The Material Choice
A properly balanced glove program should not attempt to pick one glove type for all uses. A glove program should choose an assortment of gloves that most appropriately addresses the varied needs of the end user. The goal is to maximize utility and functionality at the appropriate protection level and at the appropriate cost. We recommend that all glove programs should include each of the below material choices as appropriate.
Low Allergen Latex: Allotex® Allotex® is enzyme treated latex where the latex proteins are digested and the antigenic protein content of the latex itself is reduced by as much as 99+%. Not reliant on post processing for low allergen levels, Allotex® is simply a better latex. Gloves made from Allotex® (Dynarex/Tillotson Brand) have the same fit, feel, comfort and excellent barrier properties of a conventional latex glove.
As shown by the immunologic ELISA Test (ASTM D-6499), products made with Allotex® have antigenic protein levels of as much as 99+% less than the same product made with conventional latex. Use in high risk areas where there exists a potential for contact with bodily fluids. Low allergen latex such a Allotex® has superior extended wear barrier properties and is the material of choice in high risk environments without the fear of sensitization. Low allergen latex should also be used when there is a functional need for increased tactile sensitivity or extended wear durability and comfort.
Use in high risk environments where prolonged exposure to blood, body fluids, cleaning solutions and other chemicals is of concern. Nitrile has a high tensile strength and better chemical resistance than natural rubber latex, especially to hydrocarbon-based solutions and do not contain latex proteins.
What is Nitrile?
Nitrile gloves are made from a synthetic polymer. The nitrile polymer is an elastomer made from 3 monomers. The physical properties (chemical permeation, softness, modulus) of the nitrile are dependent on the formulation of the compound and the relative percentage of the three monomers. There is great variability between different nitrile gloves in fit, feel and comfort.
Use when there is low risk of infectious contact with direct patient care. Vinyl is an excellent choice in the food service, nonpatient housekeeping and maintenance areas.
What is Vinyl?
Poly-vinyl chloride is a plastic. To prevent PVC gloves from being as stiff as PVC pipe, plasticizers are added that soften the film. During extended use, vinyl films can experience reduced barrier effectiveness.
What is Stretch Vinyl?
Gloves are made from a softer resin that produce more flexible gloves without additional plasticizers that might weaken the film. In fact, the specifications for Stretch Vinyl call for higher tensile strength and elongation than standard vinyls. Because of this design, molds can be downsized so that the glove has a more conforming fit, producing better tactile sensitivity than typical vinyl gloves.
What is Low Modulus?
The property that most impacts the comfort of a glove is its modulus of elasticity or “modulus” for short. Modulus is the resistance of a material to stretch. The higher the modulus, the more force it takes to stretch the glove. “Low modulus” conveys that the glove is easy to stretch and thus puts less stress on the hand while worn, has greater tear and puncture resistance, increased tactile sensitivity and comfortably fits the widest assortment of hand sizes, an important consideration for users who need a skin tight glove fit. ASTM has recognized the Low Modulus Glove as a separate TYPE II Glove category.
What is Low Protein?
Although there is no formal definition of “Low Protein” as recommended by NIOSH in its 1998 Bulletin, common sense says that if a glove tests near or below the practical limit of the test for Protein, it would be “low” compared to gloves that test well above the limit. For comparison, using the Lowry test, the lower limit is 50 micrograms per g of glove while gloves can be found that test in excess of 10 times this limit. Using the more recently developed ASTM ELISA Inhibition test that can detect much smaller amounts of antigenic protein results in the single digits or below should qualify as “low protein”.
What is Powder-Free?
To qualify as a powder-free glove based on the current ASTM D-3578, a glove must not contain more than 2 milligrams of powder when tested by ASTM D-6124 test for powder. Since all gloves start out as powdered gloves, this test measures the degree of removal of these powders.
The U.S. Food and Drug Administration (“FDA”) banned the marketing, sale, and distribution of (1) powdered surgeon’s gloves; (2) powdered examination gloves; and (3) absorbable dusting powder (“ADP”) used for lubricating surgeon’s gloves, effective January 18, 2017.
What do all the different terms associated with Powder-Free gloves mean?
Polymer coated — A synthetic material is applied to the inside of the glove during manufacturing that eliminates or reduces the need for donning powders such as corn starch.
Chlorinated — The use of Chlorine during processing to harden the surface of the glove through oxidation to allow dry hand donning without powders.
Non-chlorinated — The elimination of Chlorine treatment through use of coatings. Non Chlorinated gloves have generally improved shelf life, color and smell.
Powder-Free — Meeting the ASTM specification of no more than 2 mg of any filterable residue per glove.
Powderless — Gloves made without the use of donning powder but containing >2 mg of filterable residue per glove. Powderless gloves tend to be easier to double glove than Powder-Free gloves.
Siliconized — The use of silicone instead of polymer coating or chlorination to facilitate donning the glove.
What is Non-Chlorinated?
Adding Chlorine to the wash process is an inexpensive means to modify the glove surface to allow easy dry hand donning. However, damp hand donning and extended shelf life storage are poor. The use of polymers to coat the inside of the glove considerably improves both of these characteristics at the expense of slightly harder dry hand donning.
What is BISOC Chlorination?
Chlorination is the use of Chlorine during the processing to harden the surface of the glove through oxidation to allow dry hand donning without powder. However, when chlorination is applied to the outside surface of the glove, grip characteristics are reduced. The BISOC Process (Bi-Surfacial Oriented Chlorination) reduces this problem by using a two stage chlorination process that concentrates the chlorination on the inside of the glove where it is desired.
What is Emollient Enriched Powder?
Glove starch powders are inherently drying to the skin. Their absorptive powers draw out moisture and oils that otherwise help maintain healthy skin. To prevent this,Tillotson blends Selan® hand cream with the starch prior to application. For over 25 years, this method has produced gloves with a silky feel that users prefer over conventional gloves.
What Makes TRUE ADVANTAGE Nitrile Gloves So Comfortable?
True Advantage’s unique, patented curing system “connects” the polymer particles during curing at different sites in the polymer backbone than conventional sulfur based cures. These sites allow the polymer more degrees of freedom of movement and thus allow the film to conform to the hand rather than constrict it.
What is Accelerator Free Technology?
Even though nitrile is a synthetic polymer that does not contain latex proteins, it is not necessarily free of allergens. Conventional nitrile gloves require sulfur based vulcanization to develop the necessary physical properties to impart effective barrier properties. As with latex, this re
quires the use of accelerators like carbamates, thiurams and/or thiazoles in the glove formulation. These materials can cause common Type IV allergic reactions in sensitive users. True Advantage instead uses a patented, non sulfur based curing system that eliminates the need for these accelerators.
What are the causes for Irritation Complaints from glove users?
Reactions to gloves can involve either allergic or nonallergic reactions. Because of the variety and complexity of response to different offending agents, classification of the different sensitivity reactions has been difficult and confusing. Irritant contact dermatitis, the most common, is a reactions that is not caused by an immune response, but by skin cell damage that leads to inflammation. Type IV delayed hypersensitivity, also known as Allergic Contact Dermatitis, usually involves an immune response to a chemical, rather than to protein. It can spread over a wider area than just the site of contact, and it is considered delayed in onset because symptoms can appear several hours after contact. Type I immediate hypersensitivity usually involves an immune response to the protein antigens in natural rubber latex. If an individual becomes Type I sensitized, subsequent exposure can cause an immediate reaction, with symptoms ranging from urticaria (itching and hives), swelling of tissues, wheezing, difficulty breathing, nausea, and in rare instances, anaphylactic shock.
What do I need to know about Latex Protein Levels?
ASTM has set and FDA has proposed a maximum of 200 μg/g (μg/dm2) for any glove. FDA has allowed a level of 50 μg/g (μg/dm2) as a lower limit on claims using the Lowry test. Recently, ASTM has proposed a limit of 10 μg/dm2 for Antigenic Protein based on the new ASTM ELISA Test (D-6499-00). While each one of these numbers conveys meaningful information, users should be wary of attempting to make judgments based on small differences in values around each of these numbers.
The most recent revisions to the latex examination glove standards set maximum protein to either 10 μg/dm2 by the ELISA test for antigenic protein or 200 μg/dm2 by the lowry test for total protein and a maximum powder content of 10 mg/dm2 (approximately 80 mg/glove). While not mandatory, this standard sets the mark for quality exam gloves.