Outer Gloves Research Articles

Double or Single Gloves

Surgical gloves should form an efficient barrier between surgeons and patients to prevent cross infection. Single gloves (SGs) have long been reported unsafe, and usage of double gloves (DGs) is still not universal. No study has reported the usage of DGs in pediatric orthopedic operations. The aim of this study was to assess the efficacy of DGs versus SGs in prevention of body fluid contact between patients and surgeons during pediatric orthopedic surgery. After 150 pediatric orthopedic operations, DGs and SGs were collected and tested for perforations. Gloves were tested for size, site, and number of perforations among principal surgeons, assistant surgeons, and scrub nurses. Gloves were not changed during long surgical procedures and were changed only if perforations were identified and recorded. The DGs used were Maxitex Duplex, powder-free indicator gloves and the SGs were of Gammex-Ansell. One hundred unused gloves of each group were tested as controls. Medical records of the patients were reviewed for age, sex, type of operation, duration of operation, and any postoperative wound infection. The data were entered in database and analyzed using SPSS package. The data were compared between double and SGs using t test with a level of statistical significance at P less than 0.05. Five hundred twenty-six DGs and 316 SGs were tested. Forty-three perforations were detected in DGs (8.1%). Outer gloves were breached in 7.8% and inner in 0.3% as compared with SGs in which 28 (8.7%) were perforated. In DGs, 4% had multiple perforations compared with 11.9% in SGs. There was a statistical significance (P<0.001) when the perforations of inner gloves were compared with the SGs. None of the inner perforations were recognized during surgery, but the outer gloves of the DGs were recognized in 71% as compared with 9% in SGs (P<0.001). The majority of perforations were seen in the nondominant hand in surgeons and assistants hands, whereas scrub nurses had 85% of perforations in the dominant hand. The index finger was the site of perforations in DGs (53.4%; SGs, 43%). The inner gloves were breached only when the outer glove was found to be perforated. The duration of surgery had a direct impact on the number of perforations. There were no perforations in DGs in less than 60 minutes as compared with 3 (10.7%) in SGs. Between 60 and 120 minutes, the perforations in the DGs were 11, and in SGs, 21. During the study period, 4 patients had surgical site infection. Three were superficial and one deep-seated infection. In 3 patients with infection, the gloves were found to be perforated, and 1 patient with infection had no perforations in the gloves. Our study confirms that DGs are safer than SGs during pediatric orthopedic operations. In the event of nonavailability of DGs, SGs should be changed on an hourly basis during long procedures. Lastly, there exists a relationship between surgical site infection and glove perforations.

Knitted outer gloves in primary hip and knee arthroplasty

A randomised trial was carried out to determine the rate of perforation to inner gloves when comparing latex with knitted gloves during hip and knee arthroplasty. Members of the surgical team were randomised to wear either two pairs of latex gloves (standard double gloving) or a knitted glove on top of a latex glove. In addition, participants completed a visual analogue assessment of their overall satisfaction with the gloves. A total of 406 inner gloves were tested for perforations over a four-month period: 23% of inner gloves were perforated when latex outer gloves were used and 6% of inner gloves were perforated when knitted outer gloves were used. In total, there were 64 perforations to the inner gloves; only one of these perforations was detected by the glove wearer. Wearing knitted outer gloves during hip and knee arthroplasty statistically significantly reduces the risk of perforation to inner latex gloves (p<0.0001).

Knitted Outer Gloves in Primary Hip and Knee Arthroplasty

A randomised trial was carried out to determine the rate of perforation to inner gloves when comparing latex with knitted gloves during hip and knee arthroplasty. Members of the surgical team were randomised to wear either two pairs of latex gloves (standard double gloving) or a knitted glove on top of a latex glove. In addition, participants completed a visual analogue assessment of their overall satisfaction with the gloves. A total of 406 inner gloves were tested for perforations over a four-month period: 23% of inner gloves were perforated when latex outer gloves were used and 6% of inner gloves were perforated when knitted outer gloves were used. In total, there were 64 perforations to the inner gloves; only one of these perforations was detected by the glove wearer. Wearing knitted outer gloves during hip and knee arthroplasty statistically significantly reduces the risk of perforation to inner latex gloves (p&lt;0.0001).

Anticipated Detection of Imminent Surgeon–Patient Barrier Breaches. A Prospective Randomized Controlled Trial Using an Indicator Underglove System

The double gloving indicator underglove system (IUS) is based on a colored detection of the outer glove perforation. Our objective was to determine the IUS efficiency to detect outer glove perforations and to reduce the risks of blood and body fluids exposure, warning the surgeon before the breach of the surgeon-patient barrier (SPB). A series of 100 visceral surgical procedures were randomly assigned to either double (IUS) or single gloving. The noticed glove perforations (using the water test method) and the IUS efficiency were analyzed in 99 procedures. In 49 single-gloving procedures, 19 perforations were noticed: one was immediately perceived (perceived accidental exposure, PAE); 3 were discovered as the gloves were being removed, and 15 were undetected before the water test (unperceived prolonged contact, UPC). In 50 double-gloving procedures (IUS), 16 perforations were noticed, all of them involving only the outer glove: the IUS allowed immediate detection of 3 perforations without any blood exposure; 13 other perforations went undetected but without any UPC. In conjunction with the protective quality of double gloving, the IUS allows detection of significant breaches of the outer glove before the breach of the SPB.

Self protection in surgery: The use of double gloves

This study assesses the perforation rate of single and double gloves and thus the extent to which double gloving protects the surgeon from diseases transmissible from the patient. We have also investigated whether double gloving offers the patient extra protection by reducing wound sepsis. Two hundred adult hernia repairs were performed, the first 100 single gloved and the second 100 double gloved. Glove perforation rates were not significantly different between single gloves and the outer of the double gloves. Although 46 of 400 outer gloves were perforated there were only 15 inner glove perforations and only eight of these matched the outer perforations. The percentage of operations in which the latex protective barrier was breached was reduced from 31 per cent when the surgeon wore single gloves to 8 per cent with double gloves. Wound sepsis was not increased by glove perforation nor reduced by double gloving. While careful technique remains mandatory we conclude that double gloving offers increased protection to the surgeon operating on high risk infectious cases.

Analysis of Captan on Nitrile Glove Surfaces Using a Portable Attenuated Total Reflection Fourier Transform Infrared Spectrometer

This study developed a method to produce uniform captan surface films on a disposable nitrile glove for quantitation with a portable attenuated total reflection Fourier transform infrared (ATR-FTIR) spectrometer. A permeation test was performed using aqueous captan formulation. Uniform captan surface films were produced using solvent casting with 2-propanol and a 25 mm filter holder connected to a vacuum manifold to control solvent evaporation. The coefficient of variation of the reflectance at 1735 +/- 5 cm(-1) was minimized by selection of the optimum solvent volume, airflow rate, and evaporation time. At room temperature, the lower to upper quantifiable limits were 0.31-20.7 microg/cm2 (r = 0.9967; p < or = 0.05) for the outer glove surface and 0.55-17.5 microg/cm2 (r = 0.9409; p < or = 0.05) for the inner surface. Relative humidity and temperature did not affect the uncoated gloves at the wavelength of captan analysis. Glove screening using ATR-FTIR was necessary as a control for between-glove variation. Captan permeation, after 8 hours exposure to an aqueous concentration of 217 mg/mL of Captan 50-WP, was detected at 0.8 +/- 0.3 microg/cm2 on the inner glove surface. ATR-FTIR can detect captan permeation and can determine the protectiveness of this glove in the field.

Glove perforation and contamination in primary total hip arthroplasty

We conducted a randomised, controlled trial to determine whether changing gloves at specified intervals can reduce the incidence of glove perforation and contamination in total hip arthroplasty. A total of 50 patients were included in the study. In the study group (25 patients), gloves were changed at 20-minute intervals or prior to cementation. In the control group (25 patients), gloves were changed prior to cementation. In addition, gloves were changed in both groups whenever there was a visible puncture. Only outer gloves were investigated. Contamination was tested by impression of gloved fingers on blood agar and culture plates were subsequently incubated at 37 degrees C for 48 hours. The number of colonies and types of organisms were recorded. Glove perforation was assessed using the water test. The incidence of perforation and contamination was significantly lower in the study group compared with the control group. Changing gloves at regular intervals is an effective way to decrease the incidence of glove perforation and bacterial contamination during total hip arthroplasty.

Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough?

To assess the glove perforation rate, efficacy of double gloving, effect of duration of surgery, expertise of surgeon and operative urgency on the glove perforation rate in obstetrical and gynecologic operations. From February to September 2002, double glove protocol was made necessary for all major obstetrical and gynecologic procedures. The operating surgeon, first and second assistant were included in the study. Gloves damage was noted (overt by inspection, occult by hydroinsufflation technique). Of the 156 procedures included in study, 32 procedures were performed (all emergency operations) single-gloved because surgeons found double gloving clumsy (56%), made it difficult to tie knots due to lack of dexterity (24%), or were too tight (20%). One thousand one hundred and twenty single gloves were examined after each procedure by hydroinsufflation. The overall perforation rate was 13.6% (single versus double outer gloves, 13.8% versus l3.2%, P > 0.05). Matching perforations were found in six cases (4.6%). Thus, the protection offered by double gloves was 95.4% even if the outer gloves were perforated. Four inner gloves had preexisting perforations. Sixty unused gloves checked similarly revealed a perforation rate of 1.6%. Emergency cases had higher perforation rate compared to elective surgeries (16.6% versus 10.8%, P < 0.00 1). Surgeries lasting for more than 40 min had a higher perforation rate compared to those finished in less than or equal to 40 min (18.6% versus 7.6%, P < 0.001). The middle finger of the left hand was the most commonly involved. The surgeon, first assistant and second assistant were involved in 73.6, 23.3 and 3.2% cases, respectively. Double gloving offers considerable protection against exposure to contaminants in the blood and body fluids of the patient and should be made routine, especially in developing countries where HIV, hepatitis B and C are widely prevalent. Double gloving should be made mandatory in emergency procedures, which have a higher perforation rate due to operative urgency, and gloves should be changed in operations lasting for more than 40 min to ensure integrity of barrier.

Permeability of different types of medical protective gloves to acrylic monomers

Dental personnel and orthopedic surgeons are at risk when manually handling products containing methyl methacrylate (MMA). Dental products may also contain cross-linking agents such as ethylene glycol dimethacrylate (EGDMA) or 1,4-butanediol dimethacrylate (1,4-BDMA). Skin contact with monomers can cause hand eczema, and the protection given by gloves manufactured from different types of material is not well known. The aim of this study was to determine the breakthrough time (BTT, min) as a measure of protection (according to the EU standard EN-374-3) for a mixture consisting of MMA, EGDMA and 1,4-BDMA. Fifteen different gloves representing natural rubber latex material, synthetic rubber material (e.g. nitrile rubbers), and synthetic polymer material were tested. The smallest monomer MMA permeated within 3 min through all glove materials. A polyethylene examination glove provided the longest protection period to EGDMA and 1, 4-BDMA (> 120 min and 25.0 min), followed by the surgical glove Tactylon (6.0 min and 8.7 min) and the nitrile glove Nitra Touch (5.0 min and 8.7 min). This study showed that the breakthrough time (based on permeation rate) cannot be regarded as a 'safe limit'. When the permeation rate is low, monomers may have permeated before BTT can be determined. Using double gloves with a synthetic rubber inner glove and a natural rubber outer glove provided longer protection when the inner glove was rinsed in water before placing the outer glove on top.

Ease of donning of new powder-free non-latex and latex double-glove hole puncture indication systems.

Cornstarch on surgical gloves is often used as a detackifying agent and a lubricant to facilitate glove donning. During the last century, scientific studies have demonstrated that cornstarch produces tissue injury in literally every part of the body. Because this glove lubricant cannot be removed from the glove, Dr. David Podell, an ophthalmologic surgeon, and his cousin, Howard Podell, a chemical engineer, devised the first powder-free surgical glove that could be donned easily. They coated the inner surface of the surgical glove with a methacrylate polymer lining that was bonded to the natural rubber latex. This special coating acts as a lubricant to facilitate donning with damp, wet, or dry hands. In our earlier experimental studies, we confirmed that these polymer-lined latex gloves could be donned with either wet or dry hands. More recently, the polymer-coated latex gloves were incorporated into a double-glove hole puncture indication system that accurately detected glove holes in the presence of fluid. Because this discovery has been expanded into the development of a non-latex double-glove hole puncture indication system, we have expanded our biomechanical performance studies to examine the glove donning forces of the latex and non-latex glove hole puncture indication systems. The maximum donning forces recorded for the non-latex undergloves were significantly lower than those encountered by the same respective sizes of the latex underglove. The donning forces of the thin Biogel Super-Sensitive outer gloves were remarkably similar to the donning forces of the Biogel Indicator undergloves. The thicker Biogel outer gloves encountered greater donning forces than that noted for the Biogel Super-Sensitive outer gloves. The donning forces recorded for the non-latex outer gloves were remarkably similar to those noted for the latex Biogel outer gloves. Because the results of this biomechanical performance study demonstrated that the latex and non-latex double-glove hole puncture indication systems can be easily donned by surgeons using relatively low donning forces, this study provides convincing evidence that these double-glove hole puncture indication systems can be used in all surgical procedures.

Reducing accidental injuries during surgery.

Extensive clinical investigations have demonstrated that double-gloves and blunt-tipped surgical needles dramatically reduced the risk of accidental injuries during surgery. During the last decade, double-glove hole puncture indication systems have been developed that reduce the clinical risk of accidental needlestick injuries as well as detect the presence of glove hole puncture in the presence of fluids. When the outer glove is punctured, the colored underglove becomes apparent through the translucent outer glove, necessitating glove removal, hand washing, and donning of another double-glove hole puncture Indicator system. This article presents the first biomechanical performance study that documents the puncture resistance of blunt surgical needles in latex and nonlatex single gloves and double-glove hole puncture indication systems. The technique for measuring glove puncture resistance simulates the standard test for material resistance to puncture outlined by the American Society for Testing and Materials. The maximum puncture resistance force was measured by the compression load cell and recorded in grams with a strip chart recorder. Ten puncture resistance measurements for the taper point needle, blunt taper point needle, and blunt needle were taken from five samples of the Biogel Indicator underglove, Biogel Super-Sensitive glove, Biogel glove, Biogel Skinsense N Universal underglove, and Biogel Skinsense Polyisoprene glove; and the Biogel, Biogel Super-Sensitive, and Biogel Skinsense Polyisoprene double-glove hole puncture indication systems. The magnitude of puncture resistance forces recorded was influenced by several factors: glove material, number of glove layers, and type of surgical needle. For each type of curved surgical needle,the resistance to needle penetration by the nonlatex gloves was significantly greater than those encountered by the latex glove materials. The resistance to needle puncture of all three double-glove systems was significantly greater than that of either the nonlatex or latex underglove or outer glove. The taper point needle encountered the lowest puncture resistance forces in the five single gloves and the three double-glove systems. Blunting the sharp end of the taper point needle markedly increased its resistance to glove puncture in the five single gloves and five double-glove systems. The blunt-point surgical needle elicited the greatest needle penetration force in all of the single and double-glove systems.

Resistance of double-glove hole puncture indication systems to surgical needle puncture.

Double-gloving has been shown to reduce conclusively the risk of operating room personnel's exposure to blood. Limiting risk of exposure to blood by double-gloving provides protection against the transmission of bloodborne diseases. Realizing the importance of double-gloving, a double-glove hole puncture indication system exists that accurately detects the presence of glove hole puncture in the presence of fluid. Once a glove puncture is recognized by this double-glove hole puncture indication system, it provides a warning to the surgeon to remove the punctured gloves, wash hands, and don a new, sterile double-glove hole puncture indication system. While accurately identifying the presence of glove hole puncture in the presence of fluid, this double-glove hole puncture indication system also has resistance to needle puncture superior to that of single gloves. It is the purpose of this study to document the resistance to needle puncture of latex and non-latex double-glove hole puncture indication systems using a reproducible experimental model. The resistance to needle puncture of the double-glove systems was significantly greater than that of the undergloves or outer gloves alone. The resistance to glove puncture of the non-latex and latex single and double-glove systems was significantly greater than those encountered by the latex single and double-glove systems, respectively. On the basis of their accuracy in detecting glove hole puncture, combined with their demonstrated superior resistance to surgical needle puncture as compared to single gloves, these latex and non-latex double-glove hole puncture indication systems are recommended for all surgical procedures.

Reliability and performance of innovative surgical double-glove hole puncture indication systems.

During operative procedures, operating room personnel wear sterile surgical gloves designed to protect them and their patients against transmissible infections. The Food and Drug Administration (FDA) has set compliance policy guides for manufacturers of gloves. The FDA allows surgeons' gloves whose leakage defect rates do not exceed 1.5 acceptable quality level (AQL) to be used in operating rooms. The implications of this policy are potentially enormous to operating room personnel and patients. This unacceptable risk to the personnel and patient could be significantly reduced by the use of sterile double surgical gloves. Because double-gloves are also susceptible to needle puncture, a double-glove hole indication system is urgently needed to immediately detect surgical needle glove punctures. This warning would allow surgeons to remove the double-gloves, wash their hands, and then don a sterile set of double-gloves with an indication system. During the last decade, Regent Medical has devised non-latex and latex double-glove hole puncture indication systems. The purpose of this comprehensive study is to detect the accuracy of the non-latex and latex double-glove hole puncture indication systems using five commonly used sterile surgical needles: the taper point surgical needle, tapercut surgical needle, reverse cutting edge surgical needle, taper cardiopoint surgical needle, and spatula surgical needle. After subjecting both the non-latex and latex double-glove hole puncture indication systems to surgical needle puncture in each glove fingertip, these double-glove systems were immersed in a sterile basin of saline, after which the double-gloved hands manipulated surgical instruments. Within two minutes, both the non-latex and latex hole puncture indication systems accurately detected needle punctures in all of the surgical gloves, regardless of the dimensions of the surgical needles. In addition, the size of the color change visualized through the translucent outer glove did not correlate with needle diameter. On the basis of this extensive experimental evaluation, both the non-latex and latex double-glove hole puncture indication systems should be used in all operative procedures by all operating room personnel.

Double gloving to reduce surgical cross-infection.

The findings of this review are used to provide national gloving practice recommendations in the UK, Australia (Australian College of Operating Room Nursing) and the USA (Association of Perioperative Registered Nurses). This review is also included in the draft version of the NICE surgical site infection guidelines.

Evaluation of bioaerosol exposures during conditioning of biofilter organic media beds.

Biological media air filters (biofilters) are currently being used for the treatment of inorganic and organic gases from sewage treatment plants, industrial processes, and remediation systems. The media may be organic material such as compost, wood chips, or synthetic plastic media, each with a large surface area for microorganism growth and activity. An occupational health and safety graduate student team (OHS team) evaluated potential particulate and bioaerosol exposure from a biofilter unit process used to treat hydrogen sulfide (H2S) gas generated from a primary sludge settling unit process. The OHS team included an industrial hygiene/environmental health engineering specialist, an occupational safety specialist, an occupational health physician, and an occupational health nurse. Concerns were raised regarding the possibility of adverse health effects to maintenance workers during "conditioning" of the biofilter compost-like media beds. Conditioning activities may include in-situ rearrangement of the existing media, removal from the tank/surface, drying/reinsertion of the existing media, or complete removal of the media, and replacement with new. Neither the design engineering firm nor the manufacturer had specific written recommendations or precautions regarding exposure during the conditioning of the compost beds. No personal protection equipment has been used for this activity. The expected agents for adverse health effects associated with this unit process are respirable particulate dust and bioaerosols, which may contain viable bacteria and fungi, as well as endotoxin. Safety procedures are already in place for H2S. Mixed dust from the compost media bed may cause irritation of pre-existing health conditions such as asthma, chronic lung disease, and some skin conditions, and may also lead to new health problems such as inhalation fever, occupational asthma, hypersensitivity pneumonitis, skin rashes and/or skin infections, and upper or lower respiratory infections. Air samples were taken immediately before (background samples) and during a simulation of the conditioning procedure of one of the two compost beds. Airborne samples collected during the simulated procedure yielded more bacteria per volume of collected air than the background samples. These findings suggest an increased risk for bacterial infection during the conditioning procedure. The airborne samples cultured for fungi during the simulation were less than the background sample. Stachybotrys chartarum was not detected in a sample of the filter media. As with the fungi data, endotoxin air sampling yielded less endotoxin during the simulated conditioning procedure than in the background. Two inches of rain had fallen in the 24 hours preceding the sampling, soaking the upper layers of the compost media. Sampling during an actual conditioning procedure on a warm, dry day may yield additional evidence relevant to potential health risks from dust and microorganisms. Although the data is not representative of an actual conditioning procedure, the following common sense precautions are recommended: (1) Dust minimization during dry conditions can be achieved by thoroughly wetting the compost bed prior to removing the compost, and wetting the compost again before returning it to the bed. (2) Based on scientific literature rather than this project's sampling results, the use of an appropriate respirator should be proactively considered. In addition, consideration must be given to the worker's cardiopulmonary effects associated with respirator use, decreased work performance effects, and OSHA administrative requirements of a respirator protection program. (3) Workers with immunocompromised status, asthma, allergic rhinitis/conjunctivitis, or allergic conditions of the skin, eyes, or lungs should be excluded from this particular job, unless it can be shown that their personal protective equipment is effective. (4) Protective outer wear, goggles, and gloves should be worn to minimize health risks associated with clothing garments contaminated by microorganisms.

Intraoperative glove perforation—singleversus double gloving in protection against skin contamination

Surgeons have the highest risk of contact with patients' blood and body fluids, and breaches in gloving material may expose operating room staff to risk of infections. This prospective randomised...

How often does glove perforation occur in surgery? comparison between single gloves and a double-gloving system

Background: In surgery, intact gloves protect the surgeon from bloodborne pathogens and the surgical wound from microorganisms on the skin of the surgeon. However, glove perforation is very common, and puncture rates as high as 61% are published in the literature. One objective of this study was to compare puncture rates between a unique double-gloving puncture indication system and single-use gloves, and another was to determine the extent to which glove perforations remain undetected during surgery. Methods: The study material comprised all gloves used in surgical operations at our hospital for a period of 2 months. The analysis was made by the glove type in a prospective and randomized manner. Gloves were tested immediately after the surgical procedure using the approved standardized water-leak method for 2 minutes to detect any holes. The gloves used in this study were either a double-gloving puncture indication system or the standard glove used at our hospital. Results: In 885 operations altogether, 2,462 gloves were tested; 1,020 single gloves, 1,148 double-glove systems, and 294 combination gloves were studied. The overall perforation rate was 192 out of 2,462 gloves (7.80%), and 162 out of 885 operations (18.3%). The detection of perforation during surgery was 28 out of 76 (36.84%) with single gloves, 77 out of 89 with the double-gloving system (86.52%), and 9 out of 27 with combination gloves (33.33%; P <0.001). The inner glove of the double-gloving system was punctured in 6 out of 88 outer glove perforations (6.82%). Conclusions: In view of the critical importance of safety at work by having a sterile barrier between surgeon and patient, it is very important to use a double-gloving puncture indication system, at least in operations where there is a high risk of glove perforation.

A novel method of assessing the effectiveness of protective gloves—results from a pilot study

We have devised a novel method for evaluating the effectiveness of protective gloves and have undertaken a small study to assess this approach. Three types of glove were tested in a standardised simulation test with a permethrin-based pesticide. Prewashed cotton gloves were used to collect the samples. One was worn over the protective glove on one hand to measure the potential deposition of pesticide on the hands had the gloves not been worn. A second was placed under the protective glove on the opposite hand to measure the actual deposition of permethrin on the hands when the gloves were worn. This regime was reversed half way through each test in an attempt to prevent bias. Measurable inner glove contamination occurred on 25 out of 30 occasions. Geometric mean protection factors were calculated from the ratio of outer and inner sampling glove contamination, with average protection factors of 470, 200 and 96 being obtained for the two nitrile and PVC gloves, respectively. The PVC gloves were the least effective in preventing inner glove contamination, probably because the glove was thick and fairly inflexible, causing more pesticide to enter the glove around the cuff. Although the tasks were standardised, variability occurred due to worker behaviour and equipment failure. The spray pump failed on five occasions, resulting in higher levels of inner glove contamination and a geometric mean protection factor of 32. On the occasions when the pump worked correctly, the level of protection provided by the gloves rose dramatically with mean protection factors of 220 and 450 being obtained for workers categorised as “messy” and “tidy”, respectively.

A novel method of assessing the effectiveness of protective gloves—results from a pilot study

Abstract We have devised a novel method for evaluating the effectiveness of protective gloves and have undertaken a small study to assess this approach. Three types of glove were tested in a standardised simulation test with a permethrin-based pesticide. Prewashed cotton gloves were used to collect the samples. One was worn over the protective glove on one hand to measure the potential deposition of pesticide on the hands had the gloves not been worn. A second was placed under the protective glove on the opposite hand to measure the actual deposition of permethrin on the hands when the gloves were worn. This regime was reversed half way through each test in an attempt to prevent bias. Measurable inner glove contamination occurred on 25 out of 30 occasions. Geometric mean protection factors were calculated from the ratio of outer and inner sampling glove contamination, with average protection factors of 470, 200 and 96 being obtained for the two nitrile and PVC gloves, respectively. The PVC gloves were the least effective in preventing inner glove contamination, probably because the glove was thick and fairly inflexible, causing more pesticide to enter the glove around the cuff. Although the tasks were standardised, variability occurred due to worker behaviour and equipment failure. The spray pump failed on five occasions, resulting in higher levels of inner glove contamination and a geometric mean protection factor of 32. On the occasions when the pump worked correctly, the level of protection provided by the gloves rose dramatically with mean protection factors of 220 and 450 being obtained for workers categorised as “messy” and “tidy”, respectively.

Potential exposure of hands inside protective gloves--a summary of data from non-agricultural pesticide surveys

The results of individual surveys are compared and general observations are made about the protective nature of protective gloves. A total of 190 measurements of contamination by involatile components of pesticide products were made inside the gloves. Protective gloves were nearly always found to be contaminated inside, except for public hygiene insecticide uses. Disposable gloves were sometimes used when applying public hygiene insecticides, while gloves worn for other applications were normally re-used. The data suggest that when expressing inner glove exposure as ‘amount of product per unit time’, the data distributions of the non-zero results appeared similar for all activities except for the application of antifoulings. A median value for all non-zero data was indicated at 1.36mg product per minute; a 75th percentile at 4.21mgmin−1 and a 95th percentile at 71.9mgmin−1, assuming product densities of 1.0gml−1. In default of better information, these indicators can be used in health-based risk assessment. A further 47 data related to exposure inside new gloves, and 21 data to deposition on outer gloves. These indicate that in general, gloves provide a reasonable degree of protection to non-agricultural pesticides. Due regard should be paid to ‘human factors’ when considering contamination inside gloves. When people take off dirty gloves, it is difficult to avoid touching the glove exterior. With gloves off, the subject can touch contaminated surfaces. Donning dirty gloves furnishes an inevitable contact with contamination on the outside of the gloves, and can introduce that contamination inside. A common mode of contamination could contribute to the similar distributions for hand contamination inside gloves, from very different uses.