Trapé M, Schenck P, Warren A
Employee Health Service, Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut School of Medicine, Framington 06032-6210, USA.
Am J Infect Control. 2000 Oct;28(5):352-8. doi: 10.1067/mic.2000.107199.
Latex sensitization related to glove use is a complex problem, and glove use policies that restrict exposure to powdered latex gloves alone may not provide adequate safety. This study explored health care workers' (HCWs') latex glove use and reports of related health symptoms 1 year after implementation of the latex glove replacement policy.
Two cross-sectional surveys. One was a population-based survey of HCWs at the institution (National Surveillance System for Hospital Health Care Workers); the second, a detailed survey of HCWs stratified by exposure to latex gloves (Latex Symptom Survey).
The prevalence of symptoms of dermatitis reported by latex glove users was 40.3% (National Surveillance System for Hospital Health Care Workers) and 50.0% (Latex Symptom Survey). Symptom reports increased as exposure to latex gloves increased (pairs used per day, occupations with more glove use, working in higher exposure areas, more tenure, and more hours of use per day). Aerosol symptoms and urticaria related to latex glove use were reported much less frequently than were rash, chapping, itching, or redness. HCWs, even those with skin symptoms, continued to choose latex gloves in more than 80% of the cases.
Stepwise preplacement evaluation at employee health clinics is recommended to identify and protect employees sensitized to latex. The medical community needs more understanding and education about latex gloves, latex sensitization, and available alternatives.
与使用手套相关的乳胶致敏是一个复杂的问题,仅限制接触含粉乳胶手套的手套使用政策可能无法提供足够的安全性。本研究探讨了在实施乳胶手套更换政策1年后,医护人员对乳胶手套的使用情况以及相关健康症状的报告。
两项横断面调查。一项是对该机构医护人员进行的基于人群的调查(医院医护人员国家监测系统);另一项是对按接触乳胶手套情况分层的医护人员进行的详细调查(乳胶症状调查)。
乳胶手套使用者报告的皮炎症状患病率在医院医护人员国家监测系统中为40.3%,在乳胶症状调查中为50.0%。随着接触乳胶手套的增加,症状报告增多(每天使用的手套对数、手套使用量更多的职业、在更高暴露区域工作、工作年限更长以及每天使用时间更长)。与使用乳胶手套相关的气溶胶症状和荨麻疹的报告频率远低于皮疹、皲裂、瘙痒或发红。医护人员,即使是有皮肤症状的人员,在超过80%的情况下仍继续选择乳胶手套。
建议在员工健康诊所进行逐步的岗前评估,以识别和保护对乳胶致敏的员工。医学界需要对乳胶手套、乳胶致敏以及可用替代品有更多的了解和教育。