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Michaels BS, Ayers T, Brooks-McLaughlin J, McLaughlin RJ, Sandoval-Warren K, Schlenker C, Ronaldson L, Ardagh S. Potential for Glove Risk Amplification via Direct Physical, Chemical, and Microbiological Contamination. J Food Prot 2024; 87:100283. [PMID: 38679200 DOI: 10.1016/j.jfp.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
This review focuses on the potential direct physical, chemical, and microbiological contamination from disposable gloves when utilized in food environments, inclusive of the risks posed to food products as well as worker safety. Unrecognized problems endemic to glove manufacturing were magnified during the COVID-19 pandemic due to high demand, increased focus on PPE performance, availability, supply chain instability, and labor shortages. Multiple evidence-based reports of contamination, toxicity, illness, deaths, and related regulatory action linked to contaminated gloves in food and healthcare have highlighted problems indicative of systemic glove industry shortcomings. The glove manufacturing process was diagramed with sources and pathways of contamination identified, indicating weak points with documented occurrences detailed. Numerous unsafe ingredients can introduce chemical contaminants, potentially posing risks to food and to glove users. Microbial hazards present significant challenges to overall glove safety as contaminants appear to be introduced via polluted water sources or flawed glove manufacturing processes, resulting in increased risks within food and healthcare environments. Frank and opportunistic pathogens along with food spoilage organisms can be introduced to foods and wearers. When the sources and pathways of glove-borne contamination were explored, it was found that physical failures play a pivotal role in the release of sweat build-up, liquefaction of chemical residues, and incubation of microbial contaminants from hands and gloves. Thus, with glove physical integrity issues, including punctures in new, unused gloves that can develop into significant rips and tears, not only can direct physical food contamination occur but also chemical and microbiological contamination can find their way into food. Enhanced regulatory requirements for Acceptable Quality Limits of food-grade gloves, and the establishment of appropriate bioburden standards would enhance safety in food applications. Based on the information provided, together with a false sense of security associated with glove use, the unconditional belief in glove chemical and microbiological purity may be unfounded.
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Affiliation(s)
- Barry S Michaels
- B. Michaels Group Inc., 487 West River Road, Palatka, FL 32177, USA.
| | - Troy Ayers
- Eurofins Microbiology Laboratories Inc., Des Moines, IA 50321, USA
| | | | | | | | | | - Lynda Ronaldson
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
| | - Steve Ardagh
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
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Abstract
BACKGROUND Allergic contact dermatitis (ACD) may occur secondary to topical antifungals containing potential allergens in their vehicles. Variation of allergenic ingredients among commonly used antifungal creams (AFCs) has not been well characterized. OBJECTIVE The study goal was to assess the frequency of allergenic ingredients in 4 commonly used topical AFCs. METHODS Topical AFCs (clotrimazole, ketoconazole, miconazole, and terbinafine) were selected, and the ingredient lists for these products were obtained from the US Food and Drug Administration's Online Label Repository via a proprietary name search. A systematic literature review was performed using the ingredient name on MEDLINE (PubMed) database to identify reports of ACD confirmed by patch testing. RESULTS Of the 20 ingredients analyzed, 6 had frequent allergenic potential. Propylene glycol was the most common cause of ACD identified in the literature and is an ingredient in ketoconazole 2% and miconazole nitrate 2%. Ketoconazole 2% and miconazole nitrate 2% creams contained the highest number of potential allergens (n = 3) among the 4 creams analyzed. CONCLUSIONS Of the 4 creams, terbinafine hydrochloride 1% and clotrimazole 1% contained the least number of potential allergenic ingredients. Awareness of the allergenic potential of commonly used AFCs may help health care providers when evaluating patients with ACD.
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Lee SY, Chan EL, Chan HH, Li CCK, Ooi ZH, Koh RY, Liew YK. ANTIMICROBIAL AGENTS AND ANTI-ADHESION MATERIALS FOR MEDICAL AND SURGICAL GLOVES. RUBBER CHEMISTRY AND TECHNOLOGY 2021. [DOI: 10.5254/rct.21.79901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Healthcare-associated infections (HAIs) can be common in healthcare settings, such as the intensive care unit and surgical sites, if proper precautions are not followed. Although traditional techniques are encouraged, such as educating the public and healthcare workers to practice proper handwashing or to double glove, they have not been fully effective in combating HAIs. The use of surface-modified antimicrobial gloves may be an alternative approach to prevent the transmission of pathogens between healthcare workers and patients. This paper gives a comprehensive review of strategies to produce antimicrobial gloves. The chemistry of some potential chemically synthesized antimicrobial agents and nature-inspired superhydrophobic surfaces are discussed. The principles of killing microbes must be understood to effectively select these materials and to design and fabricate surfaces for the reduction of bacterial adhesion. Also, current company trends and technologies are presented for gloves proven to effectively kill bacteria. Such glove use, when coupled with in-depth research on diverse surgical procedures and medical examinations, could ease the burden of HAIs.
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Affiliation(s)
- Siang Yin Lee
- Latex Science and Technology Unit (USTL), Technology and Engineering Division (BTK), RRIM Sungai Buloh Research Station, Malaysian Rubber Board (MRB), 47000 Sungai Buloh, Selangor, Malaysia
| | - E-Lyn Chan
- School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Hong Hao Chan
- School of Postgraduate Studies and Research, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Claire Chong Khai Li
- School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Zhe Hooi Ooi
- School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Rhun Yian Koh
- School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Yun Khoon Liew
- School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
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Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cohen SR, Cárdenas-de la Garza JA, Dekker P, Haidari W, Chisolm SS, Taylor SL, Feldman SR. Allergic Contact Dermatitis Secondary to Moisturizers. J Cutan Med Surg 2020; 24:350-359. [PMID: 32293193 DOI: 10.1177/1203475420919396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Moisturizers are cosmetic products used routinely to manage various skin conditions. Even though moisturizers are often thought to have minimal or no adverse reactions, allergic contact dermatitis (ACD) to these products can develop in some cases. Methods: We studied ingredients included in 3 of the most commonly used moisturizer brands, identified their presence in standard patch testing series, and evaluated their allergenic potential, categorizing the allergens as frequent or infrequent. The standard patch testing series used as reference were the Thin-layer Rapid Use Epicutaneous patch test (T.R.U.E. test), the North American Contact Dermatitis Group (NACDG) screening standard series, and the American Contact Dermatitis Society (ACDS) core allergen series. Results: Aveeno, Cetaphil, and Cerave products had a total of 12, 14, and 9 potential allergens, respectively, the majority of which were infrequent and not included in standard patch testing series. Conclusion: Being aware of the allergenic potential of commonly used moisturizers may help healthcare providers when evaluating patients with ACD. Further testing is recommended in a targeted manner when suspecting ACD with negative standard patch testing series or when ACD is refractory to treatment.
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Affiliation(s)
- Stephanie R Cohen
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jesús A Cárdenas-de la Garza
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Paige Dekker
- 12230 Georgetown University School of Medicine, Washington, DC, USA
| | - Wasim Haidari
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12230 Georgetown University School of Medicine, Washington, DC, USA
| | - Sarah S Chisolm
- 12239 Department of Dermatology, Emory School of Medicine, Atlanta, GA, USA
| | - Sarah L Taylor
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12279 Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12279 Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_71-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wilke A, Skudlik C, Sonsmann FK. Individualprävention beruflicher Kontaktekzeme: Schutzhandschuhe und Hautschutzempfehlungen im berufsgenossenschaftlichen Heilverfahren. DER HAUTARZT 2018; 69:449-461. [DOI: 10.1007/s00105-018-4170-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Warburton KL, Uter W, Geier J, Spiewak R, Mahler V, Crépy MN, Schuttelaar ML, Bauer A, Wilkinson M. Patch testing with rubber series in Europe: a critical review and recommendation. Contact Dermatitis 2016; 76:195-203. [DOI: 10.1111/cod.12736] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; 91054 Erlangen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK); University Medical Centre; 37075 Goettingen Germany
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology; Jagiellonian University Medical College; 30-688 Krakow Poland
| | - Vera Mahler
- Department of Dermatology; University Hospital of Erlangen; 91054 Erlangen Germany
| | - Marie-Noëlle Crépy
- Department of Occupational Diseases, Centre Hôtel-Dieu, AP-HP; Paris University Hospital; 75004 Paris France
| | - Marie Louise Schuttelaar
- Department of Dermatology; University Medical Centre Groningen, University of Groningen; 9713 GZ Groningen The Netherlands
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, University Hospital Carl Gustav Carus; Technical University Dresden; 01307 Dresden Germany
| | - Mark Wilkinson
- Department of Dermatology; Chapel Allerton Hospital; Leeds LS7 4SA UK
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