October 18, 2018
In January 2017, the FDA banned the use of powdered gloves. As a result, physicians, nurses, dentists, kitchen workers, and veterinary professionals cannot buy them or use them.
More than a year later, professionals still are trying to understand the reason for this perplexing ban (See the sidebar, “What colleagues think”).
The first documented use of gloves for medical procedures dates back to the late 1800s when Caroline Hampton, a scrub nurse at John Hopkins Hospital, developed an allergic reaction to a chemical used
for asepsis. Her soon-to-be husband, famous surgeon William Halsted (of Halsted’s principles fame), contacted the Goodyear rubber company to create thin rubber gloves. The idea was to prevent his bride from suffering a skin reaction.
In 1964, Ansell manufactured the first disposable, sterile gloves. Fine powder was found to make getting gloves on (donning) and off (doffing) more easily. Glove powder evolved over time, until the FDA’s ban.
Why exactly were powdered gloves banned? The main benefit is that the powder simplifies the application and removal of gloves. The FDA decided this
sole benefit was overshadowed by the downsides.
|What colleagues think|
Glove powder adheres to latex protein, causing it to become aerosolized when gloves are manipulated. In turn, this increases the exposure to latex, which can cause various reactions ranging from sensitivity and airway inflammation to severe allergies. This can affect both patients and health-care workers.
In addition, the body reacts to the powder, which acts a foreign substance. This has been shown to potentiate wound infection, peritoneal adhesions, and granulomatous reactions. Most of the research was done primarily in humans and lab animal models. I could not find any official statement explaining why veterinarians also are affected, but the new law does apply to us.
According to the American Latex Allergy Association, less than one percent of the general population is “sensitized to natural rubber latex.” In addition, eight to 17 percent of (human) health-care workers are affected. I am unaware of any reliable statistics related to veterinary medicine.
I tried extremely hard to better understand the reasons for the ban and obtain statistics from industry professionals. I contacted every major manufacturer and supplier, nationwide. Incredibly, not a single one would answer our basic questions on record.
So if you still own a stash of old powdered gloves, “just in case,” what should you do with them? According to the FDA, “unused supplies… will need to be disposed of according to established procedures of the local community’s solid waste management system.” In plain English, the gloves can be disposed of in regular trash.
Bottom line: The ban affects veterinary practices and we are now obligated to use unpowered surgical and exam gloves.
|Glove materials, powder|
|Medical gloves can be made of natural or synthetic polymers. Latex gloves are made of natural latex, which comes from the rubber tree. Nonlatex gloves are made of a variety of materials, including polyvinyl chloride, neoprene, and nitrile. Watch a short YouTube video on how gloves are made here.
Glove powder essentially acts as a lubricant. The first powder, used in the late 1800s, was made of spores (from Lycopodium, i.e. club moss) or pollen (from pine trees). These materials caused wound granulomas and adhesions. Talcum powder (i.e. magnesium silicate), used in the 1930s, also caused adhesions and granulomas. The year 1947 saw the first absorbable powder: modified cornstarch powder. Until recently, starch was the most commonly used type of glove powder.
Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified is a board-certified veterinary surgeon and serial entrepreneur. His traveling surgery practice takes him all over Eastern Pennsylvania and Western New Jersey. Visit his websites at DrPhilZeltzman.com and VeterinariansInParadise.com. AJ Debiasse, a technician in Stroudsburg, Pa., contributed to this article.
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