Abstract
BackgroundMedical gloves are an important piece of personal protective equipment that prevents exposure to antineoplastic agents. The permeability of medical gloves to antineoplastic agents is a crucial factor in the appropriate selection of gloves. However, the relationship between glove permeability and material type, thickness, and surface treatment is poorly understood.MethodsA continuous flow in-line cell device was used for the evaluation of the permeation of five antineoplastic agents (etoposide, cyclophosphamide, doxorubicin hydrochloride, paclitaxel, and fluorouracil) through medical gloves. Medical gloves made of three types of materials (chlorinated latex, non-chlorinated latex, and nitrile) were subjected to a permeability test. The antineoplastic agents in test solutions were tested at the highest concentrations employed in general clinical practice. Then, the relationship between glove thickness and permeability was assessed using chlorinated latex gloves with thicknesses of 0.1, 0.15, 0.2, and 0.1 mm × 2 (to represent the practice of “double gloving”).ResultsOnly cyclophosphamide and fluorouracil showed detectable permeation through the tested latex gloves. The permeability of chlorinated latex was lower than that of non-chlorinated latex. Nitrile gloves showed no detectable permeability to any of the five antineoplastic agents tested. The permeability of chlorinated latex gloves depended on the thickness of the gloves; 0.1 mm × 2 (double gloving) exhibited the highest resistance to permeation by antineoplastic agents.ConclusionsThe permeability of medical gloves was dependent on the type of material and the surface treatment and decreased as the thickness of the glove increased. The double glove was shown to prevent antineoplastic agent permeation more efficiently than did a single glove of the same total thickness. These results provided important information that will guide the appropriate selection of medical gloves.
Highlights
Medical gloves are an important piece of personal protective equipment that prevents exposure to antineoplastic agents
Test agents Among the seven antineoplastic agents listed in protocol D6978-05 from the American Society of Testing and Materials (ASTM), the following five antineoplastic agents, which were available in Japan as intravenous formulations, were used in the permeability test: etoposide (ETP, Lastet® Injection, Nippon Kayaku Co., Ltd), CPA (Endoxan® for injection, Shionogi & Co., Ltd), doxorubicin (DXR) hydrochloride (ADRIACIN® Injection, Kyowa Hakko Kirin Co., Ltd), paclitaxel (PTX, TAXOL® INJECTION, Bristol-Myers Squibb), and fluorouracil (5FU, 5FU Injection 250 Kyowa®, Kyowa Hakko Kirin Co., Ltd)
The concentrations of solutions used for the permeability tests (Ctest), molecular weight (MW), and logarithm of the partition coefficient of the five selected antineoplastic agents are summarized in Table 1 [13,14,15,16]
Summary
Medical gloves are an important piece of personal protective equipment that prevents exposure to antineoplastic agents. Several reports have indicated that healthcare professionals are exposed to antineoplastic agents despite the use of preventive devices and equipment, and may have an increased risk of carcinogenesis [3,4,5,6]. To counter this situation, guidelines have recently been formulated to standardize the relevant procedures for clinical settings [7,8,9], which provide recommendations for the optimal workplace requirements, handling procedures to minimize the exposure to antineoplastic agents, and instructions for the proper use of PPEs. Among the various items of PPE, medical gloves encounter the highest risk of exposure to antineoplastic agents during the handling process; a selection of medical gloves with low permeability to antineoplastic agents are required to prevent healthcare professionals from unintended exposure. We chose to study the permeability of gloves that are made on the same manufacturing line, in addition to the possible effects of surface treatment
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