Surgical Gloves: Why Switching to Latex-Free Options is so Important

Latex gloves are the most commonly used type of gloves across healthcare facilities in Europe. But why is it so? History. Many surgeons associate them with high performance, elasticity and comfort levels, in contrast with first-generation synthetic gloves of the early 80s. Also, purchasing departments of healthcare facilities are cost-driven, and since latex gloves are cheaper than synthetic alternatives, they are preferred. So it would seem latex is the best option for all stakeholders. Then what’s the problem here? On the surface, latex may seem like a logical choice. However, there are multiple reasons this decision is problematic for healthcare facilities. Here are two main issues to consider:

The status quo, latex allergies and COVID-19 

Operating theatre staff work hard to meet and/or exceed patients’ needs. However, this objective exists in a reality characterised by personnel shortage that worsened due to the COVID-19 pandemic. During the pandemic, 21 per cent—now 18 per cent—of persons needing care in the European Union could not access medical examinations or receive treatment because clinical teams were overstretched, and triaging prioritised certain care services (van Ginneken, Siciliani, Reed, Tille, & Zapata, 2022). And this phenomenon does not seem to have an end in the short term. According to the latest McKinsey survey, for example, 29 per cent of responding registered nurses (RNs) in the United States indicated they were likely to leave their current role in direct patient care. Many respondents have also noted their intention to leave the workforce entirely (Berlin, Lapointe, & Murphy, 2022).

Latex, while commonplace and preferred, has shown it can be a catalyst for patients becoming more ill while hospitalised and staff’s health deteriorating. The increased demand for latex gloves in the 1980s contributed to what may be considered an epidemic of adverse effects brought on by prolonged hyper exposure to latex. More specifically, the frequently used material can cause and has caused allergic reactions and sensitisation. Latex-related allergies and sensitisation have a remarkable prevalence amongst healthcare workers (HCW), affecting approximately 9.7 per cent and 12.4 per cent, respectively (Wu & Liu, 2016). On the other hand, for the general population, the prevalence rate is 4.3 per cent, with a peak of 30 per cent in high-risk patients (Nucera, Aruanno, Rizzi, & Centrone, 2020). And these figures will likely increase the longer latex gloves remain the norm.

But what do the above-mentioned percentages really mean? Two things can be assumed. First, by continuing to use latex gloves, avoidable risks are also maintained, making an already difficult situation worse—extended hospitalisation for patients and increased sick leaves for healthcare workers become more likely. For instance, due to the extent and significance of a ‘care exodus’ of workers in German-speaking countries, the impactful absence has been dubbed ‘Pflexit’, a fusion of the German word for care, ‘Pflege’, and the English ‘exit’. Also, according to a survey by the Alice Salomon University of Applied Sciences in Berlin, conducted in 2021 with around 2700 respondents, 40 per cent of nurses surveyed in Germany think about leaving the profession at least monthly. Meanwhile, around 30 per cent consider changing jobs on a monthly basis, with around a third wanting to reduce working hours (Schwausch, Richert, Gräske, & Johannes, 2022). And in Switzerland, some 300 nurses leave their job every month (Nurses demonstrate in Bern for better working conditions, 2022). Generally speaking, an estimated 1 million nurses are needed, according to the European Commission.

Hidden costs of continued latex use

Despite this current situation and the fact that latex allergies are widely covered in scientific literature, most hospitals still opt for latex-based gloves. Secondly, the impact of latex-related issues does not only include the physical conditions of patients or healthcare workers, but they also affect the financial and operational health of facilities. So, are latex gloves really the cheaper option?

With the onset of COVID-19, healthcare facilities have been spending more. Expenditures increased by around 33 per cent, compared with pre-pandemic levels (Kaufman, 2022). That, paired with tight budgets, has been a driver for facilities to opt for the ‘latex-safe approach’, which involves using hypoallergenic low-powdered and powder-free latex gloves. However, eliminating the cornstarch powder only removes the carrier and not the actual source of the allergen. How then could this be the true cost-saving approach? The answer is that it can’t. Although synthetic gloves are more expensive, this is a short-term higher cost because the long-term benefits outweigh initial spending. In fact, as confirmed by literature, resulting expenditures are lower than the amount needed to cover healthcare workers’ compensation claims for latex-related disability, as well as delayed surgeries.

To contextualise this issue, if only 1.07 per cent of healthcare workers become fully disabled, or 1.88 per cent become partially disabled, the potential hidden costs nullify the benefit of the lower-priced latex gloves.

DIRECT:

• Latex allergy disability compensation (HCW)
• Latex allergy single event compensation (HCW)
• Latex allergy compensation  in case of disability/death (Patients)
• Latex allergy defense costs (HCW)
• Latex-related medical care
• Sick leave replacement

• Cancelled or delayed surgery for latex-sensitive patients

• Latex supply replacement

INDIRECT:

• Diagnostic tests to determine sensitivity
• In- service training for staff
• Time for developing policies and procedures

INCALCULABLE:

• Decreased staff productivity
• Decreased procedures quality
• Patients and workers’ satisfaction

Reflect and be proactive for more cost-effective and safer operations

Often, regulations in the United States act as catalysts for regulatory changes within Europe. For example, the US Food and Drug Administration (FDA) ban on powdered latex gloves in 2017 pushed many European countries to align to the paradigm shift in care delivery. Another possible catalyst for change could be the current scenario in the state of Illinois, where the Latex Glove Ban Act (410 ILCS 180/) restricts the use of latex-based gloves in food preparation in 2023, and gradually from 2024 in healthcare facilities, to help prevent adverse allergic reactions. Therefore, with the above-mentioned overview of the disadvantages of continuing to depend on latex and the change in tide in other medical environments, the way forward should be clearer.

Switching to latex-free operations can be a manageable process, that is, with the right resources and support. This means having:

• Clearly defined plans
• Support from key opinion and facility leadership for the switchover
• Champions available to assist with the conversion
• A reliable partnership with a flexible, trusted and experienced supplier.

Medline can provide a full range of new generations of synthetic gloves—with quality equal to, if not better than the quality of latex-made options—that do not cause allergic reactions. We also have dedicated and knowledgeable teams available to support your facility with achieving an effective and smooth conversion to a safer and more sustainable solution—our high-quality latex- and powder-free surgical gloves. 

Paolo Pagani
Junior Product Manager, Surgical Gloves, Medline Europe

Paolo, originally from Italy, holds a Master of Science in International Business Management from Cardiff Metropolitan University. He started his career in product management in the automotive industry, eventually joining Medline Europe in September 2022. He is currently based in the Netherlands and manages Medline’s surgical gloves portfolio. Learn more on LinkedIn.