1. AWARENESS AND GUIDANCE OF DERMATITIS RISKS IN HEALTHCARE WORKERS

2. GLOVE USAGE AND LATEX POLICY FOR STAFF BRIEFING SESSIONS FOR MANAGERS

3. BACKGROUND LEGISLATION HSE VISIT LATEX ALLERGY FREQUENT HAND WASHING GLOVE USAGE HEALTH & SAFETY

4. LATEX – THE FACTS LATEX ALLERGY IS RARE SENSITIVITY IS COMMON IF IGNORED/UNTREATED – MAY BECOME AN ALLERGY MISUSE OF LATEX GLOVES

5. TYPE 1 LATEX ALLERGY HYPERSENSITIVITY TO LATEX PROTEINS – PREVIOUS FREQUENT EXPOSURE IgE LATEX SPECIFIC ANTIBODIES FOUND ON BLOOD TESTING

6. SIGNS & SYMPTOMS ITCHING CONTACT URTICARIA SNEEZING BRONCHOSPASM ANAPHYLAXIS

7. EXAMPLES CONTACT WITH LATEX

8. TYPE IV CONTACT DERMATITIS TYPE IV HYPERSENSIVITIY TO THE CHEMICALS ADDED TO RUBBER PRODUCTS COMMON VESICULAR ECZEMATOUS HOURS – DAYS AFTER CONTACT

9. EXAMPLES CONTACT DERMATITIS

10. IRRITANT CONTACT DERMATITIS CHEMICAL OR PHYSICAL DAMAGE FREQUENT HAND WASHING

11. HSE GUIDANCE ‘REPEATED AND PROLONGED CONTACT WITH WATER – MORE THAN 20 HAND WASHES OR HAVING WET HANDS FOR MORE THAN 2 HOURS PER SHIFT.’

12. HEALTH SURVEILLANCE REGULAR GLOVE USERS – DAILY BASIS (WILL BE WASHING HANDS) FREQUENT HAND WASHING >20 TIMES A DAY LATEX GLOVE USERS ANNUAL SKIN CHECKS KNOWN ALLERGY/SKIN PROBLEM REFER TO OH

13. CHRIS PACKHAM - ENVIRODERM “What is commonly termed ‘wet work’ is the most common form of occupational contact dermatitis. Studies have shown that frequent, short duration exposures to water are more damaging to the skin that a single, long term exposure. Furthermore, wearing occlusive gloves is equivalent to having your hands in water.

14. Since it is the occlusion that contributes to the dermatitis, changing gloves will not improve matters. Indeed, it may make things worse. The only thing you can do is to limit the amount of hand washing and glove wearing by carrying out a proper risk assessment and then deciding when hand washing (as opposed to a properly buffered alcohol gel) and glove wearing are really necessary.

15. This is rarely done in the NHS. With the gloves the only answer is to wear separate cotton gloves underneath the occlusive ones. It has been shown that this significantly reduces the damage that the occlusion can cause

16. Incidentally, provided you use only unpowdered, low free protein natural rubber gloves these represent virtually no hazard, except to those who are already sensitised to the latex protein. The latex allergy problem was caused by the powdered, high free protein gloves that were purchased due to their low price.

17. I am seeing increasing numbers of cases of allergic contact dermatitis in those healthcare organisations who have changed to nitrile. There have now even been two reported cases of type I allergy to nitrile gloves. Similar situation exists with the thin vinyl gloves.”

18. WASHING V GEL GEL DOES LESS DAMAGE THAN WASHING WHEN HANDS ARE DRY AND CHAFED – GEL ‘STINGS’ MOISTURISE AT BREAKS AND AT HOME

19. GLOVE CHOICE DOES THE TASK NEED GLOVES? WHAT TYPE OF GLOVE? RISK ASSESSMENT HEALTH SURVEILLANCE ANNUAL SKIN CHECKS

20. GLOVE SELECTION USE RISK FLOW CHART BODY FLUID CONTACT NON BODY FLUID CONTACT STERILE ENVIRONMENT NON STERILE ENVIRONMENT

21. GLOVE SELECTION FOOD PREPARATION PATIENT TRANSPORTING WASTE DISPOSAL BASIC PATIENT CARE DRUG ADMINISTRATION

22. FOOD HANDLING PROVIDED HANDS ARE CLEAN – NO NEED TO WEAR GLOVES TO HAND FOOD OUT ON WARDS CROSS CONTAMINATION IS THE REASON TO WEAR GLOVES

23. CLEAR NEED FOR LATEX DEMONSTRATED BY RISK ASSESSMENT ANNUAL SKIN SURVEILLANCE ONUS ON MANAGER TO ENSURE COMPLIANCE RESULTS TO OH OH FOLLOW UP WHEN INDICATED MANAGER UPDATED ON OUTCOME

24. WET WORK/FREQUENT GLOVE USAGE ANNUAL SKIN CHECKS BY MANAGERS AT APPRAISAL ONUS ON MANAGER TO ENSURE COMPLIANCE RESULTS TO OH OH FOLLOW UP WHEN INDICATED MANAGER UPDATED ON OUTCOME

25. AWARENESS SKIN BREAKDOWN INCREASED RISK OF INFECTION NON CLINICAL WORK UNTIL HEALED ALTERNATIVE SOAPS/CREAMS

26. HAND CARE ALCOHOL HAND GEL SOAP AND WATER DRYING THOROUGHLY MOISTURISE COTTON GLOVES