Latex-free versus latex-safe:
Issues managers should consider
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By Anita Shoup, RN, MSN, CNOR Clinical Nurse Consultant Molnlycke Health Care, US, LLC |
Latex allergies have been a concern in the healthcare environment for nearly two decades and can be a serious problem for patients and healthcare workers.
Today the question is: Do healthcare facilities need to go "latex-free"? Some believe that replacing latex gloves with non-latex gloves will create a latex-free environment that is safer for patients and workers with latex allergies. However, because natural rubber latex can be found in more than 17,600 medical devices, one can begin to understand that simply replacing latex gloves with latex-free gloves is only the beginning. While it is considered impossible to remove all latex from the environment, when caring for a latex allergic individual any source of latex that could potentially contact the individual should be removed.
Gloves are an essential component of patient care necessary to ensure workplace safety in healthcare environments. With the prevalence today of bloodborne pathogens such as HIV, Hepatitis B, and Hepatitis C, barrier protection is critical for healthcare workers. Workers now need to presume that any patient who presents to a healthcare facility for treatment may be infected with a bloodborne pathogen, and healthcare workers need to wear the best protection available.
When making the decision regarding latex-safe (powder-free, low protein gloves) versus "latex-free" (use of non-latex gloves), facilities must weigh all considerations.
Although the quality of non-latex gloves has improved in recent years, many healthcare practitioners prefer latex gloves because the non-latex gloves may not feel as soft and pliable. Non-latex gloves also do not come in all the varieties workers need, including thicker, thinner, less textured and more textured. Healthcare workers generally prefer the characteristics associated with latex gloves for their durability, quality, safety and needlestick injury prevention.
Double gloving may also be more difficult with non-latex gloves. This may lead some healthcare workers to forego double gloving when they should be doing so for all invasive procedures, as stated in AORN's Recommended Practices for Prevention of Transmissible Infections.
Instead of converting to non-latex gloves, many healthcare organizations are opting to use low-protein, powder-free latex gloves, creating a "latex-safe" environment. Gloves labeled "low-protein" must meet standards required by the federal government. In a latex-safe environment, non-latex gloves and other non-latex products are used when caring for patients and healthcare workers with known or suspected latex allergies, and powder-free, low-protein gloves are available for everyone else.
Cost is also a consideration. Although powdered latex gloves are the least expensive option, their typically higher protein levels may be more likely to cause sensitization and allergic reactions. On the other hand, non-latex gloves cost roughly twice the price of powder-free, low-protein gloves (and 4-5 times more than powdered latex). In addition, latex gloves are made from an abundant natural, renewable resource and are biodegradable. Non-latex gloves are made from oil-a non-biodegradable product with a volatile market.
There is a logical reason for some facilities to standardize with latex-free gloves. For example, children's hospitals, where many young patients undergo multiple surgeries for conditions such as spina bifida, might consider the option to reduce the number of potential exposures to latex proteins.
When deciding whether to create a latex-safe environment or use only latex-free gloves, healthcare facilities need to thoughtfully consider all variables and determine what works for them. It is not an issue that can be covered with a blanket statement. Facilities must take into consideration the types of surgeries they perform, their workers' needs and preferences for gloves, and the cost of glove acquisition.
Trying to force a decision that doesn't fit may cause more problems than it initially seems to solve. Every institution should make an informed decision as to whether exclusive use of latex-free gloves or creation of a latex-safe environment is the right choice for them.
Shoup is a clinical nurse consultant with Molnlycke Health Care US, LLC in Norcross, Ga. She has worked with organizations on latex allergy issues since the early 1990s, and she has written numerous articles and given many talks around the country on the topic of latex allergy. She is also a member of AORN's Perioperative Environment of Care Committee and serves as an editorial reviewer for the Occupational Safety and Health Administration's Safety and Health Topics Web pages.