Medical Gloves, Hand Hygiene Help Halt Deadly CRE

Gloves and Hand Hygiene Help Halt CRE

Hospital staffs across the country are doubling down on their efforts to stop the spread of hospital acquired infections (HAIs.)  While progress has been made in understanding and reducing the spread of MRSA, C. diff and other germs, there is a growing and far more deadly threat – carbapenem-resistant Enterobacteriaceae, or CRE.

CRE germs are resistant to antibiotics of last resort, killing one of every two patients who get bloodstream infections from them.  But it could be worse.  CRE can transfer their antibiotic resistance to other bacteria such as E. coli, making the most common cause of urinary tract infections extremely difficult to treat.  Ultimately, CRE could get out into our communities, leading to a public health crisis.

For these reasons, CDC has sounded the alarm.  In the March Vital Signs report, CDC published some alarming facts.  CRE has increased from 1% to 4% in the past decade, and one type of CRE has increased from 2% to 10%.  CRE is more common in the Northeast, but has been reported in 42 states.  About 18% of long-term care hospitals have reported at least one CRE infection during the first half of 2012.

The report also provides detailed information on what state governments, communities, health care CEOs, health care providers and patients can do to help stop the spread of CRE.

There are eight core measures for acute and long-term care facilities to implement, and at the top of the list are hand hygiene and the proper use of contact precautions.  This includes the proper use of medical gloves.

  • Hand hygiene should be performed before donning a gown and gloves.
  • Gown and gloves should be donned before entering the affected patient’s room.
  • Gown and gloves should be removed and hand hygiene performed, prior to exiting the patient’s room.

In the 2012 CRE Toolkit, the CDC states, “It is not enough to have policies that require hand hygiene; hand hygiene adherence should be monitored and adherence rates should be fed directly back to front line staff.  Immediate feedback should be provided to staff who miss opportunities for hand hygiene.”

By following CDC guidelines for CRE, several states have decreased their CRE infection rates.  Colorado is one of six states that currently require hospitals to report CRE to the Department of Public Health and Environment.  Because they are detecting and tracking the bacteria, an outbreak of CRE at the University of Colorado Hospital last August was halted.

In Florida, a year-long CRE outbreak was finally brought to an end when the facility improved its use of CDC recommendations, including the proper use of medical gloves and gowns.  This underlines the importance of proper gloving and hand hygiene, as routine as it may seem.

There is no longer any room for complacency.  This is a critical time here in the U.S.  CRE infections can be controlled if everyone involved in patient care does their part and puts forth consistent effort to follow infection control recommendations with every patient.

What do you think?  Can more be done to stop the spread of CRE?  Post your comments below.

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.

Cleanroom Gloves – Balancing ESD and Cleanliness

[dropcap]C[/dropcap]leanroom environments in the electronics, nanotechnology and semiconductor industries are especially sensitive to static.  For this reason, the electrostatic discharge (ESD) property of cleanroom gloves worn by workers is an important consideration.

Electrostatic discharge damages the electrical characteristics of a semiconductor device.  It can also cause equipment to malfunction or fail, interfering with the normal operation of an electronic system.

An electrostatically charged surface can also attract and hold onto contaminants – bad news for the cleanroom environment.  Airborne particles can cause defects in a device’s electrical circuitry.

Controlling ESD

Failing to control ESD in a cleanroom can be expensive.  Static electricity damages electronics, leading to increased manufacturing costs and lower production yields, negatively affecting a company’s reputation and profitability.  One way that cleanrooms manage static charge is by using static dissipative materials.

Static dissipative materials fall somewhere between insulative and conductive materials.  There is electron flow through or over the material, but in a controlled fashion, by the surface resistance or volume resistance of the material.  It allows the charge to dissipate, or transfer slowly to ground without causing damage.

Cleanroom Nitrile Gloves Preferred

When selecting gloves for cleanroom applications where static discharge could harm the product, or where static could lead to contamination, nitrile gloves are the preferred choice.

Gloves made from natural rubber latex are inherently static insulative, holding on to a charge and releasing it in an uncontrolled manner, leading to damage.  The surface resistance of nitrile gloves, however, is normally on the border of insulative and static dissipative.  To be considered static dissipative, the glove should have a surface resistance of more than 1 x 105 but less than 1 x 1011 ohms/sq.  The surface resistance test results for a glove can usually be found on the manufacturer’s product information sheet.

Balancing ESD with Cleanliness

Interestingly, the cleaner the glove, the lower the glove’s ESD protection.  Tom Lesniewski and Kenn Yates of the TRW Space and Electronics Group conducted an evaluation of the cleanliness and ESD protective properties of cleanroom materials, including 7 different types of nitrile gloves.

They found a clear trend – as non-volatile residue (NVR) increased, surface resistance decreased.  The surface contaminants on a glove make the glove more static dissipative, especially in higher humidity.

Because there is clear tradeoff between cleanliness and charge dissipation rate, cleanrooms requiring a high level of ESD protection should choose a cleanroom glove only as clean as it needs to be for the ISO level of the cleanroom.

[note]

HandPRO Cleanroom Nitrile Gloves provide the moderate static dissipation needed to protect highly ESD sensitive devices from damage.  The gloves are also very clean, making them a contamination-free solution for cleanrooms requiring low ionic contamination.

Learn more about HandPRO 9100 Clean Class 100 Accelerator-Free Nitrile Gloves for ISO 5 & up.

Learn more about HandPRO 1700 Controlled Environment Nitrile Gloves for ISO 6 & up.[/note]

 

How does a cleanroom glove’s ESD property impact your manufacturing environment?  Share your comments below.

HandPRO1700_CTA

Acrylates in the Dental Office – Hazards and Hand Protection

Acrylates Dental Office Hazard

In the dental office, occupational hazards are everywhere.  You wear masks and gloves to protect yourself from the dangers of infection from close contact with patients’ saliva and blood.  You give attention to your posture to minimize the risk of musculoskeletal disease.  And you wear nitrile gloves, sometimes two pair, when working with acrylates.

Or perhaps not.   A search of some popular dental journals online yielded zero articles on the hazards of what the American Contact Dermatitis Society named the 2012 Allergen of the Year – Acrylates.

Acrylates – What Are They?

Though they get little mention, acrylates are everywhere.   The salts of acrylic or methacrylic acid can be polymerized to form solid plastics.  Polymerized methacrylate was first used in the 1930s, when mass production of Plexiglas began.  It is now used in windowpanes, car lights and windshields, and streetlamps.  Over time, other acrylates have been synthesized and are now found in paints, adhesives, printing inks and medical devices.  Fully polymerized acrylic plastics are inert and harmless.  However, the building blocks – acrylates and methacrylates – are strong irritants and notorious allergens.

But what does this have to do with safety in the dental office?

Acrylates in the Dental Office

These days, many methacrylates are used in dental bonding materials.  These dental materials seem to be a major cause of contact dermatitis in dental personnel.   The polymerization (curing process) of these adhesives and materials occurs with exposure to UV light and with the help of a priming photoinitiator, or when two components are mixed causing a chemical reaction.   In both cases, unreacted monomers are released.  These “free monomers” can cause irritation to skin and eyes, asthma, and allergic dermatitis.

“Dental surgeons, assistants, and technicians are also at risk of allergic sensitization from monofunctional and polyfunctional (meth)acrylates and from the epoxy acrylate prepolymers.”  – American Contact Dermatitis Society

Widely used dentin primers and dentin bonding agents and cements that contain 2-HEMA (hydroxyethyl methacrylate) have been studied.  The authors concluded that the free monomers released from HEMA can affect dental personnel as well as patients in the immediate vicinity.

There are numerous reports of acrylate associated allergy in dental personnel, including fingertip paraesthesia and occupational allergic contact dermatitis caused by a restorative dental material with polymethylmethacrylate.

 

Testing and Protection

Testing for allergic sensitization to acrylates is difficult.  The allergens have to be kept frozen or refrigerated, delayed positive results are common, and patch testing can cause severe allergic reaction.

Methacrylate monomers penetrate vinyl and latex gloves within minutes.  For this reason, the American Contact Dermatitis Society recommends double gloving with nitrile gloves, or polyethylene gloves under nitrile gloves.  This should afford adequate protection for tasks that do not exceed 30 to 60 minutes.

Dental products such as acrylics, resins and polymer materials represent significant advances in dentistry and are here to stay.  Your best option to minimize the risk of developing an acrylate allergy is to stay informed about the signs and symptoms of allergic reactions, keep records of dental materials being used, and put in place whatever precautions are available to limit your exposure.

Are you concerned about acrylates?  Share your comments below.

Sources:
American Contact Dermatitis Society – Acrylates – Contact Allergen of the Year
Dental Occupation Hazards – A Review

Disposable Glove Quality Testing

The FDA sets high standards to ensure the disposable gloves you purchase here in the U.S. perform as expected and provide an adequate barrier for their intended use.  To meet these standards, glove manufacturers have tight quality controls and manufacture gloves according to ASTM specifications and testing requirements.

A key quality measurement that glove manufacturers publish on glove boxes, bags and product literature is AQL, or Acceptable Quality Level.

Stated as a percentage, the AQL is a statistical measurement of the quality of the gloves.  An AQL of 2.5% means that statistically, only 2.5 gloves for every hundred gloves will fail a quality test.

How AQL is Determined

Let’s say a glove manufacturer produces 10,000 gloves from the same material, settings and processes.  Two hundred gloves would be pulled randomly from the line, throughout the batch, to be tested.  To meet an AQL of 2.5%, no more than 10 gloves can fail the quality tests.  If more than 10 gloves fail, the entire batch fails, and each glove must be tested individually for quality, or else the whole batch is discarded.  An AQL of 1.5% would mean that no more than 7 gloves could fail.

ASTM D5151 Test for Detection of Holes in Medical Gloves

Disposable gloves are subjected to numerous ASTM tests throughout the manufacturing process.  One test that medical and cleanroom gloves have in common is a test for pinholes.

ASTM D5151 is the Standard Test Method for Detection of Holes in Medical Gloves, often referred to as the “watertight” test or “water leak” test.   In this test, the gloves are each filled with 1000 ml of water at room temperature, secured at the cuff and hung vertically for two minutes to check for pinholes.  If water does not leak from the glove, it gets a “pass.”

The current FDA mandated maximum AQL for examination and cleanroom gloves on this test is 2.5%, down from the previous 4.0% prior to December 2008.  Some gloves, however, are manufactured and tested to meet the lower AQL of 1.5% required for surgical gloves.  This means higher quality and fewer pinholes.

Are Your Cleanroom Nitrile Gloves Full of Pinholes?

Cleanroom Gloves and Pinholes

Cleanroom and controlled environments have unique glove requirements.  While healthcare workers primarily wear gloves to protect themselves from bloodborne pathogens, a person working in a clean manufacturing environment primarily wears gloves to protect the product or process from contamination.

Pinholes in gloves provide a path for human-borne contaminants in the clean manufacturing environment.   Just one square inch of the surface of a person’s hand can contain 10,000 microorganisms!

So how common are pinholes in cleanroom gloves?

A study published in May 2011, Integrity of Disposable Nitrile Exam Gloves Exposed to Simulated Movement,  compared cleanroom nitrile gloves to medical-grade, low-modulus and general duty nitrile gloves.  A total of thirty different glove products were tested, including six cleanroom and nine medical-grade nitrile glove products.  A modified water-leak test was used to detect a 0.15 to 0.05 mm hole in different areas of the glove, including the thumb and pinky.  What did they discover?

“The cleanroom gloves, on average, had the highest percentage of leaks, and 50% failed the water-leak test.”

Two of the cleanroom nitrile gloves tested had an out of the box failure rate of 6.25%.  The medical grade and low modulus gloves had the lowest percentage of leaks.  Even the general duty gloves performed better than the cleanroom gloves tested.   However, two of the six cleanroom gloves tested had a failure rate of zero percent.  Why such a significant difference?

The study authors indicate that it could be due to differences in nitrile material formulation.  A low-modulus nitrile glove with a higher percentage of plasticizer, which is more water resistant, was expected to perform better in the water leak test.

What was not discussed in the paper is the AQL, or Acceptable Quality Level, of the gloves tested.  The AQL for the water leak test, a test that indicates what percentage of the gloves can fail a water test for pinholes, is set by ASTM at 2.5% for cleanroom gloves.  Many manufacturers, however, use the medical grade requirement of 1.5%.  This means that less than 1.5% of the gloves from any given lot could fail due to pinholes – substantially less than 2.5%.

Clearly, there are significant differences in the quality of cleanroom gloves on the market.  To protect your cleanroom environment, select cleanroom gloves made from consistently high quality low-modulus NBR materials, and an AQL of 1.5% or less.

What is Nitrile Anyway?

Disposable nitrile gloves have become a mainstay in the medical, dental, lab, cleanroom and food handling industries.  We enjoy their strong, latex-free comfort.  But what is nitrile anyway?

The Science of Nitrile

Nitrile is a shortened term for Nitrile Butadiene Rubber, or NBR.  Although it is also referred to as NBR latex, there is no natural rubber latex (or latex proteins) in the material.  Nitrile is a synthetic rubber copolymer of acrylonitrile and butadiene.  These two materials (monomers) are placed in a stainless steel vat, and using hot or cold polymerization, a chemical reaction occurs, and voila!  Nitrile is born.

The nitrile latex is filtered and blended with an antioxidant to stabilize the material.  Next, the liquid is solidified by adding coagulating agents, then finally washed and dried.  The resulting material is referred to as “crumb rubber.”  Crumb rubber can be liquefied by product manufacturers to make nitrile rubber materials, such as floor mats, footwear, adhesives and gloves.

Low-Modulus Magic

Nitrile alone, without anything added, is a fairly rigid material.  So glove manufacturers add a small percentage other chemicals to NBR in order to create a soft, or low modulus, nitrile glove.  Over the past decade, these manufacturers have continued to improve their nitrile glove material formulations.  Disposable nitrile gloves have grown softer and more elastic.  The latest innovations in nitrile glove development include accelerator-free formulations that lower the risk of Type IV contact dermatitis in wearers.

These thin and flexible gloves are what we have all come to rely on to keep ourselves, our patients, products and food items safe.  Nitrile gloves are more resistant to oils and acids than natural rubber (latex) gloves.  The material is resistant to abrasion and puncture, making it suitably durable for many tasks.  Low modulus nitrile gloves also conform well to the hand and provide excellent tactile sensitivity.

As disposable nitrile glove formulations evolve, hand protection is becoming ever safer and more comfortable.  We look forward to continuing to bring you the very best nitrile gloves made from the latest materials.

Have you noticed the improvements in disposable nitrile gloves over the years?  We’d love to hear your comments.  Share them with us below!

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.

HandPRO Gloves Get a Fresh, New Website

For most companies, each new year brings exciting opportunities to overcome challenges, launch new products and improve communication with customers and distribution partners.

We’re no different, and this year we are starting off right with a fresh, new website.

The new www.HourglassIndustries.com brings you new information and new features, all designed to improve your experience.

Read moreHandPRO Gloves Get a Fresh, New Website

Powdered and Latex Medical Gloves to Be Banned?

Almost everyone in the glove industry heard the news back in April. Public Citizen, a consumer advocacy group, petitioned the FDA to take drastic steps to protect individuals with latex allergies. They called for a complete ban on all cornstarch powdered medical gloves, as well as a ban on all natural latex rubber medical gloves.

Read morePowdered and Latex Medical Gloves to Be Banned?

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