By Donald F. Groce
Most industries present hazards to the workforce that need to be considered to protect workers' safety and health. OSHA requires workers be provided with the correct personal protective equipment (PPE) to protect against hazards in the workplace, including gloves for hand protection. Although not as hazardous as many industries, cleaning professionals have some serious hazards to contend with on a daily basis.
Many chemicals used routinely by cleaning professionals can damage unprotected skin, and some have been shown to be toxic. A hazard from repeated exposure to cleaning chemicals over time is known as chronic exposure, while a hazard from a single exposure is known as an acute exposure. In both cases, exposure to common cleaning products can cause irritation, severe burns, or allergic and contact dermatitis.
First, let's examine common cleaning products used in the professional cleaning industry. In Table 1 are chemicals used to manufacture cleaning products and the known hazards. In Table 2 are some common cleaning products listed with the ingredients used to manufacture them and the recommended hand protection. As indicated, manufacturers of these products recommend gloves for almost half of them.
Next, let's review the types of health impact exposure to cleaning chemicals can have.
Irritation: This is the mildest skin injury from exposure to cleaning chemicals. Redness, itching and dryness can result from chronic or acute exposure to even mildly hazardous chemicals. Some individuals are more sensitive than others, but the safest move is to wear gloves whenever cleaning products are used. It is important to select the correct glove so it will not fail during use or cause the irritation itself.
Chemical burns: These result from either a short duration, acute exposure to a hazardous chemical or when the skin is exposed to a hazardous chemical before the glove is put on, technically known as occlusion. Occlusion by wearing a glove after the hand is exposed to hazardous chemicals can cause significantly higher rates of absorption by the skin. The cause is increased heat, increased water retention or perspiration, and less evaporation of the chemical.
Chemical burns can be very serious to the point of being debilitating, resulting in scarring and other permanent skin conditions. Using the correct glove is critical when working with chemicals that can cause acute skin burns.
Contact dermatitis: This skin condition, a prevalent problem for workers in many different industries, can result from exposure to chemicals, bacteria from dirty gloves, or from a reaction to the material or chemicals used to make the glove. For instance, natural rubber latex proteins and rubber processing chemicals are known to cause contact dermatitis in sensitized individuals. Contact dermatitis, an irritation or inflammation of the skin, results in blisters and can be severe enough to cause permanent scarring of the skin. In fact, skin diseases are reported to be the third highest cause of occupational disease. Only musculoskeletal disorders such as back injury and hearing damage outrank skin disease in frequency.
Occupational contact dermatitis is found in industries such as cleaning and healthcare, where disposable rubber gloves are typical. According to experts, the primary causes of contact dermatitis include exposure to chemicals, detergents, and rubber.
Detergents: Frequently a sudden occurrence of contact dermatitis is caused by changing soap or detergent. Irritant contact dermatitis can occur because of incomplete rinsing of the hands after washing with a new soap, and can be accelerated by putting on a glove after hand washing.
Skin cleansers labeled as "heavy-duty cleansers" or "waterless hand cleaners" typically have more irritating ingredients, including the listed solvents. They also often contain abrasives such as silica or wood particles. As with soaps, incomplete rinsing of these cleansers, especially the lotion type, can cause irritant contact dermatitis. And again, wearing a glove on top of the residual irritants can aggravate the condition. Many liquid soaps contain preservatives, which may include formaldehyde, a well known sensitizer. Most lotions, creams and liquid soaps also contain preservatives such as isothiazolinones, parabens and formaldehyde releasers.
Rubber Allergy: Sometimes the hazard is not from exposure to cleaning products, but from the glove itself. Although estimates for the cleaning industry are not available, estimates of the number of U.S. healthcare workers that are allergic to latex gloves range from 150,000 to one million. A small number of latex allergy sufferers become hypersensitized to latex and must make drastic lifestyle changes to avoid latex completely. With the prevalence of a compound present in more than 40,000 products, avoiding natural rubber can be difficult.
Glove Reactions: There are at least three causes of contact and allergic contact dermatitis when using gloves: natural rubber (latex) proteins, glove powder and rubber accelerators, the last of which are present in almost every elastomeric glove made.
If a cleaning professional suffers from or suspects they may have contact dermatitis, they should follow this screening protocol:
Other Allergens in the Workplace:
- Chemical Screening: Carefully list every chemical that was encountered, even occasionally, in the work place and home. Have an allergist perform a skin prick test to show allergic responses to these chemicals. A positive means contact with this chemical should be avoided.
- Natural Rubber Proteins: If an allergic reaction seems to correlate to using latex gloves, change to a synthetic glove (nitrile or vinyl).
- Glove Powder: If the allergic reaction persists after changing to a nitrile glove, the cause could be cornstarch powder. Change to a powder-free nitrile glove.
- Rubber Accelerators: If an allergic reaction continues even after changing to a powder-free nitrile glove, the cause may be rubber accelerators like carbamates, thiurams or benzothiazoles. These accelerators are known to cause allergic reactions in some individuals. In this case, a latex-free, accelerator-free powder-free glove should be used.
Cleaning professionals can perform many diverse tasks so it is important to be aware of other compounds that can cause allergic reactions. Products to watch for are shown in Table 3
. By using Step 1 above, cleaning professionals can isolate the source of other causes of allergic reactions.
Glove Selection: Material Safety Data Sheets for a chemical or product often recommend rubber gloves, a term that generally refers to latex gloves that have been used by cleaning professionals for many years. For many of the products in Table 2, a latex glove would provide excellent hand protection. However, whenever the chemicals used contain any petroleum-based product, latex gloves are Not Recommended.
Latex gloves will deteriorate rapidly in the presence of petroleum products like the aliphatic hydrocarbons listed in Table 2, for "All Surface Polish." These ingredients would quickly break down a latex glove and expose the hands to the chemicals in this cleaner. Although most of these chemicals would not be immediately harmful, they can, over time, cause drying or result in irritation and dermatitis.
Nitrile gloves offer a broader range of protection from hazardous chemicals. This is clear from Table 2. Nitrile gloves protect from essentially the same chemicals as natural rubber latex gloves. In addition, nitrile gloves also offer excellent protection from exposure to petroleum-based products. So, nitrile gloves would protect from all of the products listed in Table 2, whereas latex would offer protection from about half of the products where gloves are recommended.
Wearing gloves is an important part of effective hygiene and protection, even when gloves are listed as Not Required. Some workers have very sensitive skin and can become allergic to the chemicals they are exposed to in their workplace over time – known as sensitization.
Glove Selection: Chemical resistance data is the best information tool for gauging how long a worker can safely wear a glove before significant chemical exposure occurs. Using a resource such as www.chemrest.com to identify the best hand protection solution for chemical hazards is recommended.
Protection First: Protecting the health of the worker is the goal of everyone in the field of occupational health and industrial hygiene. Using the correct glove can significantly reduce or eliminate the potential long-term debilitating consequences of exposure to hazardous chemicals in the workplace.
Contact has many causes and can be a lifelong condition. It is very important to find the cause of the condition and eliminate or reduce exposure. This may involve:
- Changing work habits
- Avoiding certain soaps, creams or detergents
- Eliminating exposure to metals by wearing gloves when working with wet cement, avoiding cheap jewelry and avoiding nickel and coins
- Changing to a glove that offers more protection from corrosives, irritants or sensitizers
- Changing to a non-latex glove to avoid latex proteins
- Changing gloves to avoid accelerators
Latex and nitrile gloves offer excellent protection from the hazards of cleaning chemicals. Nitrile gloves are more expensive, but with the broader range of protection and with the concern over latex allergy, they should be considered seriously as the new glove of choice. New accelerator-free gloves introduced in 2002 can provide even further relief for sensitized individuals.
Donald F. Groce, Best Manufacturing, is a technical product specialist and a research chemist. Before joining Best, he worked for the U.S. Centers for Disease Control and Prevention on chemical toxicology studies that included the Agent Orange Study. He is a noted speaker and expert on a variety of occupational and workplace hazards, including latex allergies and chemical exposure-related illnesses.