In recent years, researchers have noted a significant increase in contact allergies to rubber additives among health care professionals. Although the cause of this cannot be stated with certainty, experts believe that nitrile gloves, which are most commonly used in dental care today, have contributed significantly.
In the 1980s, the use of medical gloves made of natural rubber latex was introduced into dentistry. Owing to an alarming number of allergic reactions caused by certain proteins contained in latex, synthetic alternatives like nitrile and vinyl gloves emerged shortly afterwards. While they, like other alternatives, score significantly lower in comfort and elasticity, nitrile gloves are most commonly used by dentists.
According to Michiel Paping, director of Budev, a Dutch research and development company focused on natural rubber latex allergens, type I allergic reactions, which are immediate reactions to allergens in a product, are very rare nowadays owing to improved quality standards and production processes. Type IV reactions, however, are delayed reactions to the chemicals used in the production process and are more common and can arise in response to nitrile or vinyl . “In fact, I think that synthetic rubbers cause more contact allergies than natural rubber latex,” he told Dental Tribune Netherlands.
“It is not the raw, unprocessed rubber that causes type IV allergic contact eczema but the excipients added during the manufacturing process, such as vulcanisation accelerators, plasticisers, fillers, antioxidants and colourants. Excipients are present in both natural and synthetic rubber gloves,” said Prof. An Goossens, a contact allergy expert at KU Leuven’s Department of Dermatology in Belgium.
In 2010, a soft nitrile glove was introduced that weighed only 2.5 to 3.5 g. The production lines were shortened and the vulcanisation was performed at lower temperatures to save costs and energy. However, concerns have been raised about the thinner gloves.
“Producing thinner gloves and thereby being able to fit more gloves in a shipment, saves costs for raw materials and transport. However, the production of such a thin product and vulcanisation at lower temperatures inevitably requires extra and new chemicals. In addition, it is unavoidable that thinner gloves will score worse in strength and permeability,” said Paping after his company had tested various gloves with regard to these properties.
Alongside the growing number of contact allergies in recent years that are likely caused by added chemicals or antimicrobial agents, Paping and his team have observed an increase in allergic reactions in daily practice. “Recently, we have seen that the professional body is becoming alarmed. Despite this, I am concerned that the average dentist is not aware of this matter,” he said.
“When health care professionals start working in practice, they use the same glove out of habit. When gloves are ordered, the responsible person most often looks for the cheapest product on the market. As a result, cheap gloves of unknown origin are sometimes used in dental care,” Paping said.
According to studies conducted in Finland and the Netherlands, the quality of latex gloves today is evolving and most manufacturers have eradicated the proteins that can cause allergies from their production. However, currently there is insufficient data on the new generation of latex gloves but initial studies have shown promising results.
According to the experts, a change of thinking and a policy on rubber gloves based on neutral information is urgently needed. Currently, a number of inferior products on the market owing to the fact that CE markings can be awarded based on self-assessment in Europe, Paping said. He recommended the implementation of new standards to replace the CE marking in order to promote high-quality products that are flexible, cause as little sensitisation as possible and keep permeability as low as possible.
Contact allergies caused by gloves are a growing problem and should not be underestimated, the experts concluded. “With an annual global use of more than 150 billion pieces, the medical glove is something that requires serious attention,” said Paping. “It is a condition that can threaten your career and you can develop it suddenly,” he warned.
(Edited by Claudia Duschek, DTI)
Original Source: The Dental Tribune.com