Nitrile utility gloves are recommended for wear in the dental operatory when processing instruments. Deemed “heavy duty” and “puncture resistant” to provide more protection to the hands than thinner, patient-care gloves, nitrile utility gloves are recommended by both the Centers for Disease Control (CDC) and Occupational Health and Safety Administration (OSHA).1,2 OSHA also recommends that each person in the office needing these gloves should have his or her own pair or pairs.2
Whether in the dental office or in a dental hygiene teaching setting, compliance is often poor for a number of reasons. The gloves can be oversized and tend to hamper fine-motor dexterity when disinfecting treatment areas or bagging instruments for ultrasonic or autoclave processing. Many offices offer a single pair of “communal” utility gloves for use by the entire staff. Nitrile utility glove manufacturers such as Hu-Friedy recommend that their product is “steam autoclavable up to five times.”3 However, malodor notably increases in the lining of the gloves with each subsequent autoclaving. Gloves are often stored improperly, causing retention of moisture and bacteria in the lining of the gloves.
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The Owens State Community College (OCC) dental hygiene and dental assisting students had historically been offered communal nitrile utility gloves for operatory disinfection and instrument handling prior to processing, which were replaced with new communal gloves at the beginning of each semester. During the fall 2018 semester, students reported increasing malodor from the lining of the gloves as the semester progressed, which seemed to only worsen when the gloves were autoclaved. Additionally, some students were reporting dermatitis of the hands, which they suspected was caused by communal utility glove use. The American Academy of Allergy Asthma and Immunology defines contact dermatitis as “symptoms such as a red rash, bumps or a burn-like rash on the skin.”4 When researching proper care and storage of utility gloves to prevent odor and bacterial growth, little to no information was available.
Upon assessment, new protocols were immediately put into place to (1) determine if individual/personal utility glove use versus communal utility glove use would decrease the incidence of dermatitis of the hands, and (2) to determine if improved washing and storage protocols would reduce malodor noticed with extended (one semester) use. Gloves were also swabbed and cultured for bacterial growth to determine what the best practices might be for reducing odor as well as bacterial counts.
Old protocol/communal use assessment
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The nitrile utility gloves used communally were rated for odor by students at the end of the fall 2018 semester. Any incidents of contact dermatitis were also reported. The odor ratings were completed in a “blind” manner; the students rated odor on five different gloves:
- communal, turned inside out and washed with antimicrobial soap and air-dried
- communal, not washed/not autoclaved
- autoclaved right side out
- new (never worn/used)
- autoclaved inside-out
Gloves were rated on a scale of: no odor, slight odor, odor, malodor, malodor highly offensive. The findings, although inconsistent, rated the “new” glove with the lowest odor-offensive rating: 59% no odor and 32% slight odor. The gloves that had the highest odor-offensive rating were the glove autoclaved right-side out, with 18% slight odor and 18% odor; as well as the glove autoclaved inside out, with 18% odor, 14% malodor and 5% highly offensive malodor, suggesting that autoclaving did, in fact, increase malodor. Eight of the 22 students (36%) who completed the survey reported some incidence of dermatitis of the hands during the fall 2018 semester. Two of the 22 students (9.09%) had previously experienced dermatitis of the hands prior to entering the dental hygiene program.
Gloves were then swabbed and cultured for bacterial presence, using tryptic soy agar plates inoculated by sterile swabbing, utilizing the facilities at the Owens State Community College Life and Natural Sciences Department. On February 19, 2019, the five gloves provided were tested for bacterial growth. The inside (white) palm area of each glove was swabbed. The gloves were indicated by the following numbered order:
- Autoclaved right side out
- Turned inside out, washed with antimicrobial soap and autoclaved inside-out
- New (never worn or used)
- Turned inside out, washed with antimicrobial soap and air dried
- Communal, not washed or autoclaved
Source: https://t-tees.com
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