[Consensus Document. Update on latex exposure and use of gloves in Italian health care settings]. / Documento di Consenso. Aggiornamenti in tema di esposizione a latice e impiego di guanti in ambito sanitario.

This consensus document was prepared by an Italian working group including occupational health professionals involved for many years in the management of glove- and latex-related problems in health care settings. The aim of this document was to address the most significant technical, epidemiological, clinical, environmental and prevention problems related to the use of gloves and latex. The group's recommendations are based on scientific evidence and practical experience but they cannot be considered as final. These topics need to be periodically revised. The following points should be taken into account: glove quality seems to have improved considerably but the information on glove features provided by the manufacturers is often still inaccurate or incomplete; the regulations in force provide that the manufacturers perform tests to supply evidence for the quality of the products but they do not indicate which analytical method should be used and they do not require that the results be reported in the technical data sheets. Thus the manufacturers have only to declare that their products are "in accordance with the rules"; therefore, purchasers should require the manufacturing companies to supply detailed information and verify their reliability. Moreover, the rules should be adapted to higher quality standards; occupational physicians must be involved for the correct choice and purchase of protective gloves; the use of gloves (in particular latex gloves) and latex devices in health care settings should be based on specific criteria: procedures must be available stating which kind of gloves are suitable for specific tasks. When exposure to latex cannot be avoided it is necessary to choose products that have good biocompatibility (e.g., powder free-gloves with low allergen content); once and for all latex powdered gloves should no longer be commercially available! labels for latex devices (including gloves) should report the extractable latex allergen content. Limit values for extractable latex allergens should be established; the use of synthetic rubber gloves should be encouraged since some materials (e.g., neoprene and nitrile rubber) appear to have physical properties and protective efficacy similar to latex, plus good biocompatibility; more studies should be promoted to verify the protective efficacy of new synthetic materials; health care workers should be informed about the advisability and usefulness of using materials other than latex; health care services should not cause additional risks but rather highlight the advantages for workers and patients if the use of latex gloves and devices is minimized.

[Latex and synthetic polymers gloves: protective effectiveness against biological risk]. / Guanti di latice e guanti di polimeri sintetici: efficacia protettiva nei confronti di agenti biologici.

BACKGROUND: The quick evolution of knowledge about latex and, especially, its effectiveness as protection against biological risks on one hand, and, on the other hand, as trigger of cutaneous, respiratory and sistemic allergic diseases, required a marked distinction between conditions in which latex is necessary and conditions in which latex could be substituted by syntetic polymers. OBJECTIVES: The aim of this study is to verify protective effectiveness of gloves made of syntetic polymers against biological risks compared with latex gloves which until now have been considered as the best protection. METHODS: Literature review. RESULTS: The most recent studies seem to consider neoprene gloves as the safest protection to replace latex in working activities with high biological risk exposure. CONCLUSION: The literature review marked the lack of studies exclusively focused on glove permeability towards biological agents. It seems therefore necessary to investigate this topic to validate results and to guarantee a suitable protection to workers daily exposed to biological risk.

[Cardiopathy caused by physical or chemical agents]. / Cardiopatie da agenti chimici e fisici.

BACKGROUND: Occupational cardiovascular diseases do not possess any specific clinical and physiopathogenetic features. OBJECTIVES: The paper summarizes the results of the most recent studies on chemical and physical cardiovascular risks, and assesses the current degree of risk for occupational cardiovascular disease. METHODS: Scientific literature and medline databases on this topic were carefully considered. RESULTS AND CONCLUSION: The scientific literature often provides interesting information on the cardiotoxicity of chemical and physical agents in workplaces; however, a large amount of data refers to high-dose exposures. On the contrary, nowadays exposure conditions have progressively improved and toxic concentrations in air in most cases are below the environmental threshold limit values. In workplaces multiple exposures to different cardiovascular risks, both occupational and non-occupational, are often present simultaneously and these cardiovascular diseases have not been adequately studied in comparison to other occupational organic and systemic diseases. Moreover, possible interferences between occupational cardiotoxic substances and cardiological therapy are still poorly investigated, even though such situations frequently occur.