Understanding the Hazards of Glove Powder

STAFF ISSUES Exposure Healthcare workers are exposed to glove powders when they wear gloves, work in areas where powdered gloves are used (such as the operating room, lab, and ER), or when they touch surfaces and items touched by others wearing powdered gloves. Cornstarch powder has been determined to carry latex allergens (Hesse, 1997). It has also been suggested that the use of powdered gloves may be related to increases in cases of occupational asthma and latex allergies in HCWs. Studies have shown that glove powders provide a vector for latex allergens to contaminate the air in the healthcare environment. These allergens are then inhaled, causing upper airway irritation. In a study conducted in Sweden, the investigators surveyed HCWs before and after implementation of powder-free glove use. They concluded there was a reduction in upper airway symptoms in the powderfree environment (Edelstam, 2002). Experts also believe the repeated exposure to latex by direct contact, contact with mucous membrane, or inhalation also plays a role in: Irritant contact dermatitis Delayed contact dermatitis (Type IV) Immediate Type I response (latex allergy) Depending on the source, the incidence of latex allergy is approximately: 10%-17% among healthcare workers 13%-17% among the dental population 28%-67% among the spina bifida population and 1%-6% among the general population A response to this situation has been to remove powdered gloves from these areas. But even this solution is not a panacea, as the use of powdered gloves by anyone on a team or in a department has been demonstrated to cause measurable contamination of the air by starch particles (Newsom, 1997). Skin breakdown from the irritation caused by glove powder is also an issue for some healthcare workers. In experiments conducted by Newsom and Shaw, it was demonstrated that Methicillin-resistant S. aureus (MRSA) and Vancomycin-resistant Enterococci (VRE) may be able to use glove powder as a vector and/or food source in a hospital environment (Newsom & Shaw, 1997). In 1971, the FDA required manufacturers to label their glove packages with the following warning: "Caution: Powder should be removed from the gloves after donning by wiping gloves thoroughly with a sterile wet sponge, sterile wet towel, or other effective method." Studies have shown that this procedure is not effective in removing cornstarch powder from gloves, and may in fact cause the cornstarch to clump together. Ellis pointed out in a publication that "conventional washing of the donned glove in saline solution was ineffective. It has been shown that careful washing of the gloves in two successive bowls of saline solution fails to remove all the starch." He also documents another technique that was shown to reduce the number of starch granules from 2,720 (with no attempt to remove starch) to zero when utilizing a "One-minute cleansing with 10 ml of povidone-iodine followed by a 30 second rinse under sterile water" (Ellis, 1990).

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