Why should I make the move from powdered to powder-free medical gloves?
Why switch to powder-free gloves?
Powder is used as a lubricant in the manufacture of medical gloves in order to facilitate donning and to avoid blocking of the glove. The most commonly used dusting powders are cornstarch that coats the glove inside, and calcium carbonate (CaCO3) that coats the outer surface. Exposure to powder from medical gloves can cause several undesirable reactions for both healthcare workers and patients
Risks to healthcare workers using powdered medical gloves
· Powder acts as a carrier of latex proteins and can precipitate a life-threatening Type I latex allergic reaction in sensitized healthcare workers1
· Powder has a mechanical and abrasive action on the skin of hands causing skin irritation2
· Irritant contact dermatitis disrupts the skin barrier and facilitates sensitization to latex allergens3
· Powder unbalances skin pH causing it to become alkaline which is believed to be responsible for irritative skin reactions2
· Powder residue may interact with some alcohol-based hand solutionsresulting in a gritty feeling on hands4
Risks to patients from powdered medical gloves
· Powder can cause a foreign-body reaction and granulomas can form around the powder particles5
· Powder binds with protein/allergens which can increase the risk of allergic reactions through direct contact through via the skin or mucous membranes or inhalation in hypersensitive patients1
· Powder may trigger an inflammatory response, leading to the formation of fibrous bands and post-operative adhesions5
· Powder may act as a vector of bacteria and increases the incidence of wound infection1
What countries have banned the use of powdered surgical gloves?
Although there is no ban for powdered gloves in Australia and New Zealand, the Australian National Health and Medical Research Council strongly recommends the use of non-powdered gloves6. Governments, healthcare institutions, and accrediting agencies around the world are banning and/or restricting the use of powdered medical gloves. In 2017, the US FDA banned powdered gloves7 with Japan, Korea, Hong Kong, Saudi Arabia, Philippines, Thailand, Taiwan and others following soon after. UK and Germany also banned the use of powdered NRL gloves in healthcare facilities over 20 years ago.
Is it hard to don and doff gloves if it is not powdered?
Powdered gloves were first used to ease the donning of gloves. Recent advances in glove technologies and manufacturing techniques has enabled easier glove donning and doffing by treating the inside the glove. The application of a polymer coating to the inside film of latex or synthetic gloves enhances the donning attributes of the glove in both wet and dry conditions. A wide array of powder-free latex and non-latex glove choices are available today such as polyisoprene, neoprene or nitrile providing excellent barrier protection that have the same fit, feel and comfort of powdered gloves.
Ansell will be discontinuing GAMMEX Latex Powdered gloves (3300470XX) to allow room to manufacture the most advanced surgical glove technologies. The GAMMEX Latex Textured(3313006XX) is a very similar glove in terms of thickness, comfort and grip levels.
| Reactions/Adverse Events | Powdered Gloves | Powder-Free Gloves |
| Allergies | · Allergen/protein-coated powder particles can be aerosolized when the gloves are donned or removed, thus contaminating the work environment5
· Inhalation or ingestion of these powders can lead to the sensitization and diverse allergic reactions to NRL (i.e., upper respiratory tract symptoms or eye irritation)5 |
· Reduce the risk of developing respiratory and contact allergic reactions |
| Surgical Complications | · Development of adhesions and granulomas, delayed healing and increased risk of surgical site infections1,5
· Glove powder enters the patient’s body during surgery and contaminates the wound, despite glove washing or wiping prior to undertaking the surgical procedure Clinical bulletin1 |
· Safer working environments with cost-savings in reduced healthcare personnel sickness and post-operative complications clinical bulletin |
References
1. Edlich RF, Long WB 3rd, Gubler DK, Rodeheaver GT, Thacker JG, Borel L, Chase ME, Fisher AL, Mason SS, Lin KY, Cox MJ, Zura RD. Dangers of cornstarch powder on medical gloves: seeking a solution. Ann Plast Surg. 2009 Jul;63(1):111-5. doi: 10.1097/SAP.0b013e3181ab43ae. PMID: 19546685.Brehler R, Kütting B. Natural rubber latex allergy: a problem of interdisciplinary concern in medicine. Arch Intern Med. 2001 Apr 23;161(8):1057-64. doi: 10.1001/archinte.161.8.1057. PMID: 11322839
2. Miri S, Pourpak Z, Zarinara A, Heidarzade M, Kazemnejad A, Kardar G, Firooz A, Moin A Prevalence of type I allergy to natural rubber latex and type IV allergy to latex and rubber additives in operating room staff with glove-related symptoms. Allergy Asthma Proc 28:557–563, 2007.
3. WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization; 2009. 23, Practical issues and potential barriers to optimal hand hygiene practices.
4. Edelstam G, Arvanius L, Karlsson G. Glove powder in the hospital environment – consequences for healthcare workers. Int. Arch. Environ. Health 2002; vol. 75: 267-271.
5. National Health & Medical Research Council, Australian Commission on Safety and Quality in Health Care. Australian Guidelines for the Prevention and Control of Infection in Healthcare. Canberra: Commonwealth of Australia; 2019.
6. Department of Health and Human Services. Food and Drug Administration. Banned Devices; Powdered Surgeon’s Gloves, Powdered Patient Examination Gloves, and Absorbable Powder for Lubricating a Surgeon’s Glove (2016. https://www.federalregister.gov/documents/2016/12/19/2016-30382/banned-devices-powdered-surgeons-gloves-powdered-patient-examination-gloves-and-absorbable-powder Accessed June 8, 2021