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ABSTRACTS
BRITISH DENTAL JOURNAL VOLUME 196 NO. 11 JUNE 12 2004 685
Objective
The aim of the current study was to assess the puncture resistance
and stiffness of nitrile and latex dental examination gloves.
Methods
Puncture resistance was measured by employing an adapted ver-
sion of ASTM F1342-91 using both a 316 stainless steel puncture
probe (0.8 mm diameter) and a dental injection needle (0.45 mm
diameter) interfaced to a tensile testing apparatus. Glove speci-
mens (12 cm length, 1.5 cm breadth) were removed for modulus
(M100) evaluation by assessing the force required to elongate the
specimen to 100% of the original length. Glove samples were also
aged to investigate whether puncture resistance and M100 values
varied with aging at 70°C for 7 days in an air-circulating oven.
Results
The nitrile glove types were assessed to have significantly higher
puncture resistance compared with the latex glove type when the
steel puncture probe was the pentrometer when using the one way
analysis of variance (ANOVA) at the 95% significance level. Inter-
estingly the puncture resistance for the latex glove type was sig-
nificantly higher (p < 0.001) when a dental injection needle was
used as the pentrometer compared with the nitrile glove types. The
M100 values were significantly higher for the nitrile glove types
for which the stiffness increased when the gloves were aged
(p < 0.001).
Conclusions
The higher stiffness values resulted in increased puncture resist-
ance when the nitrile glove specimens were aged irrespective of
the pentrometer type. However, the ability of latex to re-seal itself
on puncture may be beneficial when considering the protection
potential of each glove type against breaches in cross infection.
For clinicians that have experienced an adverse reaction to natu-
ral latex gloves, the results of the current study indicate that
nitrile gloves are available at reasonable cost and offer the clini-
cian comparable resistance to puncture with latex gloves.
COMMENT
Since around the mid 1980s dentists and their teams began to treat
body fluids from patients as though they were infected. It became the
norm to wear gloves when treating patients. The barrier function
provided by these is critical in conferring protection from blood borne
pathogens to the wearer. This may be compromised by manufacturing
defects or breaches in integrity during function, such as can occur
upon exposure to chemicals
1
or upon penetration by dental
instruments or equipment. By far the most commonly worn gloves are
made of natural rubber latex. Unfortunately, allergies to this material
are increasingly encountered by both clinical staff and patients.
2
As a
result manufacturers have produced alternatives made from synthetic
latex such as polyvinyl chloride (PVC) or nitrile gloves. Clearly, each
glove make and material type will have different properties and, in
order to make an informed choice, the prospective purchaser should be
informed of these.
This paper assesses the puncture resistance and stiffness of three
makes of nitrile and one type of natural latex gloves by means of
laboratory tests. A total of ten gloves of each make were examined.
Samples of glove material were harvested from all regions of the glove
for testing. Puncture resistance was determined by measuring the
force required for both a hypodermic needle and stainless steel
puncture probe to penetrate each sample under standardised
conditions of stretch. These tests were also undertaken upon samples
artificially aged to simulate clinical use.
In general, variations in the puncture force required to penetrate
each make of glove were observed. Ageing appeared to increase this.
No consistent rank order of puncture resistance was found.
Interestingly, when the dental injection needle was used as the
penetrometer, the palm regions of the gloves had the lowest puncture
resistance followed by the ring and index finger regions and the thumb
region. The index and middle finger regions displayed higher puncture
resistance than all other regions.
Although the authors perceived that the latex gloves gave
comparable puncture resistance with the nitrile gloves it was the
ability of latex to reseal itself upon penetration that offered overriding
additional protection. It should, however, be borne in mind that
wearing clinical gloves both reduces the volume of blood transferred in
needlestick injuries by 46-86%
3
and is also said to wipe the needle
clean.
4
Since the effects of these two actions are cumulative, and the
risk from transmission of an infectious agent is related to the amount
of agent transmitted, the benefit of wearing gloves is considerable.
4
1 Tinsley D. Chadwick R G. The permeability of dental gloves following exposure to certain
dental materials. 1997 J Dent 25: 65-70.
2 Edlich R F, Woodard C R, Hill L G, Heather, C L. Latex allergy: a life threatening epidemic
for scientists, healthcare personnel, and their patients. J Long Term Eff Med Implants
2003; 13: 11-19.
3 Mast S T, Woolwine J D, Geberding J L. Efficacy of gloves in reducing blood borne vol-
umes transferred during simulated needlestick injury. J Infect Dis 1993 168: 1589-1592.
4 Robinson P. Sharps injuries in Dental Practice. Primary Dent Care 1998 5: 33-39.
R. G. Chadwick, Senior Lecturer and Honorary Consultant in
Restorative Dentistry, The Dental School, Dundee
doi:10.1038/sj.bdj.4811350
Comparison of nitrile and latex examination gloves
Puncture resistance and stiffness of nitrile and latex dental examination gloves H. B. Patel, G. J. P. Fleming and
F. J. T. Burke Br Dent J 2004; 196: 695-700
RESEARCH SUMMARY
● The index and middle finger regions were assessed to have a
significantly higher puncture resistance than the other glove regions.
However, this may be less relevant in the dental surgery since
clinically these regions, along with the thumb region, were assessed
to be the most common location for glove punctures.
● For all glove types/pentrometer combinations investigated, puncture
resistance increased on aging the samples to mimic clinical usage
when gloves are routinely worn. The stiffness values evaluated were
significantly lower for the latex gloves type assessed compared with
the three nitrile glove types investigated.
● The results of the current study indicate that nitrile gloves offer the
clinicians that have experienced an adverse reaction to natural latex
gloves comparable resistance to puncture with latex gloves.
IN BRIEF
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