Dr Pravin K Nair, Consultant Microbiologist & Head Infection Control, Holy Spirit Hospital, gives an insight on using the right gloves
The topic heading looks very absurd. I would have thought the same if I had read this article 10 years before, but with development of science and more evidence coming in, the heading of my article is more relevant and in context with the current patient safety standards.
No one in the healthcare industry would be remembering William Halstead, Chief Surgeon, Johns Hopkins Hospital in 1896 as the person who discovered surgical gloves. He discovered this not to protect patients from infections but to protect his wife’s hands from dermatitis caused by mercuric chloride used for cleaning instruments and with the help of Goodyear tyre company.
The discovery and increased incidence of AIDS (HIV) in the early to mid-1980s resulted in a tremendous increase of latex examination gloves.
In 2008 ,more than 12 billion units of medical gloves were sold.
Club Moss, talcum powder and finally Cornstarch were used as lubricants for the gloves. Today most international standards do not accept the use of talc as a lubricant. Most developed countries have standards for gloves, unlike in India where atleast I am unaware of the existence of such standards.
European standard EN 455-part 3, American standards ASTM D3577 besides ISO standards are being followed by Japan, China and others.
Health and safety concerns
For patients:
Inflammation, granuloma formation, granulamatous peritonitis, adhesions, allergic responses,delayed wound healing are enough to alarm us.
Cardiac complications such as granulomatous endocarditis, thrombi have been documented (Truscott 1977).
Experiments conducted demonstrated that Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin resistant enterococci (VRE) may be able to use glove powder as vector in a hospital environment (Newsom & Shaw ,1997).
All these contribute to longer hospital patient stay and increased healthcare costs.
For healthcare workers:
Immediate type I response (Latex allergy) in approximately 17 per cent of healthcare workers.
Occupational asthma in 9 per cent of healthcare workers.
What are other countries doing?
Hospitals around the world are realising the dangers of cornstarch on examination and surgical gloves are being manufactured using powder free alternatives.
- 1997: Banned in Germany
- 2000: Banned in UK
- 2016: Banned in Japan
- 2017: The US, Saudi Arabia, South Korea and Hong Kong
In India many hospitals are unaware of the potential hazards compounded with no regulations on glove manufacturing/ imports.
Conclusion
The significance of these studies and findings justifies the consideration of switching from powdered to powder-free gloves. We at Holy Spirit Hospital, Mumbai has taken a conscious decision for being a patient centric as well as staff centric hospital hence has introduced powder free gloves from November 2017.
Come and join us in this endeavour.
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