When selecting protective gloves for use in a healthcare setting, users should consider the balance between expected risk and benefit. While adequate protection from infectious agents is the primary concern, the adverse effects caused by the individual’s repeated use of natural rubber latex (NRL) gloves are also important. If the barrier properties are damaged, infectious agents and hazardous chemicals can pass through to the skin and cause infection, skin irritation or injury, or severe allergic reactions. Use of alternative products may reduce risk of adverse reactions, but these may also increase the risk of barrier failure.

The intended use of a glove determines the type of glove needed. Variables include the potential for exposure to hazardous materials and infectious agents, the frequency of glove use, and the duration of a single use. Some of the selection criteria are:

• general material qualities, such as elasticity, sterility, shelf life, and defects in material;
• barrier properties such as lack of holes in gloves, durability (for extended use), resistance to physical stress (tension, friction, contact with hard and sharp objects), resistance to temperature changes and to chemicals; and
• low level of sensitizing chemicals and allergenic proteins on the gloves (of critical importance in a heavy glove use environment and with high-risk groups).

Although problems may be encountered with the NRL in gloves, it is considered reliable for its barrier properties, elasticity, and excellent tactile sensation. Other glove materials and formulations may be used by individuals who cannot use NRL. In the past, vinyl gloves were found to be inferior to NRL in barrier properties. Presently, several types of non-NRL gloves, including synthetic rubber, are available. These are significantly improved in quality and can be a good substitute for NRL-sensitized individuals.

Allergic reaction is still the most serious problem with NRL gloves, even though manufacturers have improved the product significantly by substantially reducing the protein levels. The safe threshold level is not known, but we do know that less protein means a reduction in sensitivity of users.

Vesna J. Tomazic is a Biologist/Immunologist in CDRH’s Division of Life Sciences, Office of Science and Technology.