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In Good Hands? Handcare a valuable investment for the organisation

Published: 10th Mar 2010 in OSA Magazine

Multi-million Dollar claims for damages have resulted in major asbestos companies being forced to cease business, further throwing great strains on the insurance industry. The UK coal mining Industry has been devastated by the level of pneumonconiosis developed by miners. Similarly, a major glove supplier sold their business to eliminate potential claims for latex allergy.

glove-worker.jpg, In Good Hands?, Brian Smith, Sentinel Laboratories, Occupational Safety Asia, March 2010

When considering protection it should encompass both staff and the organisation.  If an organisation provides unsuitable or inadequate protective products the potential of future claims can put the very existence of the organisation in jeopardy.

 It should be remembered that legally we have a duty of care to our staff. The EEC Council Directive 89/656/EEC details the minimum safety requirements for the use by workers of personal protective equipment in the workplace. However is this too simplistic an approach? Do we accept that by suitably providing protection for our workforce we also protect the organisation or, do we believe the organisation requires protection to ensure its future; should we be taking a more holistic approach.

"It should be remembered that legally we have a duty of care to our staff."

I am going to consider staff who will be working with their hands albeit in a laboratory, in production or in healthcare - where staff will be required to wear gloves, although the approach can be extended to other areas. 

The first time we meet prospective staff is at the interview when their suitability for the post will be assessed, here we find out if they are technically able and will they fit in with existing staff?  Then they may have a medical to ensure they are fit to undertake the tasks involved in the position. In such medicals, rarely is the status of the hands checked.  It is worth checking if the hands are in good condition.  Skin elasticity and hydration of the hands should be part of the evaluation. Clearly if the staff member has a pre-existing condition this should be noted on the staff records.

"in order to protect the individual and the company it is wise to use a glove meeting the correct standards"

Once our staff are trained a valuable company resource - they must then be protected by the use of suitable gloves and hand care. 

Clearly gloves should be of an acceptable standard (this will be discussed in greater detail later) however most skin irritation problems arise from the washroom.  

Medical-gloves.jpg, In Good Hands?, Brian Smith, Sentinel Laboratories, Occupational Safety Asia, March 2010

Wash Room

If the water temperature is too high this will have a deleterious affect on the skin- the optimum temperature for cleansing the skin is 32oC. Often the hot tap temperature is set too high which can severely damage the skin - certainly if hands are required to be washed regularly.

Before applying soap wet the hands - this will facilitate the soap spreading evenly over the skin and ease of rinsing off without leaving a residue. A residue of soap on the skin beneath a glove is an ideal precursor to skin irritation.

It is worthy of note that many staff use too much soap, this makes it more difficult to effectively remove.   New onto the market are foaming soaps which spread easily over the skin and are exceptionally easy to rinse off – see the Go-Jo FMX range.

Whilst discussing soaps it is worth mentioning that soap is an excellent growth medium for bacteria - for this reason the better quality products tend to be in a wall dispenser which use a disposable collapsible soap bag. The refillable dispensers from a bulk supply have a greater need (although rarely given) for regular sanitizing. Bulk supply soap is generally cheaper and of a lower quality - probably a poor choice in a professional environment.

When the hands are being dried ideally use a disposable paper towel – there is no possibility of cross contamination with other users and drying is effective and complete.  For Hot Air Dryers to be effective the air must be at a high temperature - this is not good for the skin - most users leave the drier with only partially dried hands, they simply cannot waste the time! If they have damp hands then donning gloves is difficult, also any residual moisture can elute leachable components from the glove.

In order to maintain the skin in good condition it is recommended that skin is washed regularly, removing perspiration and allowing the skin to breathe.  It is good practice to moisturise the skin with emollients – this is recommended as a minimum of twice a day – lunch time and prior to leaving the premises.  To ensure the hands remain in peak condition the hands should be moisturised with an emollient based moisturiser as frequently as required - ideally every instance the gloves are removed and they will not be replaced for periods of 15 minutes. Often moisturisers get confused with barrier creams - the difference is a barrier cream will seal the skin reducing or eliminating the ability of the skin to breathe.  An effective moisturiser will penetrate the skin and rehydrate from beneath the surface - this will not seal the skin allowing the skin to breathe. There are many good moisturising products – one I have found effective is “Hand Medic” from Go-Jo.

Which Glove to use?

There are a wide choice of gloves and you must establish the level of protection required and look closely at the manufacturing standards being offered.

Medical, industrial, laboratory and pharmaceutical gloves are widely and increasingly used in hospitals and throughout industry - possibly the same supplier providing gloves to all users. 

The protection required in a hospital is not the same as that required in industry – basically in a hospital environment the gloves are to protect the patient from the glove user, whereas in industrial applications it is the user who requires protection from what is being handled. Not surprisingly gloves for the different applications require different standards - as these are often confused (or in error used interchangeably) it is worth considering the implications of this. What would be the view taken by an insurance company if a member of staff for example in a laboratory, had an accident whilst using gloves designed for medical use? What would be the defence if a skin problem erupted even years after the event?  

In order to protect the individual and the company it is wise (and mandatory) to use a glove meeting the correct standards.

Disposable gloves are classified - Council Directive 89/656/EEC for laboratory and industrial gloves and Council Directive 93/42/EEC for the Medical Device Directive.

nitrile-gloves.jpg, In Good Hands?, Brian Smith, Sentinel Laboratories, Occupational Safety Asia

Medical Gloves

These will conform to EN455 - a non sterile glove is registered according to the Medical Device Directive are examination gloves. The product is self certified by the manufacturer.

The basic elements of EN455 are:

EN455-1 Water tightness on a batch will meet AQL 1.5 that is approximately 3% defects. This shows the level of protection to the patient.

EN455-2 Covers the physical dimensions and the strength of the glove

EN455-3 Describes the determination of natural rubber latex proteins by aqueous extraction.

On the glove box you will find:

                                                              

There will also be the statement “Class 1 Medical Device” and a note that the gloves conform to BS EN455:2000

Industrial, Laboratory and Pharmaceutical Gloves

Gloves to be to be considered as Personal Protection Equipment (PPE) are considered either simple design 

(category 1) or complex design (Category 3)- with a Category 2 glove which does not fall into the categories 1 or 3.

The basic elements are:

Category 1  Simple Design- for minimal risk only

Category 3 Complex design- designed to protect against the highest level of risk- irreversible or mortal risk. Disposable glove in this category are designed to protect against chemicals and micro-organisms. These gloves will be evaluated against the following EN420 requirements of a glove, EN374-2 testing for protection against liquid penetration and micro-organisms, EN374-3 testing against chemical permeation. EN388 testing against cut and abrasion.


On the box you will find:

      

        

Where the numbers alongside the CE  indicate the independent test house- the notified body that carried out the article 11 (a or b) certification of the manufacturing  facility to ensure the production quality and monitoring system meets the requirements of  the PPE directive ( 0134  Satra,  0120 SGS, 0493 Centexel ,0123 TUV )

Pictograms on the box indicate tests conducted and the levels achieved.

Of particular interest to us is EN374-2 which is the resistance to penetration- this is particularly important test for laboratory staff using disposable examination gloves as it indicates the barrier properties of the glove. This is normally designated on the box as 0.65, 1.5 or 4, the test is a water tightness test for the determination of holes.  This clearly indicates the protection afforded to the user from holes which may allow the ingress of bio-organisms or chemicals into the glove. For laboratory use the minimum standard for a glove should be AQL of 1.5 however if the glove had an AQL of 0.65 this would provide a greater level of security. 

The AQL figure is a statistical monitor of production; it is based on the batch size which would tell you the size of a sample of the gloves to be tested for defects.

Examination Gloves

Examination gloves have traditionally been manufactured from natural rubber latex because the technology is relatively easy and the product is exceptionally soft and comfortable in use. They do however have certain issues which can limit their use:

1) Latex allergy

Latex protein in a glove can result in a severe reaction in susceptible individuals. This is a particular problem with powdered latex gloves (rarely used in the U.K) - Powder free gloves have been leached to protein levels less than 50µg/g the level of sensitisation is above 100µg/g.  It should be remembered however if an individual has been sensitised in the past when in contact with a high protein glove they may still react to a low protein glove.

2) Chemical Resistance

Natural rubber latex gloves have an excellent physical barrier; however do not offer great protection against solvents. Laboratory and industrial customers are demanding greater protection.

3) Price

Natural rubber latex is derived from a rubber tree Hevea brasiliensis , the material was collected by low cost labour which meant the raw material was exceptionally low cost.  In the past few years world demand for latex has exploded, at a time when plantations are reaching the end of their productive life thus pushing prices up exponentially.

 

The Alternatives to latex are:

Vinyl Examination Gloves 

Vinyl Gloves are available in the “traditional” hard formulation or also in a high molecular weight formulation – which is softer and less liable to splitting. These gloves are widely used in industry particularly where the user is likely to come into contact with oils & greases. 

Vinyl disposable gloves are ideal for use with food preparation and are regulated by 1935/2004/EC, 2007/19/EC and 2008/39/EC.  The plasticizers used (phthalates) have been shown to migrate to foodstuffs, particularly fatty foods such as oil, meat and fish. Phthalates are now carefully controlled in gloves used in food preparation; however confirmation from the manufacturer that the gloves are “foods safe” should be secured if you continue to use vinyl. Disposal of Vinyl Gloves poses a problem – if  put in landfill –phthalates  can leach from the glove and contaminate watercourses. If vinyl is incinerated the temperature has to be closely monitored otherwise harmful chemicals are released to the atmosphere.

Nitrile Examination Gloves

Nitrile examination gloves were pioneered by Best Manufacturing (Now Showa Best) who developed the first soft nitrile glove approximately 15 years ago. Once the value of nitrile examination gloves was established Ansell introduced Touch & Tuff™ and Safeskin ( now Kimberly Clark) Blue Nitrile™ and shortly after Purple Nitrile™. These gloves, and later introductions from other manufacturers are premium products aimed at solving specific problems (Chemical Resistance, Latex allergy etc) not really competing directly with latex examination gloves.

Current Developments in Thin Nitrile Examination Gloves

In the past year new nitrile gloves have entered the market aimed at widening the utility of nitrile examination gloves to replace natural rubber latex examination gloves. Although there are just a few new entrants to this market we can expect many others in the future.

 

Advantages

1) Price - Thin nitrile examination gloves can compete directly in price with latex examination gloves yet offer significant other benefits.

2) Comfort - Nitrile softens rapidly on the skin to provide the most comfortable experience even when the glove is used for extended periods

3) Tactility - Close fitting nitrile provides enhanced tactility – especially with micro roughened fingertips.

4) Chemical Resistance - Nitrile is inheritably more chemical resistant than latex.

5) Improved Heat dissipation - The thin film nitrile is able to dissipate heat from the hand faster, reducing sweating and skin irritation

6) Environmental Issues

Thin nitrile gloves offer significant environmental benefits, in storage and transportation. Cases of gloves contain up to twice the quantity in a box this means that a case that would normally hold 1000 gloves may hold 2000 gloves.  This results in a reduction of packaging costs. There is also an impact on transportation costs of gloves from the manufacturing site to the distributor, and from distributor to end user. Storage costs throughout the supply chain are similarly reduced. Finally the cost of disposal of used product and packaging to land fill or incineration is significantly reduced.

Nitrile glove production is exceptionally competitive and manufacturers will seek to offer a similar product. Clearly not all will have the technical expertise and modify existing formulations to enable them to enter this fast developing market.

Thin Nitrile gloves meet the needs of both medical, laboratory and industrial users- the Kimberly Clark KIMTECH SCIENCE* STERLING* Nitrile  gloves are available as both a medical and an industrial glove, the Sempermed Xtra-Lite Has been launched as a medical grade glove.

Chemical Resistance data

A useful source of information for chemical resistance of gloves based on test data of   manufacturers gloves can be found at :

www.Chemrest.com- an excellent site which provides information on suitable gloves and also data on the toxicology of the material

www.anselleurope.com - Provides a comprehensive resource on chemicals also provides information on standards

Sempermed and Kimberly Clark at www.contaminomics.com provide easy to use chemical resistance guides. This data is on kcprofessional.com

Note take great care when the glove company provides generic test data on the glove material but has not been tested on their gloves! The information could be 20 years out of date.

Working in gloves for extended periods

There are times when gloves need to be worn for extended periods which may result in a level of irritation - this can be as a result of dusting powders or the chemical accelerators in a glove, or a reaction to the hands being bathed in perspiration. Silk glove liners provide effective protection, whilst maintaining the maximum level of tactility. The liners manufactured from ultra fine silk fabric provide a positive barrier between the skin and the glove. They are ideal when workers have an existing skin condition- allowing them to work whilst the healing process progresses. An added benefit of the liner is that it will wick away perspiration and keep the hands dryer for longer.  I have noticed that some companies use a cotton liner- this merely insulates the hand and causes a higher level of perspiration. Also I have seen nylon liners which tend to be a hard fabric which can abrade the skin.

Hand Care 24 hour 7 days a week 

Staff should be made aware that the attention given to hand care in the work place can only be effective if they take responsibility whilst out of work. Clearly if painting the house, working on the car or in the garden, their skin can be damaged   by chemicals or abrasion- they must be aware of their part in maintaining their hands and overall wellbeing.  Regular monitoring of staff will ensure that their skin viability is not impaired. I am aware that some pharmaceutical companies now conduct an evaluation of skin testing: pH, hydration and elasticity this is recorded and may be used for any remedial treatment - also it is a good monitor of the products being used and their efficacy.

Care of your staff really does provide economic value to the organisation.

Skin care is multi-faceted. Each component plays a part and like a stack of cards will fall if attention is not paid to each item in turn.  

Conclusion

I have discussed the benefits of caring for your most valuable resource - your staff. How best to ensure that new recruits and existing staff are protected whilst undertaking their tasks.  The wash room is probably one of the most important areas but generally receives the least attention. It is not difficult to decide the grade of gloves required - just ensure they meet your legal responsibilities.

Whilst there is a cost to providing the correct PPE products this is more than repaid in efficiency  and has the added benefit of ensuring the organisation is protected from protracted litigation should a member of staff experience a skin problem – now or in the future

 

Author Details

Brian Smith MRSC, Dip M MCIM, MIEx (Grad) Initially trained as a chemist, and for the first 5 years of his career worked in the laboratory analysing materials. As a result of his laboratory experience he became a product specialist in laboratory instrumentation travelling extensively throughout the U.K and latterly the world promoting laboratory instrumentation. At this time he studied marketing and export administration gaining a diploma in marketing and graduated in export administration. This led to him Gloves | Artic le becoming the export administration manager for a Unilever company specialising in laboratory products. In 1988 he established Sentinel Laboratories to meet the increasing need in the pharmaceutical and laboratory market for specialist advice in skin care and hand protection. Sentinel developed several innovative products, but is probably best known as the company which pioneered the introduction of nitrile examination gloves in the U.K - a product which now dominates the U.K and European market.

For more information on gloves please go to http://www.osedirectory.com/product.php?type=health&product_id=1

Published: 10th Mar 2010 in OSA Magazine

Author


Brian Smith


Sentinel Laboratories
Unit 12-13 Lindfield Enterprise Park
Lewes Road
Lindfield
West Sussex RH16 2LH
England


Brian Smith

Website:
http://

Email:
brian@sentinel-laboratories.com

Phone:
+44 (0) 1444 484044

brian@sentinel-laboratories.com
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+44 (0) 1444 484044

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