Stretching the boundaries with new latex-free policyOn 2 Jan 2003 in Personnel Today Comments are closed. With incidences of allergic reactions to latex gloves continuing to troublemany organisations, research by Nottingham Trent University has allowed theinstitution to develop a latex-free policy for all employees, by Nia Harris andJames Roper The use of latex gloves provides a challenge for many occupational healthprofessionals because of the incidence of latex allergies with continuous use.Many organisations have been forced to compromise between financial restraints,pressures from staff suffering latex-related problems and the unrivalledprotection offered by latex products. However, Nottingham Trent University has been able to develop a latex-freepolicy for use across the institution, following careful consideration of theoptions available. Literature search Before developing the policy, a literature search was carried out to gainsupport and guidance about the best approach to take. The available literaturedoes provide a solid basis to work from when compiling a policy. The majority of published articles on the subject concentrate on reductionof latex use within healthcare settings. Although the focus of the two leadingMedline and the Cinahl databases (see links) involves healthcare environments,evidence available on both these sources was useful in providing a basis forthe aims of the policy. The main concern was whether latex gloves should becompletely removed or their use limited by introducing strict regulations. Latex has, and continues to be used widely in healthcare environments forseveral reasons. Christopher Packham1 states that natural rubber latex offers ahigh level of biological protection that other types of glove cannot match, hasgood stretch qualities and is reasonably priced. This high level of protectionindicates that the total removal of latex from healthcare settings is notappropriate. Many institutions have attempted to create ‘latex-safeenvironments’ by reducing glove use to powder-free varieties and providingalternatives for sensitive staff. Research papers by Bowyer2 and Brehler3 assess the implications of latexhypersensitivity on the healthcare environment and give examples of reducinglatex use in healthcare. Almost all literature available on the subject ofmanaging hypersensitivity states how latex is uniquely invaluable inmaintaining adequate biological protection in order to meet requiredlegislation, such as the Personal Protective Equipment (PPE) Regulations 19924.Gathering data The next stage of the process was an enquiry to determine what types of glovewere being used and for what purpose the university staff used them. This task could have proved difficult as the institution has 2,519employees. To gather as big a response as possible, a specific ‘glove usequestionnaire’ was designed, which consisted of closed questions, thusrestricting responses to just the information that was required. The questions put to the user requested the type of gloves used in theirparticular area to be specified, asked what tasks they were required for andthe frequency of use. The questionnaire also asked the respondent to state the company from whichthe gloves were purchased (as the use of more expensive gloves would have adifferent economic impact on each department involved) and whether studentswere required to put on the gloves to complete certain tasks. This question wasimportant as the university had a duty of care towards its students underhealth and safety legislation. Because students did not receive services fromoccupational health but used an onsite surgery when seeking health advice, thismeant very little information was available regarding students with possibleallergies. To minimise repetitive responses, the questionnaire was sent by e-mail tothe principal technician in each university department. This producedcomprehensive and concise overviews of glove use. In total, 13 out of 15questionnaires sent out were returned within the time specified. Although theother two were returned after the time date set, these were from departmentsthat did not use protective gloves. Developing the policy A large variety of gloves were shown to be in use at the university – almostall were made from latex. Only one department offered nitrile gloves as analternative. The tasks for which gloves were required were also extremely varied, rangingfrom using specific chemical-grade nitrile gloves for chemical handling to theuse of powdered latex gloves for handling pottery products. There were only twoinstances where the use of gloves to protect against biological products wasevident. These were in the provision of first aid facilities and were withinthe Occupational Health Department itself. The lack of biological risk throughout the organisation prompted the nextstage of developing the policy. The decision was made that all single-use latexprotective gloves should be replaced with a suitable alternative, thusminimising the risk of hypersensitivity among staff. Following the survey, a decision was made to include all types of protectiveglove into the policy – chemical strength gloves and textile gloves, forexample, with the aim of creating an equal level of health and safety acrossall departments. The classification of glove suppliers and their products wasalso to be specified to ensure the risks of incorrect glove choice wereminimised. The main area of concern for the development of safe glove use was inchemical laboratories and in art and design areas, as these were thedepartments that required the greatest levels of glove use. However, they requiredvery different approaches. Gloves are used in art and design departments to protect users from paintsand pottery dust. Some areas also use textile dyes on a regular basis. As noneof these activities expose users to biological risk, latex gloves were notrequired. The material used to replace latex in this area was nitrile becausethese gloves offer high levels of chemical impermeability5. The rationale for using different gloves in the chemical laboratories wasdue to many of the strong chemicals interacting with latex. The solution was toensure the effective use of chemical labelling as the safety precautions onmany simply states ‘use appropriate gloves when handling this product’. As aresult many staff were using the first gloves that came to hand, regardless oftheir suitability. This meant that, for every area using gloves on a regularbasis, a mass staff education programme was required. Education programme To plan how to educate the many staff working in areas of high glove use,advice was gathered from a variety of sources. Several glove companies were contacted for the most up-to-date productinformation. Visits from representatives were arranged, to enlighten staff fromthe departments that would be most affected by a policy change. These meetingswere extremely important as they began to shape the methods that would be usedto inform all staff and students of the potential dangers of incorrect gloveuse. Many glove manufacturers were able to supply guidelines detailing thetypes of glove suitable for handing different chemicals. Another invaluable source of advice came from other occupational healthdepartments who were contacted about reviews of glove use carried out at theirinstitutions. By using some of the advice from these sources, Nottingham TrentUniversity was able to draw up an education scheme that provided advice on themethods that would be most suited to the working environment of each givendepartment. Following consultations with staff from all departments, it became apparentthat formal teaching sessions on the subject of glove use and skin care wouldbe inappropriate, as most staff would only be present during term time, soformal training days would remove staff from the college when their help insupervising students was most needed. Therefore, as an initial point of contact, it was decided to set up a postercampaign to display information from glove manufacturers, relating only to thechemicals actually used in any specific location. In addition to the practicalinformation, the displays were strategically located around the campus. The displays focused on skin care and how to spot potential problemsassociated with prolonged glove use; and contact details for the occupationalhealth service were reinforced, along with information sources to use whenstaff found it necessary to carry out risk assessments on chemicals thatrequired glove use. To ensure staff adhered to the new requirements, trials took place usinggloves from a variety of sources to help determine which products were mostfavoured. Stock supplies of gloves were reduced, with stock maintained inproportion with the gloves’ required levels of use. And more posters weredisplayed in the storage areas to act as reminders to staff about the selectionof gloves. Following the implementation of the poster campaign, the types of glovepreferred by the staff were assessed. Staff and students in the art and design areas were found to be more contentwith powder-free, nitrile gloves. Because the laboratory staff used many typesof glove, comments on their comfort and ease of use were requested. The staff involved stated how, with the changes to the risk assessingprocess, glove choice had become much more simple and all gloves used werefound to be comfortable to wear, with no skin irritation problems beingreported to the occupational health department. Conclusion The implementation of a policy controlling the use of different types ofprotective gloves has been very successful. In the initial period prior toresearching and implementing the new policy, several types of glove and severaldifferent suppliers were being used. Once the policy had been implemented,along with the poster campaign, glove use had become much more controlled. The risk of hypersensitivity had been reduced by making available only thecorrect type of gloves for the particular use. The staff working in the areasof most prevalent glove use were more aware of the potential dangers ofincorrect usage, such as exposure to chemicals or the development ofglove-related skin problems. Overall, the development of the policy has created a more equal level ofsafety in each area of the university. References 1. Packham C (2000) Technical Bulletin No.6: Thoughts on Latex Allergy, EnvirodermServices – www.enviroderm.co.uk 2. Bowyer R (1999) The implications of latex allergy in healthcare settings.Journal of Clinical Nursing, 8(2) 139-143 3. Brehler R (2001) Natural Rubber Latex Allergy: A Problem ofInterdisciplinary Concern. Archives of Internal Medicine, 161(8) 1057-1064 4. Health and Safety Executive (1992) Personal Protective Equipment (PPE)Regulations 1992. London, HMSO 5. Korniewicz, Denise M (2002) Performance of latex and non latex medicalexamination gloves during simulated use. American Journal of Infection Control30 (2) 133-138 Acknowledgements: – Graham Ayers, sales representative, Bestglove Ltd – Eileen Black, occupational health specialist, Astrazeneca R+D Charnwood,Leics – Jane Braithwaite, senior technician, Life Sciences, Nottingham TrentUniversity James Roper is a student nurse at the University of Nottingham. NiaHarris BmedSci (Hons), DipOSH, is a RGN occupational health specialist, atNottingham Trent University [email protected]@ntu.ac.ukwww.medline.comwww.cinahl.comThelaw surrounding occupational health is incorporated in a number of generalduties under the Health and Safety at Work Act 1974 etc, and in variousregulations made under this Act, such as the Control of Substances Hazardous toHealth (COSHH) Regulations 1999. The PPE Regulations (5) advise that everyemployer shall ensure that where the presence of more than one risk to healthor safety makes it necessary for an employee to use simultaneously more thanone item of personal protective equipment, such equipment is ‘compatible andcontinuous to be effective against the risk or risks in question’. Previous Article Next Article Related posts:No related photos.