Rubbing ethanol and time of use: critical factors compromising latex gloves structure / Desinfecção com etanol e tempo de uso: fatores críticos que comprometem a estrutura das luvas de látex

Abstract Introduction Personal protective equipment is mandatory to protect patients and professionals from diseases, especially in the dental environment. The risk of gloves micro-perforations is imminent when using sharp instruments or cleaning them up during lengthy clinical procedures. Objective This study evaluated the integrity of sterile and non-sterile gloves before clinical use and clarified whether friction with disinfectant solution modifies surface morphology and integrity. Material and method Samples of gloves from four different brands were divided into two groups: (1) Sterile surgical gloves (n=260) and (2) Non-sterile gloves (n=260). They were scissored and placed in Ostby's arch so that three solutions - distilled water, ethanol 70°, ethanol 96° - were rubbed with a cotton swab. After 30s, 5, 10, and 15 minutes of solution rubbing, samples were verified by a Scanning Electron Microscope. The pore sizes were measured by Image J software. Result Regardless of the brands, all gloves have been significantly affected by solutions and assessment periods. In general, remarkable changes were evident with ethanol 70° and 96°, and higher pore diameters were observed compared to distilled water. Conclusion Rubbing disinfectant solutions increases gloves' pores sizes, and time negatively influenced its quality.

Resumo Introdução Para proteger pacientes e profissionais de doenças, o uso de equipamentos de proteção individual é obrigatório, principalmente no ambiente odontológico. O risco de microperfurações das luvas é iminente ao usar instrumentos cortantes ou na tentativa de limpar as luvas durante longos procedimentos clínicos. Objetivo Este estudo avaliou a integridade das luvas cirúrgicas e de procedimento antes do uso clínico e esclareceu se o atrito com a solução desinfetante modifica a morfologia e integridade da superfície. Material e método Amostras de luvas de quatro marcas diferentes foram divididas em dois grupos: (1) Luvas cirúrgicas (n = 260) e (2) Luvas descartáveis não estéreis (n = 260). As luvas foram cortadas e colocadas em arco de Ostby, de modo que três soluções - água destilada, etanol 70 °, etanol 96 ° foram esfregadas com um cotonete. Após 30s, 5, 10 e 15 minutos de fricção das soluções, as amostras foram verificadas utilizando um microscópio eletrônico de varredura. Os tamanhos dos poros foram medidos pelo software Image J. Resultado Independentemente das marcas, todas as luvas foram significativamente afetadas por soluções e períodos de avaliação. Em geral, maiores alterações foram evidenciadas com o uso do etanol 70° e 96°, e maiores diâmetros dos poros foram observados quando comparados à água destilada. Conclusão Esfregar soluções desinfetantes aumenta o tamanho dos poros das luvas e o tempo influenciou negativamente sua qualidade.

Contribuições para a tecnovigilância das luvas de látex e a biossegurança / Contributions to the technovigilance of latex gloves and biosafety

As luvas são fundamentais para a proteção dos profissionais e pacientes contra a contaminação cruzada, especialmente no controle do risco de contato direto com fluidos corporais. O objetivo desta pesquisa foi realizar um experimento in vitro acerca das propriedades físicas das luvas de procedimento de látex, comercializadas nacionalmente, visando produzir evidências científicas para o uso seguro em situações de assistência à saúde. Três lotes diferentes de cada uma das cinco marcas de luvas de procedimento de látex foram avaliados antes do uso quanto à integridade física (presença ou não de rasgos e/ou furos). Os protocolos padrão da Society for Testing and Materials e da Food and Drug Administration American consistiram em preencher cada uma das luvas com 1.000mL de água e inspecionar danos imediatamente e após dois minutos. Ainda, quantificar e comparar a perfusão de corante através das diferentes marcas de luvas por meio de um protocolo original desenvolvido com vistas a simular a punctura acidental por agulha. Inicialmente, uma punção venosa foi simulada em um recipiente contendo cristal violeta (CV) a 1% coberto com uma placa de gelatina a 8%, que simulou a pele humana. Uma microplaca de poliestireno 96 poços foi coberta com uma luva e depois perfurada com uma agulha com calibre de 0,80x30mm acoplada à uma seringa de 20mL contendo 5mL de CV a 1%. Os resultados foram expressos em frequências absolutas e relativas. Além disso, dados obtidos da perfusão do corante através das diferentes marcas de luvas foram submetidos aos testes de normalidade (Kolmogorov-Smirnov e Shapiro-Wilk) e, posteriormente, ao teste de U de Mann-Whitney por meio do software IBM SPSS Statistics (versão 25) e nível de significância ?=5%. As luvas das marcas D (1%) e C (9,2 e 9,4%) apresentaram o melhor e o pior dos resultados de rasgos e/ou furos nas inspeções imediata e após dois minutos, respectivamente. Um total de 7% (n=21) dos rasgos e/ou furos da marca C ocorreram em um dedo/região das luvas, enquanto que 1,3% (n=4) estavam danificadas/rasgadas. A marca D permaneceu com o melhor resultado, pois apresentou somente 1% (n=3) de rasgos e/ou furos em um dedo/região. Os valores medianos das absorbâncias de todas as marcas de luva de procedimento de látex perfuradas foram inferiores ao valor mediano da absorbância da perfuração sem luva, confirmando uma retenção do cristal violeta através de todas as marcas de luva avaliadas (p<0,001). As luvas da marca E apresentaram a maior porcentagem de retenção do cristal violeta dentre todas as marcas (77,2%), seguida das luvas da marca B (65,6%). Em contrapartida, as luvas da marca D sinalizaram a menor porcentagem de retenção do cristal violeta (14,6%). Em conclusão, todas as marcas de luvas de procedimento de látex avaliadas apresentaram danos físicos com maior frequência na região entre os dedos. Ainda, em condições in vitro, as luvas de procedimento de látex mesmo depois de perfuradas barraram parcialmente a carga do material inoculado

Gloves are fundamental for professionals' and patients' protection against crosscontamination, especially in control of risk of contact with corporal fluids. The objective of this study was to perform an in vitro experiment about physical properties of latex procedure gloves, marketed nationally, aiming to produce scientific evidences for the safe use in health care situations. Three different batches of each one of five brands of latex procedure gloves were evaluated before and after the use regarding physical integrity (presence or absence of tears and/or holes). The standard protocols of Society for Testing and Materials and of Food and Drug Administration American consisted in fill each one of the gloves with 1,000mL of water and inspect damages immediately and after two minutes. Also, to quantify and compare dye infusion through different glove brands via an original protocol developed to simulate the accidental puncture by needle. Initially, a venipuncture was simulated in a receptacle containing crystal violet (CV) at 1% covered with a gel plate at 8%, that simulated the human skin. A 96-well polystyrene microplate was covered with a glove and then pierced by a needle with 0.80x30mm caliber coupled to a 20mL syringe containing 5mL of CV at 1%. The results were expressed in absolute and relative frequencies. Moreover, the data obtained from the dye infusion through different glove brands were submitted to normality tests (Kolmogorov-Smirnov and Shapiro-Wilk) and, later, to Mann-Whitney U test through IBM SPSS Statistics (version 25) software and ?=5% significance level. The gloves of brands D (1%) and C (9.2 and 9.4%) presented the best and the worst of the tears and/or holes results in the immediate and after two minutes inspections, respectively. A total of 7% (n=21) of tears and/or holes of brand C happened in one glove finger/region, while 1.3% (n=4) were damaged/torn. The brand D remained with the best result because presented only 1% (n=3) of tears and/or holes in one finger/region. The median values of absorbances of all brands of perforated latex procedure gloves were lower than the median value of absorbance of gloveless perforation, confirming a retention of crystal violet through all evaluated glove brands (p<0.001). The gloves of brand E presented the highest percentage of retention of crystal violet within all brands (77.2%), followed by gloves of brand B (65.6%). Conversely, the gloves of brand D indicated the lowest percentage of retention of crystal violet (14.6%). In conclusion, all brands of evaluated latex procedure gloves presented physical damages with higher frequency in the region between the fingers. Also, in in vitro conditions, the latex procedure gloves even after perforated partially blocked the load of inoculated material

Development of new-type landmine sweeping protective outfit / 医疗卫生装备

Objective To optimize GGF110 landmine sweeping protective outfit to improve its wearing comfort and environmental adaptability.Methods With considerations on protection performances the outfit was improved from its size, structure,humanization design and manufacturing technique,which was composed of helmet and mask,protective clothing, mine boots and protective gloves. The protective clothing was made up of an upper piece, a vest, a jockstrap and a lower piece.Results The mine boots with the existed protection performances was optimized in increased walking stability while decreased possibilities to trigger GLD111 antipersonnel mine; the protective clothing was improved in comfort and convenience with the protection performance kept the same;the helmet and mask had the problems of giddiness or dizziness due to light reflecting as well as forward head gravity center resulting from unbalanced weight;the protective gloves met the tactical and technical requirements and ensured the flexibility when mine detection and sweeping were carried out. Conclusion The outfit with high protecting performances is enhanced in comfort, safety and adaptability, and thus can be used for mine sweeping by military forces.

Use of Protective Gloves in Nail Salons in Manhattan, New York City / 예방의학회지

OBJECTIVES: Nail salon owners in New York City (NYC) are required to provide their workers with gloves and it is their responsibility to maintain healthy, safe working spaces for their employees. The purpose of this study was to determine the frequency with which nail salon workers wear protective gloves. METHODS: A Freedom of Information Law request was submitted to New York Department of State's Division of Licensing Services for a full list of nail salons in Manhattan, NYC. A sample population of 800 nail salons was identified and a simple random sample (without replacement) of 30% (n=240) was selected using a random number generator. Researchers visited each nail salon from October to December of 2015, posing as a potential customer to determine if nail salon workers were wearing gloves. RESULTS: Among the 169 salons in which one or more workers was observed providing services, a total of 562 workers were observed. For 149 salons, in which one or more worker was observed providing services, none of the workers were wearing gloves. In contrast, in six of the salons observed, in which one or more workers was providing services, all of the workers (1 in 2 sites, 2 in 1 site, 3 in 2 sites, and 4 in 1 site) were wearing gloves. Almost three-quarters of the total number of workers observed (n=415, 73.8%) were not wearing gloves. CONCLUSIONS: The findings of this study indicate that, despite recent media attention and legislation, the majority of nail salon workers we observed were not wearing protective gloves when providing services.

Avaliação da integridade das luvas cirúrgicas e de procedimentos após atendimentos odontológicos / Evaluation of the integrity of surgical gloves and procedures gloves after dental procedures

O presente estudo teve como objetivo avaliar as perfurações que acometem as luvas cirúrgicas e de procedimentos utilizadas pelos acadêmicos de Odontologia nas clínicas odontológicas da Universidade do Estado do Rio Grande do Norte. Foram analisados 139 pares de luvas, utilizadas em procedimentos odontológicos realizados por 33 acadêmicos de Odontologia. A análise foi feita por meio da insuflação em água diluída em fucsina, com o uso da técnica preconizada por Xavier et al. (2006), realizada por um único examinador. Os dados foram registrados em um formulário específico adaptado de Cavalcanti et al. (2010). Os resultados foram analisados por meio dos testes do qui-quadrado e exato de Fisher, sendo adotado o nível de significância de 5%. Em relação à frequência de perfurações, 25 luvas (8,99%) apresentaram perfurações. O 8º período apresentou o maior número de perfurações (31,8%), quando comparado com o 6º (26,3%) e o 10º (12,1%) período. Os dedos das luvas com maior índice de perfurações foram o polegar e o indicador (1º e 2º dedos) com 24,0% e 40,0%, respectivamente. A ocorrência de perfurações foi maior em procedimentos de Odontopediatria (p= 0,051). Houve um maior número de perfurações na mão dominante (56,0%) do que na mão não dominante (36,0%), e apenas 6,0% em ambas as mãos. Conclui-se que houve um valor elevado de perfurações nas luvas analisadas, e a região digital, principalmente de polegares e indicadores da mão dominante, foi onde mais ocorreram as perfurações.

The present study aimed to evaluate the perforations affecting surgical gloves and procedures gloves used by dental students in dental clinics of the University of Rio Grande do Norte. We analyzed 138 pairs of gloves used in dental procedures performed by 33 dental students. The analysis was made by insufflation of fuchsin diluted in water, and the use of the technique advocated by Xavier et al. (2006), performed by a single examiner. The data recording are made on a specific form adapted from Cavalcanti et al (2010). The results were analyzed using the chi-square and Fisher's exact test, adopting a significance level of 5%. Regarding the frequency perforations, 25 gloves (8.99%) had perforations. The eighth period showed the largest number of perforations (31.8%) compared with sixth (26.3%) and tenth (12.1%) periods. The fingers of the gloves with the highest number of perforations were the thumb and forefinger (1st and 2nd toes) with 24.0% and 40.0%, respectively. The gloves used in pediatric dentistry had a significant amount of perforations (p = 0.051). There were a greater number of perforations in the dominant hand (56.0%) than non-dominant hand (36.0%) and only 6.0% on the both hands. We conclude that there was a large amount of perforations in gloves analyzed mainly on region of thumb and index of the dominant hand was where more the perforations occurred.

Hand eczema: An update.

Eczema, the commonest disorders afflicting the hands, is also the commonest occupational skin disease (OSD). In the dermatology outpatient departments, only the severe cases are diagnosed since patients rarely report with early hand dermatitis. Mild forms are picked up only during occupational screening. Hand eczema (HE) can evolve into a chronic condition with persistent disease even after avoiding contact with the incriminated allergen / irritant. The important risk factors for hand eczema are atopy (especially the presence of dermatitis), wet work, and contact allergy. The higher prevalence in women as compared to men in most studies is related to environmental factors and is mainly applicable to younger women in their twenties. Preventive measures play a very important role in therapy as they enable the affected individuals to retain their employment and livelihood. This article reviews established preventive and therapeutic options and newer drugs like alitretinoin in hand eczema with a mention on the etiology and morphology. Identifying the etiological factors is of paramount importance as avoiding or minimizing these factors play an important role in treatment.

Responses of Patients and Guardians to Phlebotomists' Wearing Gloves and Disinfecting Their Hands / 병원감염관리

BACKGROUND: A hand hygiene policy has been introduced by the Joint Commission International Accreditation Standards for Hospitals (JCI); the purpose of this policy is to ensure that systematic standards are continuously practiced at hospitals in order to improve the quality of medical care and the safety of patients and health care workers. This policy requires that phlebotomists wear new gloves and disinfect their hands before attending a patient to prevent nosocomial infections and to protect the phlebotomists. This study aimed to assess the responses of patients and guardians regarding the hand hygiene procedures. METHODS: Between January and February 2010, a questionnaire survey was performed at our hospital for 310 outpatients, 93 inpatients, and 189 guardians. RESULTS: In all, 70.8% of respondents answered that phlebotomists did not require considerable time to remove and wear gloves, and 69.9% responded that phlebotomists could readily detect veins even with their gloves on. Besides, 81.9% respondents thought that it was sanitarily important for phlebotomists to remove their gloves and disinfect their hands after a venipuncture, whereas only 2.8% thought that this practice caused discomfort. CONCLUSION: The patients and guardians recognized that the hand hygiene procedures were important for their own safety and encouraged their application rather than considering them uncomfortable or inappropriate. Introduction and maintenance of the hand hygiene policy of JCI would not be difficult because patients or guardians recognized its importance.

Conhecimento da equipe de enfermagem acerca do uso de luvas no contexto hospitalar / Nursing team knowledge in the use of latex gloves in the hospital context / Conocimiento del equipo de enfermería en el uso de guantes de látex en el contexto hospitalario

O uso de luvas é inquestionável no cuidado à saúde, embora, a escolha entre luvas esterilizadas ou de procedimento não é consensual entre os profissionais. Teve-se como objetivo avaliar o conhecimento dos profissionais de enfermagem acerca do uso de luvas considerando diferentes atividades. Trata-sede um estudo do tipo transversal descritivo realizado em um hospital do interior do estado de Mato Grosso do Sul no mês de junho de 2007. Aplicou-se questionário por entrevista, contendo questões de múltipla escolha sobre uso de luvas em diferentes procedimentos assistenciais. Participaram do estudo profissionais de enfermagem que atuavam diretamente na assistência à pacientes. Dos 74 entrevistados observou-se que a frequência do uso de luvas em curativos representa uma temática controversa, ou seja, variou de 1,3 % a 83,7%. Outro resultado preocupante foi a alta frequência de não adesão ao uso de luvas na administração de medicação: 31,0% em intramuscular, 18,9% em intravenosa, e 40,5% em subcutânea Para execução da higiene corporal e posicionamento do paciente, as luvas foram citadas como de uso frequente. Conclui-se no computo geral, o conhecimento sobre a indicação de luvas, nas diversas atividades ainda necessita de esclarecimentos quanto à adequada utilização.

The use of gloves is unquestionable in the health care, although there is no consensus among professionals about the choice of sterilized or procedure gloves. The objective of this research was to evaluate the knowledge of nursing professionals regarding to the use of gloves considering different activities. This isa cross-sectional study, with exploratory and descriptive features, carried out in a hospital in the state of Mato Grosso do Sul interior. A questionnaire was applied through an interview, with multiple-choice questions about the use of gloves in different health care procedures. Study participants were nurses directly active in patients care. From the 74 interviewees, it was observed that the frequency of the gloves use in curatives represents a controversial thematic, in other words, it varied from 1, 3 % to 83, 7%. Another preoccupying result was the lack of compliance to the use of gloves while administering intramuscular (31.0%), intravenous (18.9%), and subcutaneous (40.5%) medication. In body hygiene and positioning patients, participants mentioned frequent gloves use. In general, knowledge about the indication of gloves in different activities still needs clarification about adequate use.

El uso de guantes es incuestionable en el cuidado a la salud, aunque no hay consenso entre los profesionales sobre el uso de guantes esterilizados o de procedimiento. El objetivo de la investigación fue evaluar el conocimiento de los profesionales de enfermería acerca del uso de guantes considerando diferentes actividades. Se tratade un estudio del tipo transversal de carácter exploratorio y descriptivo, realizado en un hospital del interior del estado de Mato Grosso do Sul. Fue aplicado un cuestionario mediante entrevista, con cuestiones de múltipla elección sobre el uso de guantes en diferentes procedimientos asistenciales. Participaron del estudio profesionales de enfermería que actuaban directamente en la atención a los pacientesDe los 74 entrevistados se observó que la frecuencia del uso de guantes en vendajes representa una temática controversia, o sea, varió de 1,3 % a 83,7%. Otro resultado preocupante fue la alta frecuencia de no adhesión al uso de guantes en la administración de medicación: (31,0%) en intramuscular, (18,9%) en intravenosa, y (40,5%) en subcutánea. Para la realización de la higiene corporal y posicionamiento del paciente, los guantes fueron citados como de uso frecuente. En el cómputo general, el conocimiento sobre la indicación de guantes en las diversas actividades todavía necesita de esclarecimientos sobre su utilización adecuada.

O uso das luvas de proteção no corte manual da cana-de-açúcar / Protective gloves for manual harvesting of sugar cane

Uma negociação tripartite entre a Fundacentro, o Sindicato dos Empregados Rurais de Araraquara e a Usina Santa Cruz permitiu a realização do estudo sobre o uso dos equipamentos de proteção individual (EPI) e das ferramentas de trabalho durante a execução da atividade de cortar manualmente a cana-de-açúcar. A problemática se manifestou frente às estratégias utilizadas pelos trabalhadores para viabilizar o uso conjunto das ferramentas e dos EPI, prescritos como obrigatórios pela Norma Regulamentadora Rural nº 4 (Ministério do Trabalho e Emprego) e pelas normas internas da empresa. A principal estratégia desenvolvida pelos trabalhadores foi emborrachar o cabo do facão com o objetivo de minimizar o efeito da falta de aderência entre a luva de proteção e o cabo da ferramenta. A metodologia utilizada no presente estudo foi analisar qualitativamente, através da aplicação de questionários, quatro modelos de luvas junto a 47 trabalhadores, além de analisar quantitativamente o coeficiente médio de atrito estático (µ) desenvolvido entre as luvas e a madeira com que é confeccionado o cabo do facão. Os experimentos foram feitos com madeira limpa e emborrachada e com luvas novas e usadas. A pesquisa qualitativa apontou a luva de proteção de raspa de couro e nylon como a preferida dos trabalhadores, pelo conforto advindo do fato desta luva se ajustar bem às mãos, de não prejudicar os movimentos e não ocasionar danos às mãos. O coeficiente de atrito estático (µe) depende do tipo de luva, da condição da luva e do tipo de superfície.

This study on the personal protective equipment (PPE) and the tools used for the manual harvesting of sugar cane resulted from a tripartite negotiation between FUNDACENTRO, the Rural Workers Union in Araraquara, and the Santa Cruz sugar mill. The subject came out while workers were trying to adapt themselves to the set of tools and PPE (Personal Protective Equipment) demanded not only by the Regulating Standard Rural nº4 set by the Ministry of Labor and Employment, but also to their companies internal rules. One of their strategies to improve their gloves adherence to the handles of their knives was covering them with rubber. Four models of gloves were analyzed not only from the point of view of their quality, through questionnaires distributed to 47 workers, but also their quantity, through the average static friction coefficient (µ) produced by the gloves when holding the wooden knife handles. Clean wood and wood covered with rubber, new and used gloves were tested. The qualitative research showed that workers prefer gloves made of leather and nylon scrapings because they fit their hands comfortably, without causing aches or blocking their movements. The static friction coefficient (µe) is determined by the glove material, its condition and the kind of surface.