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GUIDE TO MEDICAL GLOVE SELECTION

● Thanks to Ansell Canada Inc., 2006.

www.ansellhealthcare.com/america/canada/index.html

A GUIDE TO MEDICAL GLOVE SELECTION
Choosing the right glove for the right situation

With the recent rise in awareness of latex allergy issues, many new types of medical gloves have gained favor in the past several years. Each of them offer unique advantages but, at the same time, each of them comes with a certain amount of compromise in terms of barrier protection, economy, comfort, etc.

No single glove provides the "perfect" solution for all applications and it is nearly impossible for a hospital to standardize on a single type of glove material without encountering difficulties.

Latex has long been the benchmark standard for fit, feel, comfort, strength and barrier protection.
Vinyl, an economical alternative to latex, has been around for many years but in general may be associated with reduced barrier protection due to its susceptibility to tears, breakage and pinholes compared to latex.
Nitrile medical gloves have become more popular in the past several years and offer excellent tear resistance and chemical resistance although cost more than either latex or vinyl.
Neoprene has been a popular latex alternative in the operating room and is the most "latex-like" synthetic glove film available. It offers superior comfort but is also more expensive than latex.
Polyurethane is a new addition to the operating room and is another "latex-like" synthetic glove film. It offers exceptional comfort and tactile sensitivity as well as puncture, tear and abrasion resistance. However, it is more expensive than latex and other non-latex films.

This chart provides medical professionals with an easy to use guide in choosing the best glove film for their particular application. Ansell's solution oriented approach to medical gloves provides you with product options in four out of five categories: latex, vinyl, nitrile, neoprene and polyurethane. For more information on these products, or for information regarding latex allergies and other educational materials, please call us at 1-800-321-9752.

GLOVE TYPE
Level Of Barrier Protection	Excellent- The longstanding benchmark for barrier protection due to its strength and elasticity.	Excellent- Polyurethane film is very durable with a high puncture, tear and abrasion resistance.	Very Good- Neoprene provides barrier protection similar to latex.	Excellent- Nitrile film is highly resistant to punctures and tears.	Poor- Vinyl breaks and punctures easily during use and the fit around the wrist is baggy, making it a poor barrier.
Allergen Content	Varies- Latex contains protein and chemical allergens. Powder-free gloves are lower in allergens than powdered gloves.	Excellent- Polyurethane contains no latex proteins or chemical allergens.	Excellent- Neoprene contains no latex proteins but contains a low level of chemical allergens.	Very Good- Nitrile contains no latex proteins but contains some curing agents and other chemical ingredients.	Good- Vinyl contains no latex proteins but contains some curing agents and other chemical ingredients.
Strength & Durability	Excellent- Natural rubber latex is very strong and durable. Tensile strength is typically 3000 psi or better.	Excellent- Polyurethane is extremely strong with puncture resistance superior to latex, neoprene and vinyl. It exhibits excellent tear and abrasion resistance as well. Tensile strength is typically 3000 psi or better.	Very Good- Unbroken neoprene is strong. However, once punctured, the film tends to tear easily. Tensile strength is typically 3000 psi or better.	Excellent- Nitrile film is extremely strong with puncture resistance superior to all glove films. Tensile strength is typically well above 3000.	Poor- Vinyl is the weakest of the four films and tends to break and puncture easily when stressed. Tensile strength is typically below 2000 psi.
Elasticity	Excellent- Latex elasticity is superior to the other glove films currently available. Memory is very high allowing the film to always return to its original shape. Elongation limit is about. 750%.	Excellent- Polyurethane is the closest to latex, with very high memory so the film retains its original shape. Elongation limit is about 750% or better.	Excellent- Neoprene elasticity is close to that of latex and memory is very high, allowing the film to retain its original shape. Elongation limit is about 750%.	Very Good- Nitrile elasticity is very good with elongation limits typically 500% or better. Nitrile exhibits some memory, allowing the film to adapt to the wearer's hand.	Fair to Poor- Vinyl elasticity is limited and varies from brand to brand. Typical elongation limit is less than 500%. The film exhibits limited memory.
Puncture Resistance	Very Good- Latex is very resistant to punctures but can be pierced by very sharp objects.	Excellent- Puncture resistance is one of the polyurethane's strongest attributes. Its puncture resistance is superior to latex, neoprene and vinyl.	Good- Neoprene is somewhat puncture resistant.	Excellent- One of nitrile's strong points. Puncture resistance is superior to all other medical glove films currently available.	Poor- Vinyl is easily punctured by sharp objects.
Fit, Comfort	Excellent- Latex provides excellent comfort and fit due to its high elasticity and memory.	Very Good- Polyurethane provides very good comfort and fit due to its latex-like physical properties.	Excellent- Neoprene provides excellent comfort and fit due to its high elasticity and memory.	Very Good- Nitrile provides very good comfort and fit due to its high elasticity and memory. Due to a slightly tighter fit, users often choose a larger size.	Fair- Low elasticity limits fit and comfort for many users. The wrist diameter is usually very large making the glove baggy around the cuff.
Chemical Resistance *	Good- Provides good protection form most caustics and detergents. Also recommended by OSHA for cytotoxic drugs.	Very Good- Exhibits resistance to ozone, oxygen, fuel, oil and solvents as well as most chemicals.	Very Good- Provides protection form acids, alcohols, caustics, detergents and keytones.	Excellent- Nitrile exhibits excellent resistance to most chemicals especially harsh solvents.	Poor- Offers very little protection. Vinyl is easily permeated by organic solvents.
Economy	Very Good- Latex provides very good economy for general use. Powder-free versions are more expensive than powdered.	Fair- Polyurethane is more expensive than latex and other non-latex films but can be justified when weighed against the cost of managing latex allergies.	Good- Neoprene is more expensive than latex but can be justified when weighed against the cost of managing latex allergies.	Good- Nitrile is more expensive than latex but can be justified when weighed against the cost of managing latex allergies.	Very Good- Vinyl costs are typically similar to those of latex. Vinyl is a low-cost alternative to latex if latex allergies are a concern.
Recom- mended Use	Recommended as the first choice for barrier protection in the healthcare environment except for users who are allergic to latex.	Recommended as a preferred alternative to natural rubber latex due to its similarity to latex with respect to fit, feel, comfort and barrier protection. Also recommended for those with allergies and sensitive skin.	Recommended as a preferred alternative to natural rubber latex due to its similarity to latex with respect to fit, feel, comfort and barrier protection. Also recommended for those with allergies and sensitive skin.	Recommended as a preferred alternative to natural rubber latex. Also recommended for conditions where high strength and/or chemical protection is required.	Recommended as a low-cost alternative to natural rubber latex for short procedures not involving blood or body fluids.

	*Deciphering Glove Allergies* Healthcare workers may experience some type of reactions to gloves but may not know the specific cause. The guide below is helpful in identifying the causes and solutions.
Latex	Reactions to Latex Natural rubber latex is a key component of many healthcare products including medical gloves. There are thousands of consumer products that also contain latex such as clothes, adhesives, paint, rubber bands, etc. and avoidance of latex entirely can be almost impossible. Latex allergic individuals may typically suffer from a Type I allergic reaction to the latex proteins found in all natural rubber latex products. Symptoms may include an immediate reaction to latex gloves, respiratory problems, itchy eyes, runny nose and hives. All natural lubber latex gloves contain latex proteins but some gloves are specially processed to minimize protein levels. Latex allergic individuals should use non-latex gloves and it is suggested in the literature that their coworkers should use powder-free latex gloves or non-latex gloves to prevent aeroallergen transmission.
Chemicals	Reactions to Chemicals Manufacturers use a variety of chemicals to produce both latex and non-latex gloves. These chemicals include accelerators such as thiurams, carbamates and mercaptobenzothiazole that help to speed the curing process, antiozonates, antioxidants such as BHA and BHT and preservatives such as formaldehyde. Different manufacturers use different chemical combinations and nearly all manufacturers leach and wash their gloves to minimize residual chemicals in the final product. Chemical allergic individuals may suffer from a Type IV delayed reaction. Symptoms may appear within six to forty-eight hours and may be limited to the area of exposure and may include dry, thickened skin, scabbing sores, papules, peeling and vesicles. Chemical allergic individuals should use gloves that do not utilize the causative agent or gloves that have demonstrated a reduced potential for reaction in individuals sensitized to the causative agent.
Powders	Reactions to Glove Powders Cornstarch powder is used to detackify gloves and to aid in donning. Surprisingly, true allergic reactions to cornstarch powder are rare. However, cornstarch powder applied natural rubber latex gloves will bind with latex protein and can carry these allergens to the user. Powder can also irritate and dry the skin, a situation often confused with an allergic reaction. Users irritated by glove powders should switch to powder-free gloves.
Other	Other Types of Reactions Skin reactions on the hands are not always caused by gloves. Clinicians can experience irritation or allergies from insufficient hand rinsing, disinfectants, soaps, hand lotion etc.
	*Solving the Problem* The best way to identify the source of reaction is to see an allergist or dermatologist. Once the causative agent is identified, exposure should be minimized or eliminated. Powder-free gloves are recommended over powdered gloves, in general. Latex allergic individuals should switch to non-latex gloves. Chemical allergic individuals should switch to gloves that have demonstrated a reduced potential for reaction in individuals sensitized to the causative agent.

* When used within accordance with published guideline.

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