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Hi there Chris, Tracy and the list This topic has really been helpful to me; I popped into the site to have a quick catch up and was going to make a query about Nitrile gloves - Chris has answered most of my questions already! I have recently seen a chap who appears to have had an irritant reaction to Nitrile gloves used at work. I did wonder if it was more likely to be due to the occlusive effect of the gloves rather than specifically Nitrile gloves and suggested wearing cotton liners but was not sure how practical it would be for him - he works with oils as a fitter. I also advised trialling alternatives available, however, the company in it's enthusiasm to avoid Latex gloves seems to think that Nitrile will suit everyone and it is proving quite difficult to get them to source alternatives. I have obviously advised that they do need to provide alternatives but wonder if anyone has a specific alternative glove (none powdered as they do not want the oil contaminated) that they could recommend for this type of work. Thanks for all the information this site provides. Jane Jane Mann RGN; BSc (Hons) Occupational Health Advisor, EDF Energy Bury St Edmunds Duradiamond Healthcare [log in to unmask] T: 01284 726653 F: 01284 726660 Mob: 07875 116305 -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Chris Packham Sent: 22 July 2009 12:13 To: [log in to unmask] Subject: Re: [OCC-HEALTH] Sensitivity to latex Tracy, Having now spoken on the phone with you I can revise my original comments. 1. As I understand it she is wearing nitrile gloves. If she is reacting to these then this will possibly be a type IV, allergic contact dermatitis, to the chemicals used in the nitrile glove. These are frequently the same as are used in a natural rubber latex glove, but are more readily absorbed into the skin from the nitrile glove. I have seen organisations who have used unpowdered, low free protein natural rubber latex gloves for years and never had a single latex allergy (type I) problem. They then changed to nitrile and experienced a whole series of allergic reactions. Incidentally there have been two reports of type I reactions to nitrile! 2. As the RAST for this lady was negative to latex protein the probability of her being allergic to these proteins is absolutely minimal. (RAST is not 100%.) So her statement that she is sensitive to latex is not borne out by the medical evidence. Based on what you have told me my view has to be that she does not require any abnormal precautions to be taken with regard to latex. 3. The most common reaction to the tight fitting, single use gloves used in healthcare is an irritant contact dermatitis caused by the occlusive effect of the glove. This will occur irrespective of the type of glove material. Even when the gloves are only worn for short periods hyperhydration starts to build. It can take the skin some time to recover after the gloves are removed. So frequent, short term, use of gloves can result in an accumulative effect resulting in significant hyperhydration and this can lead to irritant contact dermatitis. If you combine this effect, equivalent to wet work, with frequent hand washing, the combination can easily result in irritant contact dermatitis. 4. Wearing separate cotton gloves underneath the occlusive glove has been shown to significantly reduce this problem. In Germany this has been recognised such that their Technical Regulation for Hazardous Substances No. 401 states that where gloves are being worn for more than a total of four hours in any eight hour period this constitutes a risk to the skin and special precautions (which can include the wearing of cotton gloves underneath) have to be taken. 5. Note that the RAST tests for sensitisation not allergy. It is perfectly possible to be sensitised to a substance but not allergic. We had a case of a lady who had a positive RAST to latex protein, but did not react if she was unaware of her exposure to natural rubber latex. However, if she though she was being exposed, even if there was no real exposure, she would start to react. Technical this is known as an undifferentiated idiopathic somatoform reaction, i.e. purely psychosomatic. 6. Finally, I am attaching a copy of our Technical Bulletin on latex allergy just so you have the real facts. Hope this is of some help. Regards Chris EnviroDerm Services (UK) Ltd. 2 Amery Lodge Farm, North Littleton, Evesham, WR11 8QY Tel: +44 1386 831 777 www.enviroderm.co.uk ~~~~~~~~~~~~~~~ Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH OCCUPATIONAL HEALTH JOBS http://OHJobs.drmaze.net OCCUPATIONAL HEALTH NURSING EDUCATION http://www.aohne.org.uk This e-mail and any files transmitted with it are confidential and may be protected by legal privilege. If you are not the intended recipient, please notify the sender and delete the e-mail from your system. This e-mail has been scanned for malicious content but the internet is inherently insecure and EDF Energy plc cannot accept any liability for the integrity of this message or its attachments. 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