Research Summary

Comparison of nitrile and latex examination gloves

Key Points

  • 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.

Abstract

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 version 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 specimens (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. Interestingly the puncture resistance for the latex glove type was significantly 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 resistance 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 natural latex gloves, the results of the current study indicate that nitrile gloves are available at reasonable cost and offer the clinician comparable resistance to puncture with latex gloves.

Main

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

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 chemicals1 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.1 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%1 and is also said to wipe the needle clean.1 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.1

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Chadwick, R. Comparison of nitrile and latex examination gloves. Br Dent J 196, 685 (2004). https://doi.org/10.1038/sj.bdj.4811350

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