Association of Anatomical Pathology Technology


In Search of the Perfect Glove

We live, so we are told, in a free world. People like things to be free. Free spirits, fat free, interest free and tax-free are all phrases we know and love. So why should the phrase ‘latex free’ prove to be such a distinctly unpopular expression? Well, pull up a chair and I will tell you.

We live, so we are told, in a free world. People like things to be free. Free spirits, fat free, interest free and tax-free are all phrases we know and love. So why should the phrase ‘latex free’ prove to be such a distinctly unpopular expression? Well, pull up a chair and I will tell you.

In 2008, our organisation was served an improvement notice from the Health and Safety Executive over the use of latex gloves. HSE instructed our Trust (and many others) to reduce the use of said items where possible. Our organisation took the decision to completely eliminate the use of latex gloves and we were instructed to comply with this with immediate effect. This proved to be more problematic than we had first realised.

We had used cheaper nitrile and vinyl gloves for any procedure other than post mortem work for some time. However, when we started looking at suitable alternatives for post mortem work we found there was little choice in latex free gloves. Most options were either ill fitting, had a short cuff that led to contamination of the wrist area and inside the glove, punctured too readily or the cuff rolled down exposing the skin. On top of that, have you ever tried double gloving with nitrile gloves? It is somewhat comparable to trying to push a worm back into a hole. Not that I go around tormenting worms by trying to poke them back into their holes you understand, I was merely using this analogy to demonstrate how difficult it is.

Having invested a considerable amount of time trying to source a viable alternative to latex gloves, we concluded there was no suitable viable alternative on the market. The latex gloves we were using back then came in at around £9 per box of 25 pairs. These were good quality low protein, non-sterile latex gloves. They had a snug-fitting, long cuff on them and were well suited for post mortem work. The only latex free alternatives that were considered of comparable quality and design were cost prohibitive (in the region of £90 for a box of 40 pairs). These were sterile surgical gloves. Considering we go through approximately 40 pairs of gloves during a post mortem session, it was going to significantly impact on our budget.

Our Trust was keen to move us away from using latex gloves. However, the associated problems with the cheap latex free alternatives posed a greater risk to us than continuing with the latex gloves. No staff working within the department actually suffered (or suffers) from a latex allergy, which added to our frustration at being hit with this directive. It also added weight to our argument to continue using latex gloves. A risk assessment helped to demonstrate that the alternatives were not suitable and posed additional risks to staff. The Trust allowed us to continue using latex gloves, providing all staff had regular health monitoring and we continued to explore the market for viable alternatives.

In October 2009, we had a Health and Safety inspection within the Mortuary. We were told that the continued use of latex gloves was not acceptable and were given three months to find an alternative. Again, we sourced and trialled many different gloves and, again, we struggled to find a suitable alternative. Eventually we sourced some nitrile gloves from Kimberley Clark, which, whilst not as good as the latex gloves, were a reasonable compromise. We then had a battle to get these gloves added to the NHS stores catalogue to enable us to freely order them in.

Although we had managed to find an alternative that was at least acceptable (even though there were grumbles from all concerned about the ridiculous world we live in etc!), we were still far from happy about the situation and were keen to find a latex free glove that we considered appropriate for the job. We compiled a list of features that were desirable in the design of the gloves we were after. Our requirements were that the gloves should:

  1. be latex free
  2. be durable
  3. Conform to the contours of the hand (something baggy nitrile is not good at!)
  4. have a long cuff that extends beyond the wrist
  5. have a cuff that does not roll down the wrist during use

Our supplies department were extremely helpful in sourcing gloves to trial that met these requirements and canvassing companies about what was available. This led to contact from a company called Medicare, who were looking at developing a glove designed predominantly for post mortem work. It seems that we were not the only establishment experiencing difficulties in sourcing a suitable product.

We met with the Sales Manager, Gary Sira who showed us an assortment of sterile versions of gloves they were intending to produce non-sterile versions of. These gloves were made from neoprene, which resembles the characteristics of natural rubber but without the associated health risks. We were able to provide feedback on first impressions from this meeting and were also given several pairs of the various gloves in different sizes to test them out in the post mortem room.

Some of the gloves were quite thick which, whilst reassuring from a puncture proof perspective, greatly reduced sensitivity. They were also quite difficult to don and double gloving with them felt like wearing a leather falconry glove. Double gloving reduced the circulation to the fingers too, leading to complaints from staff of numbness and tingling. I thought that this might lead to further health and safety issues from loss of fingers due to gangrene so decided that production of this particular glove would not be sensible.

Eventually, we agreed upon the best option and contacted Gary to give him our feedback. We requested that the cuff of the gloves be made slightly longer and Medicare set about putting the gloves into production.

Our next meeting with Gary was to see the finished product. It was really quite satisfying to see the finished product. Knowing that we had a hand in designing them (ho ho!) is a bonus. The gloves are soon to be added to the NHS supply chain and will be available through NHS stores.

Guy Singleton
Mortuary and Bereavement Services Manager
Colchester Hospital University Foundation Trust

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