Selecting latex gloves

Background

Natural rubber latex (NRL) proteins have the potential to cause asthma and urticaria. More serious allergic reactions, such as anaphylaxis, are also possible. NRL proteins are substances hazardous to health under COSHH (Control of Substances Hazardous to Health Regulations). Therefore, COSHH and the COSHH ACOP (Approved Code of Practice) apply, including the specific requirements for the control of substances that cause occupational asthma.

Specific approach to latex gloves

A very common route of exposure to NRL proteins in the workplace is through the use of single-use latex gloves. These gloves can be supplied 'powdered' (where powder is added to ease putting on and removal) or 'powder-free'. In powdered latex gloves, the NRL proteins can leach out of the glove material and attach to the powder particles. When the gloves are put on or removed, the powder - along with the attached NRL proteins - becomes airborne and can be inhaled. The risk of inhalation and skin exposures to NRL proteins is reduced when non-powdered, 'low-protein' single-use latex gloves are used. 'low-protein' means manufactured to the European Standards indicated by EN420 (This requires extractable latex proteins to meet the European Standards defined by EN455-3).

In 2008, the NHS Plus Occupational Health Clinical Effectiveness Unit in association with the Royal College of Physicians, produced evidence-based guidelines for the occupational aspects of latex allergy management.

These evidence-based guidelines address the likely level of risk arising from the use of single-use latex gloves.

HSE Recommends

Employers should carefully consider the risks when selecting gloves in the workplace, because of the importance of latex gloves as a source of exposure to NRL proteins.

When considering glove use in the workplace (latex or otherwise), HSE's glove selection guidance should be followed.

In summary, this means:

• Decide whether or not protective gloves are required at all to perform the task (the law requires that other means to prevent exposure should be considered in preference to gloves). There may be reasons other than worker protection that require the use of gloves eg, patient protection in healthcare. When deciding on glove selection, employers need to take account of all factors.
• If protective gloves are needed, they must be suitable. This means they provide adequate protection against the hazard and are suited to the wearer, the work and the environment in which they are used. To ensure suitability, consider the work (substances handled, other hazards, type and duration of contact), the wearer (comfort and fit) and the task (eg, need for dexterity; sterility issues). This is required to decide on the most suitable glove type, eg, single-use or reusable, and the material they are manufactured from.
  

If the employer's assessment leads to latex as the most suitable glove type for protection against the hazard, then:

• Single-use latex gloves should be low-protein, powder-free.
• Individuals with existing allergy to NRL proteins should take latex avoidance measures and should not use single use or reusable latex gloves. Employers may therefore need to provide gloves of an alternative material.
• Where the use of gloves may result in direct or indirect exposure to members of the public (eg, single-use latex gloves used in patient care; food handling; hairdressing; motor vehicle maintenance), the employer must undertake an assessment of the risks of such exposure and adopt suitable control measures to ensure the health of others is protected.

Where low-protein, powder-free, single-use latex gloves are used in the workplace, suitable health surveillance for occupational asthma must be in place. However, given that the risks of developing occupational asthma are considered to be low, a low level of health surveillance is likely to be sufficient. Examples of typical health surveillance approaches are given in the article Standards of Care for occupational asthma developed by the Group of Occupational Respiratory Disease Specialists (GORDS), which is coordinated by HSE.

Employers must be able to demonstrate that they have carried out an assessment (as set out above) to select which (if any) type of gloves they should provide. They must also be able to demonstrate that they have an effective glove use policy in place that, for example, takes account of those employees or others (such as members of the public), who may have a latex allergy.

Whenever protective gloves are used (regardless of the material), employers should provide information, instruction and training to employees on how to use them to properly protect themselves. This should include the provision of information on latex allergy, if this is appropriate.

Whenever protective gloves are used (regardless of material), employers must consider the need for, and, if appropriate, implement suitable health surveillance for work-related dermatitis ie, regular skin checks.