Protective Gloves for Occupational Use

Cover
Half Title
Title Page
Copyright Page
Table of Contents
Preface
Editors
Contributors
Terminology and Abbreviations
Section I Introduction to Prevention and Protective Gloves
	Chapter 1 Prevention of Contact Dermatitis
		1.1 Introduction
		1.2 Protective Gloves and Other Methods of Prevention
		References
	Chapter 2 Occupational Hygiene Assessments for the Use of Protective Gloves
		2.1 Introduction
		2.2 Requirements for Assessment
		2.3 The Occupational Hygiene Process
		2.4 Overview of Risk Assessment
		2.5 Hazard Characterization
		2.6 Skin Notations
		2.7 Exposure Assessment
		2.8 Risk Characterization
		2.9 Consideration of Control Measures
		2.10 Reassessment
		2.11 Industrial Battery Charging: An Example
		2.12 Worker Training
		References
	Chapter 3 Gloves: Types, Materials, and Manufacturing
		3.1 Glove Types
			3.1.1 Medical Gloves
			3.1.2 Industrial Gloves
			3.1.3 Household Gloves
		3.2 Materials
			3.2.1 Polymers Widely Used for Gloves (Mass Market)
				3.2.1.1 Natural Rubber
				3.2.1.2 Nitrile Butadiene Rubber and Carboxylated Nitrile Butadiene Rubber (XNBR)
				3.2.1.3 Polychloroprene Rubber
				3.2.1.4 Polyisoprene Rubber
				3.2.1.5 Polyvinyl Chloride
			3.2.2 Polymers Used for Niche Market Segments
				3.2.2.1 Butyl Rubber
				3.2.2.2 Chlorosulfonated Polyethylene
				3.2.2.3 Ethylene–Propylene Diene Monomer
				3.2.2.4 Fluorocarbon Elastomer
				3.2.2.5 Styrenic-Block-Copolymers
				3.2.2.6 Polyvinyl Alcohol
				3.2.2.7 Polyethylene
				3.2.2.8 Polyurethane
				3.2.2.9 Silicone Rubber (VMQ, LSR)
			3.2.3 Materials and Processes Used in Glove Inner and Outer Surfaces
				3.2.3.1 Inner Glove Surface
				3.2.3.2 Outer Glove Surface
		3.3 Manufacturing
			3.3.1 Gloves Made by Dipping
				3.3.1.1 Latex Dipping Technology
				3.3.1.2 Solution Dipping Technology
			3.3.2 Supported Gloves
			3.3.3 Cut and Sewn Gloves
			3.3.4 Gloves Made by Punching and Welding
			3.3.5 Gloves Made by Molding
		3.4 Concluding Remarks
		List of Abbreviations
		References
	Chapter 4 Extraction and Chemistry of Rubber Allergens
		4.1 Introduction
		4.2 Latex Protein Allergens
			4.2.1 Standardized Test for Assessing Residual NRL Protein and Antigen Content
				4.2.1.1 Total Extractable Protein; ASTM D 5712
				4.2.1.2 Total Antigenic Hev b Protein; ASTM D 6499
				4.2.1.3 Hev b Allergens; ASTM D 7427
		4.3 Rubber Accelerator/Chemical Contact Allergen Analyses
			4.3.1 Glove Accelerator Extraction and Spot Test
			4.3.2 Glove Accelerator Quantitative Analysis Methods
		4.4 Glove Accelerator Chemical Mechanisms of ACD
		4.5 Conclusion
		References
Section II Regulations and Standards
	Chapter 5 European Standards on Protective Gloves
		5.1 Introduction
		5.2 Development of European Standards
		5.3 European Directives and Regulations
			5.3.1 Personal Protective Equipment
			5.3.2	Medical Gloves
		5.4 Standards Related to Protective Gloves
		References
	Chapter 6 US Rules, Regulations, and Standards for Protective Gloves for Occupational Use
		6.1 Introduction
		6.2 Rules, Regulations, and Standards
		6.3 US Standards on Gloves
		6.4 Recent Changes, Important Updates, and Emerging Issues
		References
	Chapter 7 Japanese Regulations and Standards for Medical and Dental Grade Gloves
		7.1 Introduction
		7.2 The Japanese Medical Device Regulatory System
		7.3 Registration and Approval
		7.4 Medical Device Classification
		7.5 Specifications of Gloves
			7.5.1 Classification
			7.5.2 Materials
			7.5.3 Nominal, Nominal Numbers, and Dimensions
			7.5.4 Quality
			7.5.5 Other Items
		7.6 Quality Management System for Gloves as Medical Devices
		7.7 Insurance Reimbursement System for Medical Devices
		7.8 Infection Control and Glove Use
		7.9 Glove-Related Allergy and Product Selection
		References
	Chapter 8 Australian Standards for Protective Gloves
		8.1 Introduction
		8.2 Development of Australian Standards
		8.3 Aligning with International Standards
		References
	Chapter 9 Regulations and Standards for Protective Gloves for Occupational Use in Croatia
		9.1 Introduction
		9.2 Glove Standards
		9.3 Use of Latex Gloves
		9.4 Outreach Activities in Croatia
		References
	Chapter 10 Testing of Protective Effect against Liquid Chemicals
		10.1 Terms and Definitions
		10.2 Degradation Testing
		10.3 Permeation Testing
			10.3.1 Key Parameters
			10.3.2 Standard Test Methods
			10.3.3 Permeation Test Cells
			10.3.4 Factors Influencing the Permeation Test Results
			10.3.5 Evaluation of Test Results
			10.3.6 Intermittent Contact Permeation Testing
			10.3.7 Protection Index
			10.3.8 Modified Permeation Testing
		10.4 Penetration Testing
		10.5 Conclusions
		References
	Chapter 11 Standard Quality Control Testing, Virus Penetration, and Glove Durability
		11.1 Introduction
		11.2 Standard Tests for Glove Integrity
			11.2.1 The 1000 mL Water Leak Test
			11.2.2 Virus Leak Tests
			11.2.3 Puncture Resistance
			11.2.4 Breaking Strength
			11.2.5 Tear Strength
		11.3 Integrity Studies of New and Used Gloves
			11.3.1 Leak Tests on Used Gloves
				11.3.1.1 Testing with 1000 mL of Water
				11.3.1.2 Testing with a Modified Water Leak Test
				11.3.1.3 Testing with Viruses
			11.3.2 Leak Tests on Punctured Gloves
				11.3.2.1 Results from 1000 mL Water Leak Tests
				11.3.2.2 Results from Virus Tests
			11.3.3 Studies of Puncture Resistance
				11.3.3.1 Earlier Studies
				11.3.3.2 Recent Studies
		11.4 Barrier (Glove) Durability
			11.4.1 Material Fatigue
				11.4.1.1 Earlier Studies
				11.4.1.2 Recent Studies
			11.4.2 Tribologic Studies
			11.4.3 Other Factors That Influence Integrity
		11.5 Conclusions
		References
	Chapter 12 In Vivo Testing of the Protective Effect of Gloves
		12.1 Introduction
		12.2 In Vivo Testing of Gloves
			12.2.1 Patch Testing with Allergen and Glove
			12.2.2 Use of an Open Chamber System
				12.2.2.1 Testing Device
				12.2.2.2 Method
				12.2.2.3 Evaluation
		References
Section III Glove Sensitivity and Effects on Skin
	Chapter 13 Irritation and Contact Dermatitis from Protective Gloves: An Overview
		13.1 Introduction
		13.2 History
		13.3 Symptoms and Signs
		13.4 Exposure Conditions
		13.5 Skin Irritation—Strategy for Examination and Suggested Investigations
			13.5.1 Provocation Tests
			13.5.2 Patch Tests with Pieces of Glove
			13.5.3 Workplace Visits
		13.6 Summary and Conclusion
		References
	Chapter 14 Allergic Contact Dermatitis from Rubber and Plastic Gloves
		14.1 Introduction
		14.2 Frequency of Allergic Contact Dermatitis Due to Gloves
			14.2.1 Rubber Gloves
			14.2.2 Plastic Gloves
		14.3 Sensitizers
			14.3.1 Rubber Gloves
			14.3.2 Plastic Gloves
		14.4 Clinical Aspects
			14.4.1 Predisposing Factors
			14.4.2 Location and Appearance of Dermatitis
		14.5 Diagnosis and Differential Diagnosis
		14.6 Prevention of Glove Dermatitis
		References
		General Reading
	Chapter 15 Clinical Testing of Occupational Glove Sensitivity
		15.1 Introduction
		15.2 Contact Urticaria from Latex Rubber
		15.3 Allergic Contact Dermatitis
		15.4 Penetration of Chemicals through Gloves
		15.5 Conclusions
		References
	Chapter 16 Management of Natural Rubber Glove Sensitivity
		16.1 Introduction
		16.2 Manufacturing of NRL Gloves
		16.3 NRL Gloves-Related Allergens and Reactions
			16.3.1 Type I Hypersensitivity Reactions
			16.3.2 Contact Urticaria Syndrome
			16.3.3 Type IV Hypersensitivity Reactions
			16.3.4 Allergic Contact Dermatitis
			16.3.5 Irritant Reactions
				16.3.5.1 Irritant Contact Dermatitis
		16.4 Diagnostic Evaluation
			16.4.1 History
			16.4.2 Diagnostic Tests
				16.4.2.1 Type I Hypersensitivity
				16.4.2.2 Type IV Hypersensitivity
		16.5 Management
			16.5.1 Education and Awareness
			16.5.2 Product Selection in Patients with Natural Rubber Glove Sensitivity
		16.6 Conclusions
		References
	Chapter 17 Allergic Responses to Powdered Natural Rubber Latex Gloves in Healthcare Workers
		17.1 Introduction
		17.2 Natural Rubber Latex Gloves: An Overview
		17.3 NRL Allergy and Risk Factors in Healthcare Workers
		17.4 Clinical Manifestations of NRL Allergy in Healthcare Workers
		17.5 Diagnostic Tests for NRL Allergy
			17.5.1 Serum-Specific IgE Levels
			17.5.2 Skin Prick Testing
			17.5.3 Patch Testing
			17.5.4 Glove Use Test
			17.5.5 Nasal Challenge Test
			17.5.6 Diagnosis of NRL-Induced Occupational Asthma
		17.6 Treatment of NRL Allergy
		17.7 Prevention
			17.7.1 Labeling
			17.7.2 Primary Prevention
			17.7.3 Secondary Prevention
		17.8 Conclusion
		References
	Chapter 18 Other Reactions from Gloves
		18.1 Introduction, Glove Composition, and COVID-19
		18.2 Irritant Reactions
		18.3 Contact and Other Urticaria
		18.4 Chemical Leukoderma
		18.5 Endotoxins
		18.6 Ethylene Oxide and Other Sterilization Methods
		References
	Chapter 19 Occlusion vs. Contact Dermatitis
		19.1 Introduction
		19.2 Skin and Effects of Occlusion
		19.3 Local Reactions of Occlusion
		19.4 Conclusions
		References
Section IV Protection against Chemical and Microbial Agents
	Chapter 20 Gloves and Dermal Exposure to Chemicals
		20.1 Introduction
		20.2 A Conceptual Model of Dermal Exposure
		20.3 Monitoring Exposure to Assess the Protection Afforded by Gloves
			20.3.1 Available Methods for Monitoring Dermal Exposure
				20.3.1.1 Interception Methods
				20.3.1.2 Removal Methods
				20.3.1.3 In Situ Methods
				20.3.1.4 Comparison of Dermal Exposure Monitoring Techniques
			20.3.2 Role of Biological Monitoring in Assessing Dermal Exposure
			20.3.3 What Can These Methods Measure?
			20.3.4 Modeling Dermal Exposure and Uptake
		20.4 Studies That Have Attempted to Assess the Workplace Effectiveness of Gloves
		20.5 Impact of Gloves on Uptake through the Skin
		20.6 Implications for Testing the Effectiveness of Gloves
		20.7 Discussion
		Acknowledgments
		References
	Chapter 21 Percutaneous Absorption of Chemicals from Fabric (Textile)
		21.1 Introduction
		21.2 Methods
		21.3 Results
			21.3.1 Percutaneous Penetration: In Vitro Studies
				21.3.1.1 Liquids
				21.3.1.2 Gaseous Chemicals
			21.3.2 Percutaneous Penetration: In Vivo Studies
				21.3.2.1 Liquids
				21.3.2.2 Gaseous Chemicals
		21.4 Discussion
		References
	Chapter 22 Practical Considerations When Selecting and Using Gloves for Chemical Protection
		22.1 Introduction
		22.2 Should We Be Providing Gloves for Chemical Protection?
		22.3 What Factors That Affect Glove Performance Do We Need to Consider
		22.4 Why Some Gloves Can Fail to Protect
			22.4.1 Misuse
				22.4.1.1 Using the Wrong Glove
				22.4.1.2 Not Donning or Removing the Glove Correctly
				22.4.1.3 Using Gloves beyond the Time for Which They Can Provide Protection
				22.4.1.4 Improper Storage of Gloves When Temporarily Not in Use
				22.4.1.5 Incorrect Disposal
			22.4.2 Physical Damage
			22.4.3 Degradation
			22.4.4 Permeation
				22.4.4.1 Chemical Coverage, Flexing, and Stretching of the Glove
				22.4.4.2 Impact of Temperature on Glove Permeation
				22.4.4.3 Effects of Mixtures on Glove Permeation
				22.4.4.4 At What Point Do We Consider Permeation to Be Significant?
				22.4.4.5 Establishing the SMUT (Safe Maximum Use Time)
		22.5 The Effect of Occlusive Gloves on the Skin
		22.6 A Structured Approach to Selection and Use of Gloves
			22.6.1 Select Task
			22.6.2 Identify Hazard
			22.6.3 Establish Exposure
			22.6.4 Identifying Other Factors
				22.6.4.1 Dexterity
				22.6.4.2 Physical Hazards
				22.6.4.3 Temperature
				22.6.4.4 Grip
				22.6.4.5 Flexing and Stretching
				22.6.4.6 Glove Specification
				22.6.4.7 Glove Manufacturer
			22.6.5 Identify Suitable Gloves
			22.6.6 Glove Protocol
			22.6.7 In-Use Testing
			22.6.8 Acceptance Trials
			22.6.9 Incorporation into Glove System
			22.6.10 Procurement and Supply
			22.6.11 Logistics
			22.6.12 Training
			22.6.13 Monitoring for Impact on the Skin
		References
	Chapter 23 Glove Selection for Work with Acrylates Including Those Cured by Ultraviolet, Visible Light, or Electron Beam
		23.1 Introduction
		23.2 General Overview of Acrylates
			23.2.1 Chemistry1,13,14
				23.2.1.1 Oligomers
				23.2.1.2 Monomers
			23.2.2 Industrial Applications
			23.2.3 Other Occupational Applications
		23.3 Dermatological Problems with Acrylates in Industrial Applications
			23.3.1 Earlier Studies
			23.3.2 More Recent Studies
				23.3.2.1 Dental Acrylates
				23.3.2.2 Cured Acrylic Nails and Long-Lasting Nail Polish
				23.3.2.3 UV-Cured Acrylic Adhesives
				23.3.2.4 UV-Cured Inks, Paints, Varnishes, Lacquers, and Coatings
				23.3.2.5 Anaerobic Adhesives
				23.3.2.6 Two-Component Adhesives
				23.3.2.7 Cyanoacrylates
				23.3.2.8 Isobornyl Acrylate (IBA)
		23.4 Resistance of Protective Gloves to Permeation by Acrylates
		23.5 Recommendations for Protective Gloves for Work with Acrylates
			23.5.1 Brief Direct Contact with Acrylates without Organic Solvents
			23.5.2 Long-Lasting Contact with Acrylates without Organic Solvents
			23.5.3 Long-Duration Contact with Acrylates with Organic Solvents
			23.5.4 Handling of HDDA or DPGDA with or without Solvents
		23.6 Conclusions
		Acknowledgments
		References
	Chapter 24 Chemical Permeation through Disposable Gloves
		24.1 Introduction
		24.2 Finding Information
		24.3 Test Methods
		24.4 Disinfectants
			24.4.1 Chemical Permeation Studies
			24.4.2 Recommendations
		24.5 Isocyanate Compounds
			24.5.1 Chemical Permeation Studies
			24.5.2 Recommendations
		24.6 Cytostatic Drugs
			24.6.1 Earlier Chemical Permeation Studies
			24.6.2 More Recent Chemical Permeation Studies
			24.6.3 Recommendations
		24.7 Solvents
			24.7.1 Chemical Permeation Studies
			24.7.2 Recommendations
		24.8 Other Chemicals, Mixtures, and Formulations
		24.9 Conclusions
		Acknowledgments
		References
	Chapter 25 The Selection and Use of Gloves against Pesticides
		25.1 Introduction
		25.2 Dermal Exposure to Pesticides
		25.3 Comfort and Use of Gloves
		25.4 Exposure Scenarios
			25.4.1 Mixing and Loading
			25.4.2 Distribution
			25.4.3 Reentry
			25.4.4 Non-Occupational Use
		25.5 Important Determinants Describing Penetration Characteristics of Gloves
		25.6 Permeation of Pesticides through Gloves
			25.6.1 Carbamates
			25.6.2 Pyrethroids
			25.6.3 Aryloxyalcanoic Acids (Phenoxy Herbicides)
			25.6.4 Organochlorines
			25.6.5 Organophosphates
			25.6.6 Fungicides (Wettable Powders)
			25.6.7 Fumigants
		25.7 Resistance of Gloves to Penetration of Pesticides
			25.7.1 Polyethylene Gloves
			25.7.2 Latex/Natural Rubber
			25.7.3 PVC
			25.7.4 Neoprene
			25.7.5 Silver Shield™/Laminate
			25.7.6 Nitrile
			25.7.7 Additional Considerations
		25.8 Pesticide Formulations
		25.9 Use of Gloves After Storage, Washing, or Cleansing
		References
	Chapter 26 Gloves as Protection against Microbial Contamination
		26.1 Introduction
		26.2 Protection against Microorganisms
			26.2.1 Surgery
			26.2.2 Patient Care
		26.3 Barrier Integrity of Gloves
		26.4 Effects of Chemicals Commonly Used in Medical Care
		26.5 Selection of Gloves
		26.6 Conclusions
		References
Section V Special Topics
	Chapter 27 Hydro-Alcoholic Gels and Glove Use
		27.1 Introduction
		27.2 Preventive Measures
			27.2.1 Respect for Physical Distance between Individuals
			27.2.2 Ventilation
			27.2.3 Wearing a Facial Protective Medical Mask
			27.2.4 Hydro-Alcoholic Gels for the Protection of the Hands against COVID-19 Infection
			27.2.5 Ingredients That Enter in the Composition of Hydro-Alcoholic Gels
				27.2.5.1 Ethanol
				27.2.5.2 Emollients (Humectants)
				27.2.5.3 Viscosity Enhancers
				27.2.5.4 Miscellaneous
			27.2.6 Skin Lesions of the Hands Related to Hydro-Alcoholic Gels
				27.2.6.1 Skin Dryness Linked with the Application of Ethanol
				27.2.6.2 Irritant Contact Dermatitis
				27.2.6.3 Atopic Subjects
				27.2.6.4 For All Patients, Atopic or Not, the Nuisance Is Quite Obvious
			27.2.7 Use of Gloves in Occupational Medicine
			27.2.8 The Concomitant Use of Hydro-Alcoholic Gels and Gloves against COVID-19
			27.2.9 Skin Lesions of the Hands Due to Gloves Used Simultaneously with Hydro-Alcoholic Gels
		References
	Chapter 28 Clinical Relevance of Masks in the Operating Room
		28.1 Introduction
		28.2 Materials and Methods
			28.2.1 Search Strategy
			28.2.2 Eligibility
			28.2.3 Data Screening
			28.2.4 Data Extraction
		28.3 Results
		28.4 Discussion
		References
	Chapter 29 Are Masks Effective as Source Control in Index Influenza Patients? A Review
		29.1 Introduction
		29.2 Materials and Methods
			29.2.1 Search Strategy
			29.2.2 Eligibility
			29.2.3 Data Screening
			29.2.4 Data Extraction
		29.3 Results
		29.4 Discussion
		References
	Chapter 30 Extended Use and Disinfection of N95 Respirators and Exam Gloves During a Pandemic
		30.1 Introduction
		30.2 Extended Use of N95 Respirators
		30.3 Supporting Research on N95 Respirators
			30.3.1 N95 Methods Implemented in Hospitals
			30.3.2 N95 Methods under Investigation
			30.3.3 N95 Methods Not Recommended
		30.4 Extended Use of Disposable Exam Gloves
		30.5 Supporting Research on Exam Gloves
			30.5.1 Physical Integrity
			30.5.2 Mechanical Integrity
		30.6 Additional Issues During the Pandemic
		30.7 Conclusions
		References
Index