Very interesting 

Kind Regards 
Teresa Fox 
Occupational Health and Wellbeing Nurse Specialist.

Orchard Gate Enterprises Ltd- delivering robust attendance management and performance advice to businesses of all sizes . 

Tel: 07970050225
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On 10 Feb 2012, at 14:12, Chris Packham <[log in to unmask]> wrote:

> Lindsey
> 
> You are spot on! Prior to the "universal barrier precaution" policy coming
> into being (and not just in the UK) there were few manufacturers in the Far
> East for the single use latex gloves (I have been told just 14 but cannot
> verify this). Quality was generally high, with low free protein levels. Even
> with the use of powder at that time there was no 'latex epidemic' since the
> powder could not combine with the proteins that were not bioavailable. With
> the enormous increase in the requirement for single use latex gloves, the
> existing manufacturers could not cope and a whole raft of new producers
> appeared. The impression I have from what I have read and my visit to
> Malaysia for the Malaysian Rubber Manufacturers' Association is that these
> were less concerned with quality and more with maximising profit. At the
> same time the vast increase in glove use was putting pressure on healthcare
> budgets, so the drive to find cheaper gloves developed. Thus high free
> protein gloves started to appear, since these were cheaper to manufacture.
> Since the post vulcanisation chemical treatment was also skipped (cost
> saving again), the gloves were 'sticky' and difficult to don, so powder
> (modified corn starch) was applied as a 'lubricant'. This acted as a carrier
> for the latex proteins which could now become airborne and inhaled.
> According my conversations with a German expert (Prof. Henning Allmers),
> sensitisation develops from inhalation exposure, but can then manifest
> itself as a skin problem.
> 
> In her book "Allergien gegen Latexhandschuhe" (unfortunately only available
> in German) Dr. Angelika Heese has a table showing the free protein as
> measured by the Lowry method in various gloves. This varies from less than
> 10 to over 500, a significant range. Prof. Turjanmaa and her group studies
> this and commented that: "The gloves in categories 'very low' and 'low'
> contain such low levels of the main natural rubber allergens that they are
> suitable not only for non-allergenic persons but also for most of the
> sensitized users." Turjanmaa K, Kanto M, Kautiainen H, Reunala T, Palosuo T;
> Long-term follow-up of 160 adult patients with natural rubber latex allergy;
> J Allergy Clin Immunol 2002, 110, 70-74
> 
> The problem with nitrile is that many of the same chemicals (thiurams,
> mercaptobenzothiazoles, etc.) are used in the manufacture of the single use
> gloves, although the more expensive ones often avoid the use of these. Thus
> the more expensive ones are less likely to initiate sensitisation and
> allergic contact dermatitis. Guess which version tend to be purchased. 
> 
> Whilst manufacturers - at least the good and responsible ones - will
> indicate or advise on the level of free protein in their gloves, I have not
> yet managed to get the same level of information on nitrile gloves on the
> levels of free chemicals.
> 
> Note also that I am referring exclusively to 'single use' gloves. There has
> never been any significant type I latex allergy problem with the reusable
> gloves, such as for household work, cleaning, etc.
> 
> Hope this is of some help.
> 
> Chris 
> 
> Chris Packham
> FRSPH, FInstSMM, MCMI, MIIRSM, MBICSc
> EnviroDerm Services
> Unit 10, Building 11, The Mews, Mitcheldean, GL17 0SN
> Tel: +44 1386 832 311 (office), Mobile: +44 7818 035 898
> www.enviroderm.co.uk
> 
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