Development of the medical glove has revolutionized protection of health care providers and patient. The manufacture of latex gloves involves the combination of a complex raw material, a variety of chemical additives, and multiparameter processes developed to meet customer requirements. Dermal compatibility issues related to these chemicals have been known since the 1930s, when the first cases of irritant and allergic contact dermatitis due to a variety of rubber products were first documented. With occupational exposure to hepatitis and HIV, there has been a re-emphasis on the importance of hand protection. As would be expected, the increased glove usage has resulted in an increase in frequency of irritant and allergic contact dermatitis (delayed Type IV); however, it is the occurrence and rising incidences of immediate Type I hypersensitivity to allergenic proteins from natural rubber that have caused the greatest concern. Research on this issue is slowed because sensitized individuals recognize different peptide antigens and not all have routine (consistent) latex contact, occupational or otherwise. It is proposed in this article that the cause is multifaceted. This additive approach includes agricultural yield, ripening and fumigation practices, environmental-protection concerns, exposure to powder vehicles of inflammation, chemical contact sensitizers and protein allergens, hospital sterilization practices, rapid supply-demand resolution (i.e., use of poor quality gloves), and increased latex exposure. The result is that individuals become more susceptible and are exposed to more sensitizing allergens, which pushes them toward their threshold of reaction decades before the amount of exposure would have reached the same level in the past. To provide a safe, functional hand covering, manufacturers must endeavor to create hand protection that is durable, biocompatible, and effective. Protection of the health care provider and patient is the primary concern.
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