Impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among healthcare workers of an intensive care unit: a quasi-experimental study.

BACKGROUND/OBJECTIVE: After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU). METHODS: A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual's percentage of compliance using the t test for paired data before and after the intervention. RESULTS: Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% confidence interval [CI] 51-59%) using powdered latex gloves and 60% (95% CI 57-63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI 2.5-7.6%, p < 0.001). CONCLUSION: Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

[Hand eczema in COVID-19 outbreak: whether or not to wear gloves?] / Handeczeem in tijden van corona.

Because of COVID-19 outbreak people wash more often their hands and use more often and longer disposable gloves. The natural skin barrier function is damaged by washing hand or using disinfectants, because of this allergic and irritative hand eczema develops. Allergic hand eczema can be caused by materials which people work with, and by ingredients of creme and soap, but also by wearing gloves. To prevent hand eczema, good protection of the hands is essential. It is very important to have knowledge about different gloves to inform (health) worker about wearing gloves in the proper way.

Permeation of limonene through disposable nitrile gloves using a dextrous robot hand.

OBJECTIVES: The purpose of this study was to investigate the permeation of the low-volatile solvent limonene through different disposable, unlined, unsupported, nitrile exam whole gloves (blue, purple, sterling, and lavender, from Kimberly-Clark). METHODS: This study utilized a moving and static dextrous robot hand as part of a novel dynamic permeation system that allowed sampling at specific times. Quantitation of limonene in samples was based on capillary gas chromatography-mass spectrometry and the internal standard method (4-bromophenol). RESULTS: The average post-permeation thicknesses (before reconditioning) for all gloves for both the moving and static hand were more than 10% of the pre-permeation ones (P≤0.05), although this was not so on reconditioning. The standardized breakthrough times and steady-state permeation periods were similar for the blue, purple, and sterling gloves. Both methods had similar sensitivity. The lavender glove showed a higher permeation rate (0.490±0.031 µg/cm2/min) for the moving robotic hand compared to the non-moving hand (P≤0.05), this being ascribed to a thickness threshold. CONCLUSIONS: Permeation parameters for the static and dynamic robot hand models indicate that both methods have similar sensitivity in detecting the analyte during permeation and the blue, purple, and sterling gloves behave similarly during the permeation process whether moving or non-moving.

Transmission of vibration through gloves: effects of material thickness.

It might be assumed that increasing the thickness of a glove would reduce the vibration transmitted to the hand. Three material samples from an anti-vibration glove were stacked to produce three thicknesses: 6.4, 12.8 and 19.2 mm. The dynamic stiffnesses of all three thicknesses, the apparent mass at the palm and the finger and the transmission of vibration to the palm and finger were measured. At frequencies from 20 to 350 Hz, the material reduced vibration at the palm but increased vibration at the finger. Increased thickness reduced vibration at the palm but increased vibration at the finger. The measured transmissibilities could be predicted from the material dynamic stiffness and the apparent mass of the palm and finger. Reducing the dynamic stiffness of glove material may increase or decrease the transmission of vibration, depending on the material, the frequency of vibration and the location of measurement (palm or finger). Practitioner Summary: Transmission of vibration through gloves depends on the dynamic response of the hand and the dynamic stiffness of glove material, which depends on material thickness. Measuring the transmission of vibration through gloves to the palm of the hand gives a misleading indication of the transmission of vibration to the fingers.

Muscular responses to handle perturbation with different glove condition.

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 the polyester glove, bare hand, and latex glove, respectively). Lower COF increased the integrated EMGs and handle displacement until stabilization of the perturbed handle. The low-friction glove resulted in 16% (p=.01) greater muscular effort and 20% (p=.002) greater handle displacement, compared to the high-friction glove. Muscle reaction time was not influenced by glove condition. Cutaneous sensation and reflex eliciting forearm muscle activity appear to play an important role in detecting and responding to the perturbation initially, while the forearm and latissimus dorsi muscles primarily contribute to stabilizing the perturbed handle compared to other shoulder and upper arm muscles. Therefore, low-friction gloves, cutaneous sensory dysfunction, and weakened forearm and latissimus dorsi muscles may jeopardize persons' ability to stabilize a grip of a handle after perturbation.

Primary prevention of natural rubber latex allergy in the German health care system through education and intervention.

BACKGROUND: The development of occupational asthma and allergic skin reactions caused by natural rubber latex (NRL) allergy are risks for health care workers. There are few published studies to suggest that intervention programs to reduce exposure will lead to primary prevention of sensitization. OBJECTIVE: This study assesses the effects of intervention to reduce the incidence of NRL allergy in personnel working in health care facilities insured by the German statutory accident insurance company for health care workers, Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege, with approximately 3 million insured employees, by switching to powder-free NRL gloves. METHODS: The timing of introduction of intervention strategies, such as education of both physicians and administrators, together with regulations demanding that health care facilities only purchase low-protein, powder-free NRL gloves are reported. We reviewed the annual numbers of reported suspected cases of NRL-caused occupational allergies and the amount and type of gloves used in German acute-care hospitals since 1986. RESULTS: The purchase of powder-free NRL examination gloves exceeded that of powdered gloves for the first time in 1998. This only became true for powder-free NRL sterile gloves 2 years later in 2000. The incidence of suspected occupational NRL allergy cases rose until 1998 and has declined steadily since. There was a 2-year lag between the beginning of the decline in the purchase of powdered NRL examination gloves and the beginning of a decline in suspected NRL-caused occupational asthma cases. CONCLUSIONS: Despite the effect of increased recognition of NRL allergies, education about NRL allergies in health care facilities combined with the introduction of powder-free gloves with reduced protein levels has been associated with a decline in the number of suspected cases of occupational allergies caused by NRL in Germany on a nationwide scale. These results clearly indicate that primary prevention of occupational NRL allergies can be achieved if these straightforward and practical interventions are properly carried out and maintained.

Thermal properties of handwear at varying altitudes.

BACKGROUND: Total handwear insulation (I(T)) is dependent on the rate of heat transfer in air through the skin-handwear interface, handwear layers, and the surface boundary air layer. As altitude increases, the corresponding decrease in air pressure reduces convective heat loss. As convective heat losses decline, I(T), which is inversely related to the rate of heat loss, should increase. Increasing air velocity also reduces the insulation (Ia) provided by the boundary layer. METHODS: The military issue test handwear, Light-duty glove (LD), Trigger-finger mitten (TF), and Arctic mitten (AM), were fitted over a biophysical hand model. Model surface temperatures were 25 degrees C, and air temperature was 10 degrees C. The handwear was tested at simulated altitudes of sea level (101 kPa), 2500 m (75 kPa) and 5000 m (54 kPa) in still air and at 5 m x s(-1). RESULTS: Overall, the effects of wind and altitude on I(T) were significant. Differences for I(T) between 0 and 5000 m were significant for LD and TF. Increases in I(T) greater than 10% are considered of sufficient magnitude to alter comfort sensation. CONCLUSIONS: Differences of that magnitude occurred most frequently between 0 and 5000 m. The present results are consistent with an increase in I(T) with increasing altitude. Changes in I(T) were greater in still air and for less insulated handwear where the contribution of Ia to I(T) was more important.

What you need to know about latex allergy.

Learn the pathophysiology and types of latex allergy, including diagnostic criteria.

The value and limitations of protective gloves in medical health service: Part I.

The value of protective gloves in the health care environment is well known. However, these gloves are not perfect. Some are permeable to microorganisms and various chemicals, and/or result in side effects for health care professionals. Gloves that offer the greatest protection and least side effects are highly desirable. Field of application rules and regulations, materials and manufacturing, and test methods of protective gloves are described in Part I of this three part series.

Protección de las extremidades superiores / Protection of the upper extremities

Diferentes condiciones afectan el nivel de protección que los guantes resistentes a los productos químicos pueden proveer. Antes de elegir un guante, hay que asegurarse de considerar el producto químico con el que se ha de trabajar, concentración, temperatura y la cantidd de tiempo que el guante estará en contacto con el producto. Abrasión, raspados y cortes pueden dañar las manos, los guantes de trabajo para propósitos generales pueden ayudarlo a proteger las manos de éstos incómodos accidentes. Hay seis pasos para elegir el guante más apropiado: 1-seleccionar el material correcto. 2-Elegir el mejor largo y espesor. 3-Decidir sobre el recubrimiento. 4-Seleccionar el agarre justo. 5-Considerar las características de la mano. 6-Usar el tamaño más apropiado