What Factors Can Weaken the Protective Properties of Gloves?

Sin­gle-use med­ical gloves are designed to pro­tect the per­son wear­ing them and pre­vent the trans­mis­sion of pathogens and bio­log­i­cal con­t­a­m­i­nants between patients. The pro­tec­tive prop­er­ties of gloves are main­tained, pro­vid­ed that the effec­tive­ness of fol­low­ing the cor­rect usage guide­lines is upheld. What fac­tors can affect the dete­ri­o­ra­tion of the prop­er­ties of sin­gle-use med­ical and pro­tec­tive gloves, and what mis­takes should be avoid­ed?

What does the protection provided by gloves depend on?

Rękaw­ice medy­czne są pod­sta­wowym narzędziem pro­fi­lak­ty­cznym stosowanym w prak­tyce szpi­tal­nej. Chronią dłonie przed przy­pad­kowym zabrudze­niem mate­ri­ałem bio­log­icznym i zapo­b­ie­ga­ją jego przenosze­niu. Za właś­ci­woś­ci ochronne rękaw­iczek odpowia­da przede wszys­tkim mate­ri­ał, z którego zostały wyko­nane. W powszech­nym uży­ciu są nitrile gloves (z gumy syn­te­ty­cznej) oraz latek­sowe and winy­lowe.

Microorganism permeation

Rękaw­ice muszą stanow­ić bari­erę dla mikroor­ga­nizmów. Europe­js­ka nor­ma EN 455–1 określa, że każ­da seria rękaw­iczek musi być pod tym wzglę­dem kon­trolowana i uzyskać odpowied­ni poziom AQL, pod­czas tes­tu wod­nego. Dla rękaw­ic medy­cznych wynosi on maksy­mal­nie 1,5 – im niższy poziom, tym rękaw­ica jest bardziej szczel­na. Obec­nie wiele rękaw­ic, zwłaszcza nit­ry­lowe posi­a­da obniżony poziom AQL wynoszą­cy 1,0. Poziom AQL (szczel­noś­ci) jest kon­trolowana obow­iązkowo, dla każdej par­tii pro­duk­cyjnej wykonu­je się wyry­wkowe test wod­ny wykry­wa­ją­cy ilość dzi­u­rawych rękaw­ic.

Anoth­er stan­dard test­ing pro­ce­dure is the assess­ment of the mate­ri­al’s resis­tance to virus­es and blood­borne pathogens using the bac­te­rio­phage Phi‑X 174. It has an extreme­ly small diam­e­ter (27 nm). For com­par­i­son, the HIV virus is approx­i­mate­ly 100–150 nm, the HBV virus is 42–47 nm, and the HCV virus is 30–38 nm. There­fore, if the bac­te­rio­phage Phi‑X 174 can­not pen­e­trate the gloves, larg­er virus­es will also be unable to do so.

Oth­er require­ments and tests relat­ed to the bar­ri­er prop­er­ties or pro­tec­tive prop­er­ties of gloves are spec­i­fied in stan­dards EN 455–1‑2–3‑4, as well as EN 374–2‑3. You can find a list of stan­dards for gloves and an expla­na­tion of labelling here.

Resistance to damage

The pro­tec­tive prop­er­ties of gloves against the ingress of pathogens are main­tained as long as there are no micro-dam­ages to the glove, which can occur, for exam­ple, dur­ing nee­dle punc­ture and mate­r­i­al intru­sion. How­ev­er, this is a sit­u­a­tion that is obvi­ous enough that the moment of intru­sion is eas­i­ly notice­able.

Less obvi­ous are sit­u­a­tions in which the dete­ri­o­ra­tion of the prop­er­ties of med­ical gloves occurs dur­ing improp­er don­ning or removal of gloves, incor­rect usage, or stor­age. In such cas­es, the glove’s sur­face may be com­pro­mised, lead­ing to the for­ma­tion of invis­i­ble micro-dam­ages that could poten­tial­ly become points of infec­tion.

To min­i­mize the risk of such dam­age that can reduce pro­tec­tion, gloves are man­u­fac­tured to be both flex­i­ble and resis­tant to stretch­ing. In this regard, both latex and nitrile gloves per­form very well and pro­vide excel­lent pro­tec­tion against both the pen­e­tra­tion of pathogens and the for­ma­tion of micro-dam­ages.

Resistance to chemicals

The pro­tec­tive prop­er­ties of gloves can also be reduced through chem­i­cal sub­stances with which med­ical per­son­nel come into con­tact. Cer­tain oils, fats, ozone or oth­er chem­i­cal agents can weak­en the struc­ture of latex or syn­thet­ic rub­ber, increas­ing the risk of tear­ing. In such sit­u­a­tions, vinyl gloves may be a bet­ter choice. Although they are less flex­i­ble and more prone to tear­ing, they pro­vide bet­ter pro­tec­tion in con­di­tions where there is a like­li­hood of con­tact with the afore­men­tioned sub­stances. You can read more about the dif­fer­ences between the mate­ri­als used for gloves here.

The aging processes of gloves

The aging process­es of med­ical gloves can impact their pro­tec­tive prop­er­ties. It has a real effect on the bar­ri­er prop­er­ties of the mate­r­i­al and its stiff­ness. Over time, the mate­r­i­al becomes more sus­cep­ti­ble to tears and micro-dam­age. There­fore, med­ical gloves should not be used beyond their expi­ra­tion date, and they should be stored in appro­pri­ate con­di­tions to pre­vent accel­er­at­ed aging of the mate­r­i­al.

What affects protection? Non-compliance with the rules

Gloves pro­vide excel­lent pro­tec­tion for the user; how­ev­er, one must not for­get to adhere to hand hygiene prac­tices and the cor­rect way of don­ning and doff­ing gloves. It is dur­ing the removal of gloves soiled with bod­i­ly flu­ids that pathogens are often inad­ver­tent­ly trans­ferred to the skin. There­fore, it is cru­cial to thor­ough­ly wash or dis­in­fect hands after glove removal, which plays a role in pro­tec­tion against health­care-asso­ci­at­ed infec­tions. Knowl­edge of hand hygiene, is nec­es­sary to ensure that no unwashed areas are left on the skin and under the nails.

Bibliography:

1. Katarzy­na Maj­da, Sła­womir Gondek, Zmniejsze­nie iloś­ci zakażeń szpi­tal­nych poprzez odpowied­ni dobór rękaw­ic, Skamex Sp. z o.o. Sp.k.

2. Syl­wia Łagan, Mag­dale­na Markiewicz, „Oce­na wybranych właś­ci­woś­ci fizyko­chemicznych rękaw­iczek diag­nos­ty­cznych”, Aktu­alne Prob­le­my Bio­mechani­ki, nr 14/2017, s. 29–36;

3. Sła­womir Gondek, „Porów­nanie cien­kich rękaw­ic diag­nos­ty­czno-ochron­nych latek­sowych i nit­ry­lowych w kon­tekś­cie poziomu ochrony przed Covid-19 oraz inny­mi zagroże­ni­a­mi.”, skamex.com.pl

4. Kinga Przy­go­da, Ręk­wice medy­czne – skutecz­na bari­era ochron­na zespołu oper­a­cyjnego – Mer­ca­torMed­ical Pro­tect­ing (30.11.2015);

5. Cen­tral­ny Insty­tut Ochrony Pra­cy – Państ­wowy Insty­tut Badaw­czy, „Rękaw­ice chroniące przed czyn­nika­mi bio­log­iczny­mi”, ciop.pl