Latex free doesn't mean allergy free: How health systems are optimizing PPE strategies to offer superior protection to employees

With COVID-19, personal protective equipment acquisition has been top of mind for healthcare leaders across the country. PPE concerns aren’t new, however. Even before the pandemic, healthcare organizations were reexamining their purchase criteria for medical gloves. To reduce allergic reactions among employees and patients, many providers converted to latexfree environments.

Despite this transition, allergic reactions haven’t disappeared. In fact, Type IV chemical allergy occurrences have increased due to the chemical accelerators used in many non-latex gloves. These allergic reactions are costly, resulting in rescheduling of procedures, workers’ compensation claims and staff turnover.

Becker’s Hospital Review recently spoke with Gina Gilbert, BSN, RN, senior director of professional education and clinical affairs at Ansell, about the safety challenges facing healthcare organizations and how Ansell’s innovative PI KARE skin friendly technology eliminates the risk of Type I latex allergies and dramatically reduces the risk of Type IV chemical allergies.

To reduce allergic reactions, hospitals have transitioned to non-latex environments

In the 1980s and 1990s, use of medical gloves escalated in response to the human-to-human transmission of hepatitis C and HIV. This change significantly increased worker exposure to natural rubber latex (NRL) and NRL allergies became a growing concern as a result.

In response, many hospitals and healthcare systems have converted to non-latex products. Dating back to 2005, studies have found that conversion to non-latex helped reduce long-term healthcare costs and the costs of converting to a non-latex environment were lower than employee compensation claims for latex-related disability.1

Eliminating latex gloves has also provided logistical advantages. "Hospitals can consolidate their glove lines which simplifies ordering. Many hospitals discover that eliminating latex gloves frees up space in the operating room for storage. Staff time to create protocols and training teams is also greatly reduced, as is the risk of potential litigation," said Ms. Gilbert.

Latex free doesn’t mean allergy free: Type IV chemical allergy occurrences are on the rise

To eliminate the risk of latex allergies, many hospitals and healthcare facilities have moved to 100 percent nonlatex gloves. While Type I latex allergies have decreased significantly, Type IV chemical allergies still occur and have actually increased over time.

Among healthcare workers, delayed chemical allergies or sensitivities cause over 49 percent of occupational skinrelated reactions.2 Research has found that the standard chemical accelerators used in glove manufacturing cause up to 82 percent of these allergies or sensitivities.2,3 Chemical allergies represent a significant occupational hazard and are the second highest occupational disability reported to the Occupational Safety and Health Administration.

A Type IV chemical allergy is a delayed hypersensitivity reaction that typically develops six to forty-eight hours after exposure to a specific allergen, like chemical residues from the glove manufacturing process. Reactions typically involve dermatitis at the site of contact and range in severity from mild discomfort to reactions that could significantly affect healthcare workers’ ability to perform their jobs. Most Type IV chemical allergies are localized and uncomfortable. Unlike Type I latex allergies, they are not life threatening.

Glove selection protocols are essential, especially during a pandemic

The organizational and financial costs associated with occupational skin dermatosis in healthcare are significant, resulting in $1.5 billion in direct and indirect costs.4 One anaphylactic episode alone can cost between $5,000 and $25,000.2,3 In addition, a Type I latex allergy or a Type IV chemical allergy can hinder a healthcare worker's ability to practice their profession. Learn more about the hidden cost of latex at www.ansell.com/nonlatex.

"It's important to keep in mind that all non-latex gloves help eliminate the risk of Type I latex allergies, but not all non-latex gloves offer the same prevention for Type IV chemical allergies," Ms. Gilbert said. "Understanding the differences in glove materials, characteristics and their chemical profiles is a critical part of the glove selection process."

When selecting gloves, healthcare organizations must ensure that they are functional and effective. It’s nearly impossible for hospitals to standardize on one single type of glove or glove material that will meet every caregiver’s needs.

“Remember to involve staff in the selection and evaluation of gloves. Key considerations include quality, low or no allergen content, flexibility, durability, strength, grip, comfort, ergonomic support and testing for use with chemotherapy drugs,” Ms. Gilbert said.

Innovative medical glove technologies eliminate the risk of latex allergies and dramatically reduce chemical allergies

Ansell has taken the monumental step of producing medical gloves that eliminate the standard chemical accelerators known to cause Type IV chemical allergies. Ansell’s proprietary PI-KARE technology uses biologically safer, novel accelerators that drastically reduce the risk of Type IV chemical allergies and sensitization, while simultaneously eliminating the risk of Type I latex allergies. PI-KARE’s chemical accelerators are either completely consumed during manufacturing or remain within the glove film matrices, allowing better skin tolerance.

Ansell’s PI-KARE technology eliminates the five chemical accelerators most commonly known to cause allergic contact dermatitis: zinc diethyldithiorcarbanmate (ZDEC), zinc dibutyldithioocarbamate (ZDBC), sodium dibutyldithioocarbamate (SCBC), zinc mercaptobenzothiazole (ZMBT) and diphenylthiourea (DPTU). PI-KARE is also free from diphenylguanidine (DPG), cetylpyridinium chloride (CPC) and casein.

Ansell, a global leader in safety solutions, owns and operates its R&D and manufacturing facilities. With this, they have been able to develop revolutionary innovations and advancements in PPE bringing positive outcomes to patients and healthcare workers alike such as PI KARE. PI KARE can be found in the entire portfolio range of polyisoprene (PI) surgical gloves which provides not only safety to surgeons and their patients, but also various options to support unique surgical applications such as orthopedic or cardiovascular. In addition to innovation, the company is committed to continued investment and expansion in manufacturing capabilities to meet global demand for PPE.

Conclusion

This year has been unprecedented, as hospitals and health systems have grappled with additional safety requirements on top of existing demands for efficiency. Despite the challenges, Ansell is committed to helping organizations thrive with innovative, high-quality solutions that support workplace safety and patient care goals. “Ansell can help you identify the optimal glove choice for your facility and our experienced clinical field team will onboard new safety solutions smoothly,” Ms. Gilbert said. “Safety is our primary concern, along with product reliability and durability.”

Additional detailed information on PI KARE and other safety innovations within Ansell products can be obtained at ansell.com/pi-kare-beckers.

References

1. Vandenplas O, Raulf M. Occupational latex allergy: the current state of affairs. Current Allergy Asthma Reports. 2017;17(3):14. doi:10.1007/s11882- 017-0682-5.
2. Higgins C, Palmer A, Cahill J, Nixon, R. Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinical. 1993-2014. Contact Dermatitis. 2016;75(4):213-22.
3. Heese A, Hintzenstern JV, Peters K, Koch HU, Hornstein OP. Allergic and irritant reactions to rubber gloves in medical health services. Journal of American Academy of Dermatology. 1991. 25:831-839.
4. Vandenplas O, Raulf M. Occupational latex allergy: the current state of affairs. Current Allergy Asthma Reports. 2017;17(3):14. doi:10.1007/s11882- 017-0682-5.
5. Food and Drug Administration. Process for Making Available Guidance Documents Related to Coronavirus Disease. 2020. Accessed December 21, 2020. https://www.govinfo.gov/content/pkg/FR-2020-03-25/pdf/2020- 06222.pdf.

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