologic conditions: household hand dermatitis (21), occupational hand dermatitis (18), latex glove irritant contact dermatitis (9), diaper dermatitis (5), cutaneous wounds (17), and allergic contact dermatitis (ACD) (10). In this study, the investigators used a split body approach, in a double-blind randomized fashion, where one body site was treated with a traditional petrolatum-based cream while the other body site was treated with a hydrogel-based barrier/repair cream. Both subject and investigator assessments were recorded by questionnaire. Results: The hydrogel barrier/repair cream showed better skin improvement than the petrolatum-based cream in both subject assessment (62%, P = .0048) and investigator assessment (75%, P = .0000003). Conclusion: Hydrogel barrier/repair creams might represent a new, effective approach to skin protection.

Latex hypersensitivity can pose a threat to anyone, but health-care providers are among the high-risk groups for developing latex hypersensitivity. Latex hypersensitivity likely results from health-care workers' increased use of gloves following implementation of universal precautions. It is also believed that the antigenic load of latex gloves causes an increase in latex hypersensitivity resulting from massive production of gloves. Although there are many studies on the prevalence of latex hypersensitivity among health-care workers, there appear to be discrepancies, which may affect the different apparent prevalence. Testing for latex hypersensitivity raises another problem. Latex allergens cannot be identified specifically; therefore, there is no standard test or testing solution that can identify hypersensitive persons. Although latex glove hypersensitivity was first identified in the late 1970s, there remain many uncertainties associated with it; as a result, there is a growing concern among health-care providers. The authors offer several precautions to avoid the development of latex hypersensitivity.

1. The prevalence of latex allergy in health care workers is estimated to be between 10% and 17%. 2. Reactions from wearing latex gloves can include irritant contact dermatitis, allergic contact dermatitis, and contact urticaria from latex proteins. 3. Individuals with a history of atopy, multiple surgeries early in life (particularly with bladder catheterization), or allergies to certain foods are considered at risk of latex allergy. 4. An early intervention protocol and documentation forms are offered for occupational health nurses faced with assessing potentially latex allergic employees.

Even though the advantages of thoracoscopy for complicated pleural empyema are well recognized by most authors, the initial access and the creation of an acceptable surgical field are difficult. The authors describe an original technique that makes this procedure easier to perform in these cases. Five patients with a mean age of 86 months (range 10 months to 14 years) with complicated pleural empyema are presented. All patients received general anesthesia. A device made with a finger of a latex glove was attached to a disposable intravenous (IV) plastic infusion set BT-26 Biom® with 4-0 silk and inserted through the first trocar. At the remaining end of the IV plastic infusion set, a 60-ml syringe was attached. The balloon (finger of a latex glove) was insufflated inside the thorax with 300–500 ml of saline. Then the device was deflated and removed, and an acceptable surgical field was therefore created. The procedure was satisfactory in all five patients. Mean surgical time was 64 min (range 40–...

The permeability of four glove materials to various antineoplastic drugs was studied. Eighteen antineoplastic drugs posing potential health hazards to handlers were prepared at the highest concentrations normally encountered by hospital personnel. Four glove materials-nitrile rubber, latex, polyurethane, and neoprene-were exposed to the drugs for 30, 60, 90, and 120 minutes. Glove thickness was measured with an electronic digital caliper. Random samples of material were selected from the glove fingertips, and triplicate samples were tested for each drug at each interval. For a majority of the drugs, a bacterial mutagenicity assay was used to measure the amount of drug (if any) that permeated the material. High-performance liquid chromatography was used for drugs not tested with the bacterial assay. The nitrile gloves were the thinnest (0.12 mm), and the latex gloves were the thickest (0.18 mm). The four materials were generally impermeable to each drug. One sample of the nitrile gloves appeared to have a defect, allowing >5% of the drug solution to pass through at 30 minutes. One sample each of the latex, polyurethane, and neoprene gloves demonstrated minimal permeability (< or =1%): One latex glove sample was permeated by carmustine, and paclitaxel permeated one sample each of the polyurethane and neoprene materials. Nitrile rubber, latex, polyurethane, and neoprene gloves were impermeable to 18 antineoplastic drugs in most, but not all, cases.

A golfer presented with facial and hand eczema. He had exacerbations of his hand eczema prior to golf tournaments. Being an authorized golf club repairman, he had been working with a two-part glue containing an epoxy resin (ER) based on diglycidyl ether of bisphenol A (DGEBA) and the hardener diethylenetriamine (DETA) for approximately 4 years before he developed any skin problems. He was patch-tested with the standard, which contains an ER based on DGEBA (DGEBA-R), epoxy (containing DETA), and rubber glove series and had positive reactions to DGEBA-R only. Other work materials (a latex glove, a golf glove made of leather, and part of the handle of his own golf club "as is" and in a methyl tert-butyl ether extract) were tested, with negative results. Allergic contact dermatitis from ER affects the skin by direct contact; the dermatitis is usually localized to the hands and forearms. If the face and eyelids are involved, the dermatitis may be due to exposure to airborne hardeners or reactive diluents, exposure to airborne dust from residual monomers, or ectopic allergic reactions. Our repairman had sandpapered an old glued surface, which may have led to possible airborne dust formation, thus explaining the facial eczema. Therefore, a worker with contact allergy to ER may continue working provided the skin is protected from contamination.

Objective To describe an innovative approach for enclosed morcellation using a surgical glove in multiport laparoscopic surgery. Methods Power morcellation was performed within an insufflated surgical glove in a completely enclosed manner between January and May 2014. The specimen was placed into the glove within the abdomen. The glove opening and thumb were exteriorized through the umbilical and left lower abdominal trocar incisions, respectively. The optical trocar and optic were inserted into the glove, which was then insufflated. The thumb tip was cut, and a power morcellator was inserted through this finger. The morcellation was accomplished within the completely enclosed glove. The thumb tip was closed, and the glove, containing residual specimens and bloody fluid, was removed from the abdomen through the umbilical incision. Thus, the risks of bag piercing and leakage during contained power morcellation were eliminated. Demographic and operative data were collected and analyzed for all cases. Results Thirty multiport laparoscopic myomectomy and morcellation procedures were performed during the study period. The median operative time was 85 minutes (range 60-140 minutes). The median morcellation preparation time, total morcellation time, and withdrawal time were 6 (range 4.5-14), 32 (range 15-55), and 1.2 (range 1-1.5) minutes, respectively. No intraoperative complications or bag ruptures were recorded. Conclusion With our innovative technique, a disposable latex glove can be used for an enclosed morcellation that avoids piercing the enclosure container within the abdominal cavity, thereby offering decreased risks related to bag perforation and leakage compared with previous contained power morcellation techniques. Level of evidence III.

Objectives: (a) To compare the effectiveness of five cloth gloves for cut resistance and their ability to prevent inner latex glove perforation. (b) To evaluate the safety, efficacy, and comfort of the outer gloves when reused. Setting: Tertiary care level I trauma hospital and biomechanics laboratory. Methods: Laboratory evaluation consisting of assessing cut resistance and fabric deterioration and clinical assessment of all cloth gloves worn as a liner between two latex gloves. Results: Laboratory testing demonstrated significant differences in cut resistance, with gloves divided into three groups: most resistant (Centurion®, which required over 3,000 slices or 1,300 chops to failure), resistant (MedArmor®, failing at eighty-five slices or 121 chops; Paraderm®, failing at thirty-eight slices or ninety-four chops; and Repel®, failing at forty-six slices or seventy-five chops), and least resistant (Protek®, failing at two slices and less than two chops). Clinically, 3 percent of all the inner latex gloves demonstrated a perforation, with no violation of the skin in any of the five types of cloth gloves used. Only the Protek and MedArmor cloth gloves were positively ranked for comfort. Conclusion: All gloves provided equal prdtection with respect to inner latex glove perforation during all of the orthopaedic procedures, with comfort being the most important variable. Gloves should be selected based on comfort, because it appears that all gloves provide equal protection during surgery regardless of the material woven into the fabric.

Occupationally related hand dermatitis has been attributed to frequent hand-washing, exposure to possible sensitizers and latex glove use. The authors conducted a study to determine the prevalence of occupationally related hand dermatitis in dental personnel. They found that 75 (19.2 percent) of 390 subjects self-reported they had a positive history of hand dermatitis. Further testing of 53 of these subjects indicated that only 9.4 percent reacted to the 45 allergens tested, and 3.8 percent had an allergy to latex.

1. The increased use of natural rubber latex barrier protection to prevent exposure to bloodborne pathogens has led to an increase in latex related health reactions, particularly associated with glove use. 2. The three types of reactions to latex in order of frequency include irritant contact dermatitis, allergic contact dermatitis, and immediate systemic/anaphylaxis reactions. 3. The management goal for all reactions is to avoid unnecessary restriction from the appropriate use of latex (gloves) which provides the best barrier protection, while protecting individual workers from exposure that results in sensitization or causes sensitized individuals to have serious reactions. 4. Choose non-latex gloves when barrier protection from bloodborne pathogens is not an issue. When selecting a latex glove, choose a glove that is low in proteins and powder free to control airborne latex exposure.

The importance of stress or fatigue as a source of latex glove failure has been mentioned in several recent studies, but little work has been done to examine the underlying mechanism of these failures. The present work was undertaken to develop techniques for very early detection of structural changes in glove barriers. This was accomplished by monitoring the ion permeability and electrical properties of vulcanized latex glove material during cyclic fatigue in saline. Alteration in the conductance and capacitance of the membrane during the fatigue cycle showed that catastrophic failure of the material was preceded by deviation in the conductance of the membrane 8–10 min before rupture of the material. Disruption of the material coincided with capacitive “discharge” of and ion transport across the membrane. Follow-up examination by optical (100×) and scanning electron microscopy (SEM) revealed failure of the original fibril network structure surrounding the latex particles. Failure corresponded to processes consistent with repeated stress and rupture of the fibrils responsible for maintaining membrane integrity. Cyclic creep-strain measurements were carried out on the latex glove material. The estimated strain during cyclic fatigue was consistent with use during normal flexing of the glove finger. The fatigue life-time of the glove material was found to be about 2 h. Based on these studies, we conclude that failure of the glove material due to hole formation is preceded by gradual thinning (and weakening) of the membrane in localized regions. This suggests that latex inhomogeneities (defects) are the ultimate cause of failure. These findings confirm the importance of stress in explaining the source of some glove material failures, especially those failures not obviously accompanied by sharp instrument or needle penetrations. The results of the fatigue study emphasize the importance of changing gloves during prolonged use. © 1997 John Wiley & Sons, Inc. 1 J Appl Polym Sci 64 553–566, 1997

The steady increase in anaphylactic reactions to latex medical gloves has raised increasing awareness in the medical community. Even gloves claimed to be hypo-allergenic still may contain substantial amounts of IgE-binding proteins. We have studied non-powdered latex and synthetic examination glove extracts for their allergenicity using the immunoblot technique. Protein levels varied considerably among glove extracts and the amount did not always correlate with the presence of allergenic proteins. IgE binding proteins were found in 2 of the 7 powder-free latex glove brands. Synthetic glove extracts did not contain allergens. The study demonstrates that immunoblot analysis is a useful technique in order to select gloves with a minimal risk to raise IgE antibodies.

Introduction: The most difficult step of percutaneous renal surgery is to obtain an appropriate access to the renal cavities, which reduces the risk of vascular injury and leads to a bette...

The effect of wearing gloves on timely muscle reaction to stabilize handle perturbation was investigated. Thirteen adults gripped a horizontal overhead handle to which an upward force was applied at a random time. Muscle reaction time, integrated EMGs for eight muscles, and handle displacement were compared among three glove conditions affecting the coefficient of friction (COF=0.32, 0.50, and 0.74 for a polyester glove, a bare hand, and a latex glove, respectively). A lower COF increased the integrated EMGs and handle displacement until the perturbed handle was stabilized. The low-friction glove resulted in a 16% greater muscular effort (p = 0.01) and a 20% greater handle displacement (p = 0.002), compared with the high-friction glove. The muscle reaction time was not influenced by the glove condition. Spinal reflex eliciting forearm muscle activity in response to the change in pressure at the hand appears to depend on somatosensation. The spinal reflex with a short latency time may play an important role in the initial response to a perturbation. The latissimus dorsi muscles as well as the forearm muscles show a large activity level compared with other shoulder and upper arm muscles and may play a major role in the later stabilization of the perturbed handle. Therefore, low-friction gloves, sensory dysfunction, and weakened forearm and latissimus dorsi muscles may jeopardize persons’ ability to stabilize a grip of a handle after perturbation.

This paper presents the case of a cadaver buried in a pine grove, in loamy soil at a depth of about 1.8 m. The case is quite interesting due to the fact that one hand of the victim was bare and the other one was clad in a latex glove. In the laboratory, the severed hands were gently washed with water. The left palm exhibited signs of advanced decomposition. The ridges were visible only on the thumb. The gloved hand was found to be in much better condition. There were signs of saponification on the palm. Ridges on both the palm and all fingers were visible. The fingers of the right hand, palm prints, and the thumb of the left hand were successfully matched against a ten-print card. The match provided the police with a positive identification of the missing person.

Natural rubber-degrading microorganisms were isolated from waste of rubber processing factory in Cam Thuy of Vietnam. Four of them belong to Streptomyces sp. that showed the higher abilities for natural rubber degradation than the others. They are able to use both deproteinised natural rubber (DPNR) and synthetic rubber cis-1,4-polyisoprene (SR) as a sole source of carbon. Gel permeation chromatography (GPC) analysis revealed that these strains degraded DPNR and SR to low-molecular-weight products. The growth of isolates occurs essentially on the latex glove pieces after one month of incubation in mineral salt medium. The total nitrogen contents of glove pieces were determined using Kjeldahl method, which were 10-20 times higher than that in un-inoculated sample. Moreover, the degradation was also confirmed by observing the growth of isolates on glove’s surface using scanning electron microscopy (SEM).

BACKGROUND: Nonammoniated latex, ammoniated latex, and latex glove extracts have been used as source materials for the preparation of allergenic extracts for the diagnosis of latex allergy. These materials showed different patterns of protein bands and immunoreactive bands. However, their IgE–reactive repertoires were not compared. OBJECTIVE: The goals of this study were to compare the IgE reactivity and to define the common IgE–reactive epitopes among three latex allergenic extracts. METHODS: Two serum pools were obtained from adults and children with latex allergy to evaluate the IgE reactivity among three latex extracts. IgE reactivity and IgE–reactive proteins were compared by inhibition ELISA and inhibition immunoblot methods, respectively. RESULTS: In this study inhibition curves were similar for nonammoniated latex and ammoniated latex but were different when the latex glove extracts were used. Several protein bands of ammoniated latex and latex glove extracts could not be inhibited by the nonammoniated latex. The ammoniated latex and latex glove extracts were able to remove all the latex-specific IgE from the serum. CONCLUSION: The IgE–reactive proteins differ among different latex extracts. Ammoniated latex and latex glove extracts contain more complete immunoreactive repertoires for detecting IgE antibodies. Our study provides useful information for selecting the latex extract. (J ALLERGY CLIN IMMUNOL 1996;97:1116-20.)

New puncture and cut resistant hand protection systems have been developed to enhance the barrier to cuts and needle puncture injuries during surgical procedures. It is important, however, that these new hand protection systems do not reduce tactile sensitivity or dexterity during surgery. Consequently, it was the purpose of this report to compare the cutaneous sensibility and dexterity of physicians' hands covered by these new puncture and cut resistant hand protection systems to that of the standard surgical latex glove. The hide (Medak) portion of the Life Liner and the polyethylene (Spectra) portion of the FingGuard, which offered the greatest resistance to needle puncture, were associated with the greatest reduction in cutaneous sensibility, as determined by moving and static two-point discrimination, aesthesiometer pressure sensation, and discrimination of suture size and configuration. In addition, the physicians believed that the puncture and cut resistant Life Liner glove liner markedly interfered with their handling of surgical instruments. The ultimate benefit of these puncture and cut resistant hand protection systems must be determined in well-controlled clinical trials.

Over the last decade the use of latex examination gloves by dental professionals has increased significantly. The proliferation in latex glove use is primarily due to recommendations and guidelines established by both the Centers far Disease Control and the Occupational Safety and Health Administration. Because a significant number of dental professionals are wearing latex examination gloves, it is important to understand the limitations and restrictions associated with wearing these gloves. This study investigated the effects of hand condition on three-jaw chuck pinch strength, power grip strength and manual dexterity. Hand condition consisted of three levels: (1) bare hand, (2) hand with a normal sized latex examination glove and (3) hand with a tight fitting latex examination glove. The results of the study indicated that latex examination gloves do not have an effect on three-jaw chuck pinch strength or power grip strength. However the study suggested that ill-fitting latex examination gloves significantly reduce manual dexterity.

An in-vitro study was carried out to investigate the effects of contamination of the porcelain surface on the shear-bond strength of a dual-cure composite luting cement to etched, silanated porcelain. Furthermore, the effects of different cleaning regimens were studied. A total of 390 etched, silanated porcelain specimens were randomly divided into 13 groups of 30. Shear-bond strengths were measured for a control group and for specimens contaminated with saliva, die stone, and latex gloves. Freshly contaminated samples were subject to three cleaning regiments; water wash and dry, cleansing with acetone, and cleansing with 37% phosphoric acid gel. Bond strengths to the cleansed surfaces were measured. Weibull analysis and analysis of variance were applied to the results. Saliva and latex glove contamination did not significantly affect shear-bond strength. Die stone contamination markedly reduced the bond strength and cleaning did not restore the bond strength for these specimens. Contact between porcelain veneers and stone models should therefore be avoided. The wash/dry and phosphoric acid cleaning regimens did not significantly improve or reduce bond strengths for contaminated specimens. Acetone cleaning produced a marked reduction in bond strength under all experimental conditions and should not be used.

In the previous chapter, we learned that both optical and electrochemical immunosensors can be implemented in a microchannel to facilitate rinsing steps that are labor-intensive and require a skilled operator. In fact, there have been attempts to provide a higher level of automation and to increase ease of use for immunosensors (and certainly other biosensors as well), through fabricating more complicated microchannels. These attempts have usually been achieved by utilizing a concept known as lab-on-a-chip.

To determine the quantity, variability, and mean aerodynamic diameter of latex aeroallergens in a large medical center, we collected air samples from work sites by using area and personal breathing zone air samplers, and we measured latex allergens by an inhibition assay with IgE antibodies from latex-sensitive individuals. Latex aeroallergen concentrations in 11 areas where powdered latex gloves were frequently used ranged from 13 to 208 ng/m3, and in areas where powdered latex gloves were never or seldom used, concentrations ranged from 0.3 to 1.8 ng/m3. Installation and use of a laminar flow glove changing station in one work area did not reduce latex aeroallergen levels. Large quantities of allergen were recovered from used laboratory coats and anesthesia scrub suits and from laboratory surfaces. Latex allergen concentrations in personal breathing zone samplers worn by health care workers in areas where powdered gloves were frequently used ranged from 8 to 974 ng/m3. Exposure likely occurs when gloves are changed and as a result of resuspension from reservoirs of powder in the room and clothing. Latex allergens were found in all particle sizes but were predominant in particles greater than 7 microns in mass median aerodynamic diameter. Results of electrophoretic immunoblotting showed that the aeroallergens are primarily the higher molecular mass components of the latex glove proteins. Measures to control exposure can be monitored by both area and personal air sampling with this immunochemical approach. Use of gloves with low allergen content or powder-free gloves appears to be more effective than use of a laminar flow glove changing station in reducing aeroallergen levels.

Background and Objective.Wearing of gloves reduces transmission of organisms by healthcare workers' hands but is not a substitute for hand hygiene. Results of previous studies have varied as to whether hand hygiene is worse when gloves are worn. Most studies have been small and used nonstandardized assessments of glove use and hand hygiene. We sought to observe whether gloves were worn when appropriate and whether hand hygiene compliance differed when gloves were worn.Design.Observational study.Participants and Setting.Healthcare workers in 56 medical or care of the elderly wards and intensive care units in 15 hospitals across England and Wales.Methods.We observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Observers also recorded whether gloves were or were not worn for individual contacts.Results.Gloves were used in 1,983 (26.2%) of the 7,578 moments for hand hygiene and in 551 (16.7%) of 3,292 low-risk contacts; gloves were not used in 141 (21.1%) of 669 high-risk contacts. The rate of hand hygiene compliance with glove use was 41.4% (415 of 1,002 moments), and the rate without glove use was 50.0% (1,344 of 2,686 moments). After adjusting for ward, healthcare worker type, contact risk level, and whether the hand hygiene opportunity occurred before or after a patient contact, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54-0.79]; PConclusion.The rate of glove usage is lower than previously reported. Gloves are often worn when not indicated and vice versa. The rate of compliance with hand hygiene was significantly lower when gloves were worn. Hand hygiene campaigns should consider placing greater emphasis on the World Health Organization indications for gloving and associated hand hygiene.Trial Registration.National Research Register N0256159318.

Substantial exposure to isocyanates may occur during spray painting in autobody shops, yet information is lacking on the efficacy of the protective clothing used during spray painting. We investigated the personal and workplace factors associated with painters' dermal protection use during a large-scale exposure assessment study. Survey data indicated that 69% of painters always used gloves, with latex gloves (47%) and nitrile gloves (34%) used most frequently. Among latex glove users, 53% used thin latex (0.05-0.13 mm), 6% used medium latex (0.15-0.20 mm), and 12% used thick latex (0.20 mm). Among nitrile glove users, 27% used thin nitrile and 45% used medium nitrile. Sixty-three percent of painters always used coveralls, 44% preferring one particular brand. Although overspray presents an opportunity for dermal exposure to the neck and face, only 19% of painters protected these areas with personal protective equipment. Painters who always used coveralls were more likely to use gloves (odds ratio = 7.9, p = 0.061). Painters who reported ever having smoked cigarettes used gloves (p = 0.05) and coveralls (p = 0.04) more frequently. Painters who sprayed more than 34 clear coat jobs per month used coveralls most frequently (p = 0.038). Exact logistic regressions along with random sample calculations indicated that the survey results were independent of the shops. Because of the small sample size in this study, future research is warranted to corroborate these results. Studying the effectiveness of gloves and coveralls against polyurethane paints and understanding the underlying motivators and preferences for painters and business owners is needed for the development of best practices for the selection and use of dermal protection.

This paper reported an improvement to the previously proposed maximum-minimum variation (MMV) test for protein estimation. The proposed method utilizes single protein test as compared to three protein tests for MMV. In addition, a new computerized algorithm namely maximum-minimum area variation (MMAV) has been proposed in order to estimate the protein concentration in the latex glove. The new proposed technique, give significantly better results in terms of consistency and accuracy than existing methods. Besides, the method reduces the chemicals usage, lab consumables, and the need for certain hardwares. Thus, it is more environmental friendly.

When a survey was distributed to students, faculty and staff of a dental school to determine the incidence of latex glove reactions, 15 percent reported adverse reactions to glove use. The most frequently reported symptom was dermatitis, followed by urticaria, sweating, conjunctivitis and rhinitis.

Objectives: Design, construct, and characterize an apparatus to evaluate dermal protective clothing for resistance to polymerizing materials. Specifically, we evaluated the permeation of the most common glove material used in automotive collision repair (0.10‐0.13 mm or 4‐ 5 mil latex) with representative isocyanate-containing clear coats. Our ultimate goal is to make informed recommendations on dermal protective materials to prevent isocyanate exposures and reduce the likelihood of occupational illness in automotive collision repair and other industries. Methods: A novel permeation panel was developed to assess dermal protective clothing. With this apparatus, up to eight test materials may be evaluated under typical-spray application conditions. Solid collection media comprised of 1-(2-pyridyl)-piperazine (2-PP)-coated fiberglass filters or colorimetric SWYPE pads were placed behind test materials to capture permeants. The 2-PP-coated filters were subsequently analyzed using a modified OSHA42/ PV2034 method. Color change in the SWYPEs provided an immediate field estimate of breakthrough time. In addition, Teflonfilters were mounted proximal to the permeation cells to measure the mass of clear coat applied to the panel and to evaluate loading homogeneity. This study evaluated the permeation of isocyanates through 0.10‐0.13 mm latex glove material at a fixed time (30 min post-spraying) and over a time course (6‐91 min post-spraying). Results: Monomers 1,6-hexamethylene diisocyanate (HDI) and isophorone diisocyanate (IPDI) permeated through (0.10‐0.13 mm) latex glove material under typical glove use conditions (30 min). The latex glove material exhibited immediate breakthrough, with a permeation rate of 2.9 ng min 21 cm 22 . The oligomeric forms of HDI and IPDI did not permeate the latex glove material. The spray application at 71 6 5F was fairly homogeneous (33.7 6 8 mg weight of dry clear coat per 5 cm 2 ). Conclusions: The permeation panel is a viable method to assess dermal protective clothing performance against polymerizing materials. Thin (0.10‐0.13 mm) latex gloves were determined to be ineffective barriers to the isocyanates commonly found in clear coats. Because this type of glove is used frequently in auto body shops, the potential for isocyanate exposure is of concern. Permeation tests with other dermal protective clothing materials and other clear coat formulations are needed to make recommendations about alternative materials.

Latex allergy is an important concern from an occupational safety aspect and affects compliance of glove usage, which directly influences infection control practices aimed at providing safe medical care for both the health care worker (HCW) and patient. The Dr george Mukhari Hospital (DgM) in Pretoria has a staff complement of 1500 doctors and nurses who use latex gloves occasionally or regularly. The objective for this study was to evaluate the current prevalence of latex allergies and staff awareness of latex glove allergies as well as the availability of alternatives. occupational health and laboratory records were reviewed for evidence of latex allergy and a crude rate of 4% was determined in this study population over the study period. Interviews assessing HCW knowledge and practices regarding latex glove allergy and alternatives were performed using a questionnaire. Results from the interviews identified numerous gaps in knowledge regarding latex allergies and alternatives even amongst those who had latex allergies.

Currently, health workers including residents and fellows do not have a suitable phantom model to practice the fine- needle aspiration biopsy (FNAB) procedure. In the past, we standardized a model consisting of latex glove containing fresh cattle liver for practicing FNAB. However, this model is difficult to organize and prepare on short notice, with the procurement of fresh cattle liver being the most challenging aspect. Handling of liver with contamination-related problems is also a significant draw back. In addition, the glove material leaks after a few needle passes, with resulting mess. We have established a novel simple method of embedding a small piece of sausage or banana in a commercially available silicone rubber caulk. This model allows the retention of vacuum seal and aspiration of material from the embedded specimen, resembling an actual FNAB procedure on clinical mass lesions. The aspirated material in the needle hub can be processed similar to the specimens procured during an actual FNAB procedure, facilitating additional proficiency in smear preparation and staining.

Overview of Health and Safety in the Health Care Environment, D. A. Sterling Epidemiology, J. M. Boiano, J. P. Sestito, S. E. Luckhaupt, C. F. Robinson, and J. T. Walker Back Injury Prevention in Health Care, W. Charney, A. Hudson, S. Gallagher, J. D. Lloyd, A. Baptiste, A. Nelson, J. A. Haley, M. Matz, B. D. Owen, A. Garg, J. Villeneuve, J. Gilmore, and W. Martin Emerging Infectious Diseases, W. Charney, J. H. Lange, G. Mastrangelo, J. Lavoie, Y. Cloutier, J. Lara, G. Marchand, and Office of Emergency Preparedness Disinfection and Infection Control, E. J. Stewart, R. N. Olmsted, P.-G. Zanoni, L. Lee, J. Millogo, and K. M. Duesman Progress in Preventing Sharps Injures in the United States, J. Doe, J. Perry, A. E. Gomaa, J. Jagger, and Emergency Care Research Institute Violence in the Health Care Industry, J. Lipscomb, J. Rosen, M. London, K. McPhaul, J. A. Simonowitz, California Occupational Safety and Health Administration, and Service Employees International Union Prevention of Slip, Trip, and Fall Hazards for Workers in Hospital Settings, J. W. Collins and J. L. Bell Ergonomics, M. Wan, Kaiser Permanente, J. Villeneuve, and G. Fragala Chemodrugs, T. P. Fuller Tuberculosis Engineering Controls, L. M. Conroy, J. E. Franke, B. S. Tepper, J. Mehring, D. Hodge, D. Kass, W. Charney, J. Fisher, C. Ishida, P. M. Sutton, M. Nicas, and R. J. Harrison Electrocautery Smoke: Reasons for Scavenging, J. D. Paz, Stackhouse, Inc., National Institute for Occupational Safety and Health, L. V. Kayman, Association of Operating Room Nurses, W. Charney, S. Miller, S. Campbell, and B. Reynolds Safe Use of Ethylene Oxide in the Hospital Environment, A. R. Reich Monitoring Aldehydes, E. W. Finucane and W. Charney Pentamidine, W. Charney, L. Rose, and P. Quinlan Ribavirin, J. Bellows, R. J. Harrison, W. Charney, K. J. Corkery, R. Kraemer, and L. Wugofski Trace Anesthetic Gas, E. W. Finucane, A. Schapera, W. Charney, P. A. Heinsohn, and D.L. Jewett Cost-Benefit, W. Charney and D. Maynes Clinical Approach to Glove Dermatitis and Latex Allergy, D. Shusterman Latex Glove Use: Essentials in Modern Hospital Safety, W. M. Truscott Health and Safety Hazards of Shiftwork: Implications for Health Care Workers and Strategies for Prevention, J. Schirmer Radiation Protection in Hospitals, J.-P. Gauvin Reproductive Hazards in Hospitals, L. V. Kayman Medical Waste, M. L. Garvin, H. B. Kuhn and E. Peters The Occupational Hazards of Home Health Care, E. Askari and B. DeBaun Caring Until It Hurts: How Nursing Work Is Becoming the Most Dangerous Job in America, Service Employees International Union Laboratory Safety, W. Wood Biological Exposure Index Testing: Two Case Studies, W. Charney, M. Lipnowski, and L. Wugofski Functions and Staffing of a Hospital Safety Office, L. V. Kayman and J. F. Clemons Education for Action: An Innovative Approach to Training Hospital Employees, M. Weinger and N. Wallerstein Stress Factors, L. A. Job, W. E. Shearn, K. Kahler, J. Pearl, and M. McDonald Case Studies of Health Care Workers in the Compensation System, L. S. Colbert Index

An improvement to previously proposed maximum-minimum variation (MMV) test for protein levels quantification is reported. The additional process is artefacts segmentation in latex glove sample by using k-means clustering algorithm. The new proposed maximum-minimum clustering variation (MMCV) technique, give significantly better results in terms of consistency and accuracy than existing methods.

While we are asleep, forests, meadows, and fields teem with nocturnal mammals. Dramatic scenes of predation take place, all unseen by humans. In this exercise, we will learn how to indirectly record such nocturnal interactions between predator and prey.

The wide range of problems that occur in association with occupational skin exposure has brought into focus the need to understand the role of allergens in skin disease. Their impact on health, their role in the causation of skin disease, and the measures that can be instituted to regulate, control, and prevent skin problems are receiving increased attention by OR managers because of the associated costs of skin reactions in OR nurses and the inherent dangers associated with latex allergy. Latex gloves have become a standard part of OR attire, and even though they serve as the primary form of hand protection in the OR, gloves also may serve as one of the key causes of contact or allergic dermatitis in OR personnel. The high frequency of latex glove allergy, especially in OR nurses and surgeons, focuses attention on the need to evaluate the type and quality of surgical latex gloves selected for use. When instances of new skin reactions appear in nursing personnel. OR managers should look for recent changes in glove brands, scrub products, or antimicrobial agents as possible trigger allergens. In such circumstances, managers may wish to use hypoallergenic products as a solution. Although hypoallergenic and/or powder-free gloves or scrub products may be more costly on a unit basis, when compared to the time lost from work, physical discomfort of the worker, and the expense of treatment, they are really quite a bargain.

Many women suffer from perineal pain following chilbirth injury, and this often has numerous negative consequences for them (Steen and Cooper, 1998). The majority of women in the UK will be advised to take regular baths and paracetamol (Sleep, 1990) to ease this pain. Some women will be offered icepacks, which are produced by either freezing a normal saline sachet, a water-filled finger from a latex glove, or even better, a condom!

The paper reports a cross-sectional study to determine the prevalence and type of symptoms, causal agents and awareness of latex glove reactions amongst four professional groups. The study was done at diagnostic imaging departments within ten major hospitals in Southeastern Nigeria. Radiologists/resident radiologists, radiographers, radiology nurses and darkroom technicians who were occupationally exposed to latex gloves were investigated between June and September 2006 to determine the level of latex hypersensitivity. The results show that prevalence is similar to that demonstrated elsewhere with 12.4% of individuals expressing latex associated symptoms. Symptoms included itching and redness of hands, dry cracked skin, soreness of eyes, and upper respiratory tract complaints. There are strong relationships between number of gloves used per day, duration of glove use and expression of symptoms. About 62.8% (n=76) of the respondents had previous knowledge of hypersensitivity reaction to latex gloves prior to this investigation. The paper concludes that latex hypersensitivity is a real problem amongst diagnostic imaging healthcare personnel in our locality. This preliminary work, therefore, provides the basis of a much larger controlled study in the future. African Journal of Health Sciences Vol. 15 (1&2) 2008: pp. 28-33

The frictional properties of rubber surfaces modified by various treatments have been investigated in order to understand the factors which reduce the friction and give the surface appropriate qualities for practical use. The study was in two stages. Initial measurements were made on thin sheets of hot-vulcanized natural rubber; then followed tests on latex glove material to see how the initial results and understanding related to the application. Measurements of friction coefficient were made against a wavy glass plate, giving reproducible results, and against finger skin. Supplementary measurements were made of surface roughness and hardness, liquid contact angle, and water absorption. Factors of importance in the reduction of dry friction were found to be an increased surface roughness and hardness. In practice, difficulties may be experienced under slightly wet or damp conditions, which can increase the friction above the dry value. Here it was found to help if the surface treatment could absorb water. For surgeons' gloves in contact with moist skin, one particular treatment, a hydrogel polymer coating, gave the necessary surface roughness, hardness, and water absorptivity, making the gloves easy to don and pleasant to wear.

BACKGROUND Surgery on digit and nail requires a clear bloodless field that is often achieved by a tourniquet. OBJECTIVE The objective is to present a simple, effective, and safe tourniquet for digital surgery. MATERIALS AND METHODS A latex glove and a nylon zip-tie were used. A long strip is cut from the little finger tube of a latex glove. This is used for wrapping around the digit for exsanguination. The pressure is then maintained with a household nylon zip-tie. The finger strip is then cut to expose the operative field ready for surgery. The tourniquet pressure can be adjusted by tightening or loosening of the nylon zip-tie. RESULTS Exsanguination and a bloodless field can be effectively achieved. The long tail of the nylon zip-tie reminds the operator to remove it at end of the surgery. CONCLUSION A latex strip and nylon zip-tie combo serves as a simple, effective, and safe tourniquet for digital surgery.

Powder flew into the air as the size 7-and-a-half latex glove snapped snuggly onto my right hand. I jockeyed sideways, turned and then sunk my left hand into its awaiting outstretched glove. The scrub nurse's blue eyes floated about her surgical mask, drifting north, south, east and west as I

This study was conducted to evaluate the effect of normal use on latex glove integrity in a flow cytometry laboratory. The gloves were tested using the 1,000 microL water-tight test and met industrial standards (less than 4% leakage) before, but not after use. More durable gloves, or more frequent changes of gloves, may be needed to ensure adequate barrier protection for laboratory workers during routine procedures.