Glove usage and reporting of needlestick injuries by junior hospital medical staff.
The use of gloves when conducting invasive procedures and the reporting of needlestick injuries have been strongly encouraged. Despite this, neither practice appears to be universal. In order to determine the rates of glove usage and needlestick injury reporting, we conducted a survey of junior doctors in three hospitals in the UK. Of the 190 respondents, the majority rarely wore gloves for venesection, insertion of intravenous cannulas or arterial blood gas sampling. For more major procedures (insertion of central venous lines, insertion of thoracostomy tubes, suturing) gloves were invariably worn. Only 17.5% of needlestick injuries were reported. The rates of glove usage and needlestick injury reporting were lower than previous studies have demonstrated in North America. Surgeons suffered the most needlestick injuries and were the least likely to report them. The low reporting rate may have serious implications, particularly in view of the new Government guidelines on needlestick injuries which involve HIV-infected blood. By failing to use gloves and report needlestick injuries, junior doctors, in particular surgeons, are placing themselves and patients at increased risk of blood-borne transmissible diseases. (+info)
The hazards of vinyl glove ingestion in the mentally retarded patient with pica: new implications for surgical management.
OBJECTIVE: To report experience with the treatment of complications of vinyl glove ingestion in mentally retarded patients with pica. DESIGN: A retrospective case series. SETTING: Two university-affiliated hospitals. PATIENTS: Five mentally retarded patients, 4 with a history of pica, who were admitted for the management of complications resulting from the ingestion of vinyl gloves. MAIN OUTCOME MEASURES: Type of complication, treatment and operative outcome. FINDINGS: The patients ranged in age from 26 to 46 years. One patient died while awaiting surgical consultation of massive gastrointestinal bleeding from a large gastric ulcer caused by a vinyl glove bezoar (VGB). Four VGBs were removed surgically. Endoscopic removal was difficult or impossible because the gloves had become hardened and matted. CONCLUSIONS: VGB should be considered in institutionalized mentally retarded people with a history of pica when they present with gastrointestinal symptoms. VGBs should be removed directly by laparotomy, gastrotomy or enterotomy. Endoscopic removal is not recommended. (+info)
Health care worker disability due to latex allergy and asthma: a cost analysis.
OBJECTIVES: The reported prevalence of occupational allergy to natural rubber latex is 8% to 17%, and that of latex-induced occupational asthma is 2.5% to 6%. Conversion of medical facilities to "latex-safe" can reduce employee sensitization, impairment, and disability. The purpose of this study was to determine the cost of a latex-safe approach, compared with that of continued latex glove use, and to identify the level of worker disability required to make the latex-safe approach financially preferable to a health care institution. METHODS: The costs of 2 strategies--latex-safe vs the status quo--were calculated from the perspective of 3 health care institutions. A break-even point was calculated for each facility. RESULTS: In all facilities, the cost of using nonlatex gloves exceeded the cost of using latex gloves. In all 3 facilities, however, 1% or fewer of those at risk would have to become fully disabled or fewer than 2% would have to become partially disabled for the continued use of latex gloves to exceed the cost of the latex-safe approach. CONCLUSION: Health care facilities, regardless of size, are likely to benefit financially from becoming latex-safe even if latex-related disability levels are extremely low. (+info)
Evaluation of the quality of surgical gloves among four different manufactures.
A randomized trial was conducted to evaluate the quality of four different brands of surgical gloves in terms of the perforation rate, ventilation, fitness, allergic reaction, elasticity, thickness, powder, and satisfaction. Gloves of four different manufactures which were used by various medical centres were distributed to participants according to a computer-generated randomization table. A structured questionnaire was self-administered by volunteers immediately after the surgical procedure to gather the information from participants, including the demographic data, allergy history, length of use, and variables of quality measures. Two brands, A and D, were significantly inferior to the best manufacture among the four, B, in terms of the ventilation, elasticity, and thickness, odds ratios ranging from 6 to 24, p < 0.05. For the amount of corn starch powder and satisfaction, all three other brands were inferior to brand B, odds ratios ranging from 6 to 44, p < 0.05. Gloves worn longer than 2 hours had a slightly higher perforation rate post procedures (11.5% vs. 2.1%, p = 0.048). The rate of latex allergic reaction was not significantly different between surgeons (8.3%) and the others (6.7%). No difference of the allergic reaction rate was found between subjects with allergy history (7.7%) and those without the history (7.5%). The quality of surgical gloves differs from brand to brand. The government and institutions should take the responsibility of monitoring the quality of surgical gloves in order to provide a safer and more comfortable environment for the surgical personnel and patients. (+info)
Dental surgeons with natural rubber latex allergy: a report of 20 cases.
Latex allergy is becoming a major occupational health issue and dental surgeons are at risk from becoming sensitized to natural rubber latex. A study was conducted to investigate risk factors and glove-related symptoms reported by dentists with natural rubber latex allergy. Twenty dentists, who had undergone serological or dermatological testing for a Type I allergy to latex, were identified from a questionnaire survey. Risk factors investigated were: gender, years in clinical practice, exposure to latex gloves, atopic history and food allergy. The majority of dentists (75%) gave an atopic history. Glove-related adverse reactions ranged from cutaneous to systemic manifestations. All twenty dentists reported itching of the hands in response to latex gloves. One respondent was unable to continue in dental practice because of her glove-related allergies; nineteen dentists were able to continue by using synthetic, non-latex gloves. (+info)
A review of current literature on epidemiology of immediate glove irritation and latex allergy.
Natural rubber latex (NRL) allergy has attained world-wide importance with the diagnosis of glove hypersensitivity, contact urticaria, rhinitis, conjunctivitis, asthma and anaphylaxis. In the present report, the latest literature of the epidemiology of NRL allergy is reviewed, an account on the incidence of NRL allergy (19 new cases of contact urticaria/100,000 workers per year) among health care workers is given and the prevention of NRL allergy is discussed. Among health care workers, NRL allergy has gained prominence particularly with the spread of AIDS and an increase in the use of rubber gloves for barrier protection. For screening NRL allergy, a simple and quick test based on a self-administered questionnaire has been presented, but it needs further evaluation before routine use can commence. Further analytic studies will show if the use of low allergen gloves reduces the incidence of NRL allergy. (+info)
Natural rubber latex aeroallergen exposure in rubber plantation workers and glove manufacturers in Thailand and health care workers in a UK hospital.
OBJECTIVES: To estimate personal airborne natural rubber latex (NRL) concentrations for three occupational exposure groups; rubber plantation workers and NRL glove manufacturers in Thailand and health care workers in the UK. To utilise these data to classify the populations into appropriate exposure groups for the exposure-response analysis in the epidemiological study on latex allergy. METHODS: Two rubber plantations (110 workers), three NRL glove manufacturing factories (583 workers) in Thailand and one UK hospital (490 workers) were selected for the study. A preliminary workplace survey was carried out at each workplace in order to assign job titles subjectively in to high, moderate or low exposure groups for the purpose of sample selection. Between 5 and 20% of workers from each group for the three populations were then selected randomly for personal measurement of latex airborne allergens. Personal sampling was conducted using a 25 mm PTFE filter loaded in to an IOM sampling head at 2 l. min(-1). NRL aeroallergens were measured by an inhibition assay with NRL-specific IgE antibodies from NRL-sensitised people. RESULTS: A total of twenty-two personal samples were collected from plantation workers, sixty-one samples from the glove manufacturer employees and twenty seven from health care workers. The highest geometric mean (GM) NRL aeroallergen concentration was found in the glove manufacturing factories (7.3 microg m(-3)), followed by the rubber plantations (2.4 microg m(-3)) and the UK hospital (0.46 microg m(-3)). Amongst the NRL glove factories, the NRL aeroallergen concentrations were highest for those conducting the following tasks; glove stripping, glove inspections and packing of powdered gloves. The GM NRL aeroallergen for these tasks were in the range of 12.9 to 17.8 microg m(-3). CONCLUSIONS: In the process from tapping and manufacture of latex gloves through to their use the highest exposure to NRL aeroallergens is likely to occur in the manufacturing factories. Exposure to aeroallergens for the plantation workers was considered to be moderate and that of health care workers to be low. (+info)
Intraoperative contamination of synthetic vascular grafts. Effect of glove change before graft implantation. A prospective randomised study.
OBJECTIVES: to investigate the incidence of intraoperative graft contamination, bacterial species and the influence of change of surgeon's gloves on contamination. DESIGN: a prospective randomised study. MATERIALS AND METHODS: forty patients had implantation of synthetic vascular grafts. All patients received intraoperative cloxacillin (2.0 g) or clindamycin (0.6 g) intravenously. The procedures were randomised to two groups: Group 1 - surgeons changed the gloves before the first contact with the vascular prosthesis and Group 2 - operation without glove change. The growth of all bacterial species from graft segments and from the gloves was recorded. The susceptibility to antibiotics was tested. RESULTS: the number of contaminated grafts was similar in the two groups. Growth of bacteria was recorded from 92.5% (37/40) of the graft segments and 33% (51/156) of glove imprints. Of the cultured species, 75% and 47%, respectively, were identified as coagulase-negative staphylococci (CNS). Twenty-eight per cent of CNS were resistant to cloxacillin, 15% to clindamycin, and 10% to cloxacillin and clindamycin. In all, 25% of the CNS strains were resistant to the prophylactic antibiotic used. In 50% of cases, the antibiogram of the CNS strain recovered from gloves agreed with that of the strain harvested from the graft. CONCLUSIONS: a high incidence of graft contamination was found which was not reduced by changing gloves. However, changing gloves did seem to reduce the number of bacterial species. (+info)