Understanding Glove Related Contact Dermatitis

[dropcap]Y[/dropcap]ou may wear disposable nitrile, latex or vinyl gloves many hours each work day.  If your hands develop dry, itchy, irritated areas or blisters, you are understandably concerned.  Wearing gloves and having healthy skin is imperative in your line of work.

Could your gloves be to blame?  In this Q&A article, we’ll help you get the bottom of the types of glove related contact dermatitis, their causes, and how you might find a resolution for your skin condition.

Q.   What is contact dermatitis?

A.   Occupationally related contact dermatitis is a skin condition that can develop from frequent and repeated use of hand hygiene products, exposure to chemicals and glove use. Contact dermatitis is classified as either irritant or allergic.

Irritant contact dermatitis is common, nonallergic, and develops as dry, itchy, irritated areas on the skin around the area of contact.  It is usually caused by an irritant, such as the chemicals commonly used in the manufacture of hand products and gloves.  It can also be caused by water, (including improper hand drying before donning gloves,) soaps, detergents, solvents, acids, alkalis and friction. Diagnosis is made by reviewing the patient’s medical history, current symptoms, and exclusion of Type IV and Type I hypersensitivity.  This is not an allergic reaction.

Allergic contact dermatitis (type IV hypersensitivity) often manifests as an itchy, red rash, sometimes with small blisters, beginning approximately 6 to 48 hours after contact.  Like irritant dermatitis, it is usually confined to the areas of contact.  It can result from exposure to accelerators and other chemicals used in the manufacture of most latex and non-latex gloves.  Diagnosis is made by reviewing the patient’s medical history, current symptoms and by performing a skin patch test.

Q.   What are chemical “accelerators?”

A.   Chemical accelerators are used in the glove manufacturing process to “accelerate” the linkage of rubber molecules in natural rubber latex or synthetic rubber latex, such as nitrile and vinyl. The chemicals transform the liquid rubber into a thin, strong and elastic glove film, and stabilizes the material.

These sulfur-based chemical accelerators (dithiocarbamates, thiurams and mercaptobenzothiazoles (MBT)) cause the majority of skin dermatitis reactions.

Q.   What are “accelerator-free” gloves?

A.   Accelerator-free gloves, like FreeStyle1100, and Scion700 are manufactured using a breakthrough cross-linking technology that does not use chemical accelerators (dithiocarbamates, thiurams and mercaptobenzothiazoles (MBT.)) The result is a thin, soft and stretchy glove that is actually stronger than traditionally manufactured nitrile glove material.

Q.   What does “Low Dermatitis Potential” mean?

A.   This is an FDA approved claim reserved for gloves that have been tested, and are 1) proven free of chemical accelerator residue, 2) will not induce skin irritation, and 3) will not cause any potential sensitization reaction.

Q.   How long should I try accelerator-free gloves?

A.   Each person is unique. Some individuals know within a few hours, while others require an extended trial of several days or even weeks to know if accelerator-free gloves will resolve their hand dermatitis. (Additional samples of FreeStyle1100 are available for individuals needing a longer period of time to evaluate the glove.)

Q.   Is there anything else in a glove that can cause allergic contact dermatitis?

A.   Yes.  Although 90% of glove allergies are caused by accelerators, the remaining individuals may be reacting to other substances sometimes used in the manufacture of gloves, such as lanolin, polyoxypropyleneglycol (a coagulant,) dyes (organic or inorganic,) quaternary ammonium compounds, and preservatives.

Q.  How important is it to resolve contact dermatitis early?

A.   Skin is an important barrier to bloodborne pathogens and disease. Broken skin due to ongoing irritation or allergy puts an individual at higher risk. A chronic skin condition is painful, and could result in an individual having to abandon their career choice.

Q.  I don’t have contact dermatitis. Should I still consider switching to an accelerator-free glove?

A.   Yes. According to NIOSH, “Because the prognosis of occupational irritant and allergic dermatitis is poor, prevention is imperative. This fact is emphasized by one study showing that 75% of patients with occupational contact dermatitis developed chronic skin disease.” (1) With thousands of potentially harmful chemicals being introduced into the workplace each year, it is important to reduce your exposure wherever possible.

References
NIOSH (The National Institute for Occupational Safety and Health,) Allergic & Irritant Dermatitis(1)
CDC (Centers for Disease Control and Prevention) Frequently Asked Questions, Contact Dermatitis and Latex Allergy

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Tips to Avoid Contact Dermatitis This Winter

Tips to Avoid Contact Dermatitis This Winter

The winter season is here.  That means colds and flu, and overly-drying, heated air in our homes and workplaces.  Add necessary frequent hand washing to this combo and you may end up with a very uncomfortable situation – contact dermatitis.

Contact dermatitis can be divided into two categories – irritant and allergic.  Irritant contact dermatitis is the most common type.  It can be as mild as a rash, or as debilitating as dry, itchy skin that can crack and bleed.  It occurs because the outer layer of your skin has been damaged.  Most often, this is due to harsh soaps and damaging chemical solvents.  Allergic contact dermatitis occurs when an allergen triggers an immune response in your skin.  It shows up as a red rash, with bumps and sometimes blisters.  It can be caused by natural rubber, the sulfur-based chemical accelerators used in the production of many non-latex gloves, as well as perfumes, cosmetics and hair dyes.

A Pricey Problem

Dermatitis is a widespread problem.  Up to 35 percent of all occupational diseases are skin diseases, with contact dermatitis making up the majority of the cases.  In 2005, The Society for Investigative Dermatology and the American Academy of Dermatology reported that contact dermatitis was associated with more than 9 million physician office visits resulting in more than $1.4 billion spent on treatment.

Because of increased exposure to chemicals, detergents and frequent hand washing, workers in health care, construction, food service and cleaning are especially vulnerable.  Individuals with a history of eczema, latex allergy, prone to sunburn, and repeated exposure to water should be especially careful in order to avoid dermatitis.

What You Can Do

To avoid occupational contact dermatitis, carefully take stock of your environment and habits:

Health Care Workers  –   After washing with soap and water, are you drying your hands gently, so that you do not cause unnecessary damage to your skin?  If you are starting to notice a rash, has your facility recently changed to a new brand of hand soap?  Your skin may be irritated by a chemical in the new product.   Because alcohol-based hand rubs do not cause dermatitis, the CDC recommends they be used whenever possible in health care settings.  These foams and gels often contain emollients and substantially reduce skin irritation and dryness.

Industrial / Cleaning / Food Service Workers – What chemicals, oils and cleaning agents do your hands come into contact with?  Are you wearing the right glove material (nitrile vs. latex) to protect your hands from that irritant?  Are you around wet cement, cement dust or paper dust?  These irritants can also cause dermatitis.  Make sure you are wearing disposable gloves to protect your hands.   If your hands do come into contact with cement or chemicals, wash your hands immediately with a fragrance-free, neutral pH hand soap with emollients, and gently dry your hands without excessive rubbing.  (Alcohol-based hand rubs are not recommended for food service workers, as its effectiveness is reduced when in the presence of food proteins.)

You will likely experience dry hands this winter.  The cold air and wind chaps your hands, and the low humidity level further removes moisture from your skin.  By paying careful attention to how you wash and dry your hands, and protect your skin from harsh detergents and chemicals, you can greatly reduce your chances of developing painful contact dermatitis.

Could your gloves be the problem?

Try FreeStyle1100 and Scion700 Nitrile Exam Gloves with “Low Dermatitis Potential”

The sulfur-based chemical accelerators – carbamates, thiurams and mercaptobenzothiazoles (MBT) – commonly found in non-latex gloves can lead to contact dermatitis.  If you suspect your gloves are causing your current skin irritation, request a sample pack of FreeStyle1100 Accelerator-Free Nitrile Exam Gloves and Scion700 Nitrile Exam Gloves with Low Dermatitis Potential.

Disposable Gloves Reduce Risk of Foodborne Illness

Foodborne illness.  No restaurant operator wants those words associated with their establishment.  To ensure their food is safe, many hours are devoted to employee education and ongoing training.  Hand hygiene and disposable gloves are an important part of safe food handling.

Restroom Germs and Cross-Contamination

A critical component to safe food handling is proper gloving and hand hygiene. “Restroom germs” such as E. coli, Staphylococcus, Giardia, Hepatitis A, Norovirus, and Shigella can be transmitted from hands to food.  Cross-contamination can also occur, transferring pathogens such as salmonella.  Restaurants offering gluten-free foods have the added concern of  gluten being accidentally transferred.

The problem of foodborne illness has real consequences – both for customers and food service establishments.  In 2009, a McDonald’s location in Illinois was linked to a hepatitis A outbreak that resulted in a class-action lawsuit.  And in New York City alone, dining out was linked to 3,500 hospitalizations in 2008 for food-borne illnesses and some 1,300 cases of salmonella.

But even if employees were always diligent about washing their hands, hand washing alone is not enough to prevent food-borne illness.  Routine hand washing does not remove all bacteria, and it only takes a small amount to make someone sick.  An additional barrier, such as a disposable glove, is needed.

FDA Food Code 2009

To help make food safer, the Food and Drug Administration (FDA) released an updated Food Code in 2009.  Here are some of the food handling rules:

  • Employees may not touch ready-to-eat foods with bare hands, except when washing fruits and vegetables, or when otherwise approved.  They must use a barrier, such as deli tissue, spatulas, tongs or gloves.
  • Wearing gloves is not a substitute for proper hand washing. Gloves can fail, and allow bacteria and viruses through, so employees must wash their hands before donning gloves to work with food.
  • Gloves should be changed often.  Gloves should be changed when they become damaged or soiled, after 4 hours of wear, or after handling raw foods.
  • Glove should be worn for a single task.  A food service employee should never handle money, take out the trash or perform other tasks and return to handling ready-to-eat food without changing their gloves.

Gluten-Free Food Handling

Restaurants such as Subway that are starting to offer gluten-free foods are giving special attention to hand hygiene and proper gloving and food handling.  And rightly so.  An employee that handles regular gluten-containing bread and then handles gluten-free bead without changing gloves has just cross-contaminated the food.  While this may not affect a customer with a non-celiac gluten intolerance, it spells real trouble for a customer with true Celiac Disease.

Glove Selection Considerations

Restaurant operators or managers selecting gloves for employees are necessarily concerned with cost.  But the cheapest gloves may not be the best choice.  Considering the following criteria will help ensure the right glove is purchased for the right job.

  • Proper Fit – For the safety of the employee, properly fitted gloves are essential.  Gloves that are too loose can result in serious bodily injury.  Glove that are too tight lead to hand strain.
  • Proper Material – Consider the dexterity needed for the tasks the employee is performing.  While a poly glove may be suitable for assembling a sandwich, a more form fitting nitrile glove is better suited for tasks like slicing and chopping.
  • Comfort – A comfortable glove that provides adequate grip and tactile sense will increase employee compliance and safety.
  • Allergens – Allergens and chemical sensitivities should be considered.  Employees concerned about latex sensitization should be offered a non-latex alternative, like nitrile gloves.  Please note that some individuals may be sensitive to the chemicals commonly found in non-latex gloves.  If this is the case, accelerator-free nitrile gloves like FreeStyle1100 are now available.

By carefully educating employees about hand hygiene and providing gloves that are suitable to the task and comfortable to wear, restaurant operators can be confident they are doing their part to reduce the risk of food-borne illness.

Accelerator-Free Nitrile Exam Gloves – A Better Alternative

As hospitals and other healthcare facilities have increasingly moved from latex exam gloves to nitrile exam gloves, skin irritation and allergy to non-latex gloves has also increased. To identify individuals with hypersensitivity to nitrile gloves, a new skin prick test has been developed by Dr. Santhosh Kumar of Virginia Commonwealth University, Richmond. “If the patient is positive,” says, Dr. Kumar, “we tell them to avoid nitrile gloves,” and he recommends vinyl gloves as an option.

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New Glove Materials Make Nitrile Gloves Better

Nitrile gloves have come a long way. In the early days, when nitrile gloves were the “new” latex-free option, healthcare professionals did not find them nearly as comfortable as natural rubber latex gloves. And the price for these new medical nitrile gloves was higher than latex. Still, in order to reduce the very real problem of latex sensitization, the healthcare world began to transition to nitrile gloves.

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