Hand Gloves & Compliances

[box type=”shadow” ]Hand gloves cater to varied applications across industries but more importantly, it is a major tool of safety that safeguards the wearer from self contamination and cross contamination. Be it food handlers or health workers or for that matter cleaning professionals, the compunction and compulsion of wearing gloves are the driving forces behind adhering to hygiene compliances. However, even today in India, there is a general reluctance to wear hand gloves. Vijayalakshmi Sridhar assesses the importance of hand gloves in segments like cleaning and healthcare. A report[/box]

In 90% cases, it is not uncommon to find cleaners cleaning without wearing gloves or food handlers serving food with bare hands or for that matter hospital washroom janitor working without any protection. In hospitals, doctors use hand gloves for sterile surgical procedures, for surgeries and also for patient examination. Nurses and other healthcare workers use hand gloves during patient care to protect themselves from blood and other body fluids and also from HIV, HbsAg, HCV and other contact infections. Food outlets, personel care centres and the housekeeping industry also warrant the use of hand gloves.

The general reluctance to wear them is because of lack of enforcement, opines Jayachandran Pillai, CEO, Clean Pro, a facility management firm based out of Bangalore. “Basically in India, wearing gloves was never a practice. Menial jobs, irrespective of a private or government organization, was being done by a set of people who were never bothered to be educated.” Even though, gloves are an inherent part of workplace uniform and as important as wearing helmets or boots at workshops, it is seldom given that importance in common places like a washroom, which is much more contaminated and hazardous.

“The use of gloves when not indicated represents a waste of resources,” affims Dr Dhruv K. Mamtora, Consulting Microbiology and Infection Control Officer, S.L. Raheja Hospitals, Mumbai. He is also a member of IAMM, IATP and ISID. This approach of adhering to compliances is no doubt good. At the same time, not implementing the same in places which may not have statutory obligation but require compliance is generally evaded. Further, even in places where gloves are used extensively as a matter of compliance, lack of proper handling of gloves too can create infection. “Improper handling may also result in missed opportunities for hand hygiene. The use of contaminated gloves caused by inappropriate storage, inappropriate handling and techniques for donning and removing, may result in germ transmission,” he adds.

Glove market

The hand glove market in India is big and growing, with a lot of brand presence. From cotton to nitrile, and from powder-free to slip-proof, the varieties are amazing and customised for utility in each industry. The general consumption of gloves depends on the patient/client footfall and corresponding use. Maximum sterile supply in hospitals are for OT, procedure rooms and for routine dressing purposes. The examination gloves are used in laboratory, critical care and other areas where direct patient blood or body fluid exposure is anticipated. In facility management, hand gloves are used while cleaning restrooms in residential and commercial establishments.

Strength, comfort and fitting of gloves are the factors that guide in choosing the right brands. Hospitals are guided by their own purchase policy too. Surgicare, with its tested quality and peerless performance remains the surgeons’ choice in hospitals. Brands like 3M and Scotch brite are very commonly used in the housekeeping industry.

Guidance for appropriate use

Though worker awareness for using gloves is high in hospitals, it has to be on par with utility for proper and appropriate use. “Appropriate task for gloves usage is not adhered always. We encourage users by continuous training and awareness and by sensitizing that every patient has to be considered sero positive. Both donning and doffing are equally important,” says Rani Dharanipathy, Chief Nursing Officer, Billroth Hospitals, Chennai.

At Raheja, there is induction training given to staff. In service training sessions for various categories of staff, awareness of infection control practices, include use of personal protective equipment, standard precautions and isolation precautions. Also the training includes appropriate steps of wearing personal protective gear and method of discarding same as per biomedical waste disposal rules prescribed by government authorities.

In cases of non-compliance

If glove usage is skipped, hazards are many, points out Dr Dhruv. “Risk of blood borne infections like Hepatitis B, hepatitis C and HIV is one of the major risk factors, especially in countries with high prevalence rates. When gloves get punctured through a sharp object or during surgery, it poses a risk of blood and body fluid exposure. Hand hygiene needs to be performed in such cases and use of fresh pairs of gloves is worn.”

To avoid these exigencies, emphasises Jayachandran, “The users should be educated. Use of gloves should be made mandatory and it should be the responsibility of the floor manager or supervisor at site and part of the SOP of all companies.”

The glove industry does not have any compliance norms. But with the tightening of environment protection measures, the industry could experience some serious manufacturing guideline changes. Dr Dhruv explains thus.

“The coatings normally used on medical gloves include hydrogels, acrylics, silicone polymer, polyurethane, polymer-blends and nitrile. Polymer coatings are odour-neutral and promote consistentcy. In latex gloves, polymer coatings provide a barrier between the latex glove material and the wearer, helping to limit the migration of latex protein. Both chlorination and polymer coatings are effective at creating a glove that dons and doffs easily. Done correctly, both processes yield gloves that exceed standards for hand protection.

“The government is coming up with new guidelines of biomedical waste management which mentions about phasing out of chlorine compounds, including gloves and blood bags. Accordingly, the latex gloves need to undergo the process of chlorination for significantly reducing the level of extractable latex proteins, making the glove less likely to cause latex allergy in the wearer. Nitrile exam gloves are chlorinated when no polymer coating is preferred. Slowly the polymer coated gloves will overtake if government policies for protecting environment are strictly adhered.”

Nonetheless, compliances can be built in each application and adherence can be experienced only through awareness and education.