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How many hospital pharmacies with sterile areas for handling and preparing cytotoxic drugs are aware that one of the greatest risks that they are taking is with the lives of their staff? The risk is that a pharmacy staff member will contract type 1 natural rubber latex (NRL) protein allergy.
Exposure over time to the proteins in NRL can cause an individual to become latex-sensitised. The longer the exposure period and the higher the level of proteins in the gloves, the greater is the potential risk of sensitisation.
It is inevitable that among pharmacy staff who wear latex cleanroom gloves on a daily basis, a number of individuals will over a period of time develop type 1 latex protein allergy. This is an irreversible and potentially life-threatening condition.
There is a proven link between prolonged exposure to the proteins in latex gloves and acquisition of type 1 allergy.
Although this does not mean all latex glove wearers will become latex-allergic, a study by the Association of Operating Room Nurses (AORN) in the USA found a significant percentage of latex-sensitised employees were predisposed to acquisition of type 1 latex protein allergy (see Table 1).(1)
In the UK, the Trades Union Congress (TUC) has called for a total ban on the use of latex gloves in the National Health Service, citing a figure of 100,000 staff at risk of developing a latex allergy.
Legal actions have been successfully brought against employers by employees who have become latex-allergic, on the basis that despite the availability of alternative gloves, employers were unwilling to change from using latex gloves.
Incident 1: September 2000
A respiratory therapist in Wisconsin, USA, was awarded $1m for acquisition of a work-related latex protein allergy.
Incident 2: July 2004
A former NHS nurse was awarded £354,000 in damages for personal injury, loss of future earnings and loss of pension. She is now obliged to carry an adrenaline injection at all times in case she comes into contact with latex.
Incident 3: July 2004
Less than a month after the award was made in the above case, an Australian nurse received AUS$428,000 in compensation from Illawarra Area Health Service, Sydney, after acquiring a latex-protein allergy at work.
The advantage of latex gloves is that, with their elastic properties, they offer the ideal combination of fit, comfort, grip and tactility, which is frequently required when undertaking delicate procedures. Latex is also resistant to a wide range of substances, particularly alcohols, acids and fats. However, gloves made using alternative latex-free materials are typically criticised for their poor tactility, stiffness, poor grip, poor fit and low elasticity. Nonlatex gloves are also generally far more expensive than the equivalent latex gloves.
The most straightforward solution would appear to be to stop using latex gloves. However, this has proved difficult to put into practice.
Given the scale of the problem, continuous efforts have been made to find an alternative material that includes the excellent physical properties of natural rubber latex but excludes the potential to cause irreversible damage to the health of some users.
However, a range of sterile cleanroom gloves manufactured from a proprietary blend of nonlatex polymers is now available. These gloves are 100% latex-free and have exceptional performance against cytotoxic drugs.
Advantages of these gloves – manufactured by UK company Nitritex under the brandname BioClean – comprise:
For more information on BioClean gloves, contact Nitritex’s sales department by telephone on +44 (0)1638 663338 or via email at firstname.lastname@example.org
1. Korniewicz DM, Garzon L, Seltzer J, Kennedy N, Feinleib M. Implementing a nonlatex surgical glove study in the OR. AORN Journal 2001;73;2:435,437-40,442,445.