Korniewicz Denise M, El-Masri Maher, Broyles John M, Martin Christopher D, O'connell Kevin P
Schools of Nursing and Medicine, University of Maryland, Baltimore, MD 21201-1579, USA.
Am J Infect Control. 2002 Apr;30(2):133-8. doi: 10.1067/mic.2002.119512.
In response to the rise in latex allergies, gloves made from a variety of nonlatex materials have been introduced into the health care environment. To date, at least 1 study, by Rego and Roley (1999), has reported that both latex and nitrile medical examination gloves provide comparable barrier protective qualities. The purpose of our study was to determine the effects of glove stress, type of material (vinyl, nitrile, copolymer, latex), and manufacturer on the barrier effectiveness of medical examination gloves.
A total of 5510 medical examination gloves (1464 nitrile, 1052 latex, 1006 copolymer, and 1988 vinyl) were divided into 2 groups: stressed and unstressed. Unstressed gloves were visually inspected and water-tested according to the Food and Drug Administration water-testing standards. Stressed gloves were manipulated according to a designated stress protocol, visually inspected, and then subjected to the same Food and Drug Administration water-testing standards.
Our limited sample size demonstrated that nitrile gloves had the lowest failure rate (1.3%), followed by latex (2.2%); vinyl and copolymer gloves had the highest failure rate (both 8.2%). With use of a logistic regression analysis adjusting for manufacturer and stress, latex examination gloves were found to be 3 times more likely to fail than nitrile gloves (odds ratio, 3.2; 95% CI, 1.37-7.50). Nitrile gloves were also found to fail significantly less often than vinyl or copolymer gloves (odds ratio, 12.60; 95% CI, 5.80-27.40).
Nitrile examination gloves are a suitable alternative to latex, whereas vinyl and copolymer examination gloves were found to be less effective barriers. Further research is indicated to determine whether nitrile gloves can provide effective barrier qualities during clinical use versus laboratory simulations.
为应对乳胶过敏率的上升,多种非乳胶材料制成的手套已被引入医疗环境。迄今为止,至少有一项由雷戈和罗利(1999年)开展的研究报告称,乳胶和腈类医用检查手套具有相当的屏障防护性能。我们研究的目的是确定手套应力、材料类型(乙烯基、腈类、共聚物、乳胶)和制造商对医用检查手套屏障有效性的影响。
总共5510只医用检查手套(1464只腈类、1052只乳胶、1006只共聚物和1988只乙烯基)被分为两组:有应力组和无应力组。无应力手套按照美国食品药品监督管理局的水测试标准进行目视检查和水测试。有应力手套按照指定的应力方案进行操作,目视检查,然后同样按照美国食品药品监督管理局的水测试标准进行测试。
我们有限的样本量表明,腈类手套的失败率最低(1.3%),其次是乳胶(2.2%);乙烯基和共聚物手套的失败率最高(均为8.2%)。通过使用逻辑回归分析对制造商和应力进行校正后发现,乳胶检查手套失败的可能性是腈类手套的3倍(优势比,3.2;95%置信区间,1.37 - 7.50)。还发现腈类手套失败的频率明显低于乙烯基或共聚物手套(优势比,12.60;95%置信区间,5.80 - 27.40)。
腈类检查手套是乳胶的合适替代品,而乙烯基和共聚物检查手套的屏障效果较差。需要进一步研究以确定腈类手套在临床使用中与实验室模拟相比是否能提供有效的屏障性能。