Analysis of Contact Allergens in Single-Use Polyvinyl Chloride Medical Examination Gloves in the US
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Polyvinyl chloride (PVC) gloves are recommended as a safe alternative for patients with rubber accelerator allergy. However, allergic contact dermatitis to other chemicals in PVC gloves has been reported.
OBJECTIVE
To analyze single-use PVC medical examination gloves in the United States for the presence of potential contact allergens.
METHODS
Using liquid chromatography-mass spectrometry, 20 unique PVC gloves were analyzed in triplicate for 6 chemicals: benzisothiazolinone, bisphenol A, mono(2-ethylhexyl) maleate, tricresyl phosphate, triphenyl phosphate, and triphenyl phosphite.
RESULTS
All 20 PVC gloves contained detectable quantities of benzisothiazolinone (range, 0.001-1.48 parts per million [ppm]), bisphenol A (0.01-0.11 ppm), triphenyl phosphate (0.01-2.11 ppm), and triphenyl phosphite (0.001-0.22 ppm). Eighteen (90%) gloves contained mono(2-ethylhexyl) maleate (0.001-0.14 ppm) and 3 (15%) contained tricresyl phosphate (0.001-0.002 ppm).
CONCLUSIONS
Known allergens were present in all 20 PVC gloves. However, the detected levels were mostly low and their relationship with sensitization and elicitation thresholds requires further study.
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Additional Info
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Analysis of Contact Allergens in Polyvinyl Chloride Examination Gloves in the United States
Dermatitis 2023 Sep 05;[EPub Ahead of Print], T Norman, J Guenther, I Asante, BL AdlerFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This is a great article in which the researchers did detailed chemical analysis on a lot of different polyvinyl chloride (PVC) gloves. It was very reassuring — while potential allergens were found in all the gloves, they were at such low levels that it was hard to imagine that any of them could be clinically relevant, with the possible exception of benzisothiazolinone (BIT). This isothiazolinone, fortunately, does not generally cross-react with other isothiazolinones according to the most recent data out of Europe. However, it is becoming a surprisingly common cause of positive patch test reactions, with over 10% of patients testing positive in the most recent NACDG data, a higher percentage than methylchloroisothiazolinone/methylisothiazolinone 0.02% and formaldehyde 2%!
So, in general, I still empirically recommend PVC gloves as being very low risk for causing ACD. However, I will now be a little more cautious. If I was not patch testing to BIT, I would try testing people to their own gloves if they had persistent hand eczema.
If you do not have access to comprehensive patch testing and you have patients you are worried about glove allergy in, you can Google "accelerator free nitrile gloves" or "accelerator free surgical gloves." However, my experience is that there is no such thing as a truly, completely non-allergenic glove. So, if they do not get better with the first allergen-free gloves, try to have them keep doing trial and error, and, once they find one that does not make them break out, have them stick exclusively to that exact brand — it is not sufficient to stick to a glove type (nitrile, latex, neoprene, PVC ) — they have to stick the exact brand that works for them.