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High temperature post washing versus DPNR latex High temperature washing of the latex film is very effective in reducing the overall protein allergen content of a latex film. Diagram 4 schematically represents how High Ammonia (HA) NR and DPNR latices are coagulated to form films and then on-line leached. The high ammonia latex starts the process with a much higher level of extractable proteins (EP) than the enzyme treated DPNR latex. The online leaching process has a similar effect on both films, but as can be seen from the diagram the leaching only occurs from one side of the film. In Table 1 there is a comparison of the total allergen content of finished gloves made from standard HA latex and two types of commercially available deproteinized latices. The allergen content was measured using the FITkit TM . The results show The high temperature post washing is, however, better, because it is able to extract more of the EP as both sides of the film are exposed to the cleaning process. The hot water also hydrates the rubber film and �� Diagram 4 Production process of DPNR latex Latex Type Glove Type High Temp Post Washing that although the DPNR latices produced films with low allergen content, the post processed gloves had values of more than 20 times lower. The preferred protocol for the High Temperature Post Washing was Hev b1 ng/ml Hev b3 ng/ml �� Hev b5 ng/ml as the film’s interstitial spaces are enlarged, the protein allergens are easily extracted. As a result, the final film formed by using standard HA latex has a lower protein allergen content than the film formed using the DPNR latex. �� to initially wash the gloves in an industrial washer with hot water, temperature greater than 80 ̊C, containing a non-ionic surfactant for at least 20 minutes. The initial wash was then followed by two clean hot water, temperature greater than 80 ̊C, rinse cycles. Hev b6.02 ng/ml Sum of 4 µg/g Total Allergens AU/ml High Ammonia Latex Powder-free Yes
Implications for latex sensitive people Gloves made from NRL are still considered to provide the wearer with the best protective barrier with the added benefits of tactile sensitivity and comfort. With manufacturers now providing low allergen gloves the incident rate of latex sensitization has dramatically reduced. In a study conducted by Dr Henning Allmers in German hospitals 9 , he concluded that the preventative measures to avoid occupational NRL allergy, mainly the complete replacement of powdered NRL gloves by low protein, powder free gloves and the use of NRL-free materials by sensitized individuals, provided for a successful secondary prevention by keeping sensitized healthcare workers in the workplace. These preventative measures also brought about a significant reduction in the suspected cases of NRLcaused occupational asthma and/or skin symptoms for approximately half of all the German hospital staff involved in the Dr Allmers’ study. Conclusions Natural rubber latex gloves still remain the barrier of choice amongst healthcare professionals. Manufacturers have developed technologies that allow them to produce low allergen gloves as well as synthetic gloves. High Temperature Post Washing remains the most effective way to reduce the NRL allergen content of NRL gloves. Providing low allergen powder free gloves and synthetic alternatives, to healthcare workers significantly reduces the risk of sensitization. Ansell Healthcare Europe N.V. Riverside Business Park, Spey House, Boulevard International 55, B-1070 Brussels, Belgium Tel. +32 (0) 2 528 74 00 Fax +32 (0) 2 528 74 01 http://www.anselleurope.com, E-mail info@eu.ansell.com Paul Cacioli, Ph. D. Ansell Limited Level 3, 678 Victoria Street Richmond, VIC 3121 Australia Lai Hee Meng Ansell Healthcare Lot 16 Perisiaran Perusahaan Selangor Darul Ehsan Sha Alam, 40000 Malaysia The Ansell name and logo are trademarks owned by Ansell Limited, or one of its affiliates. © 2005 All Rights Reserved. References 1. FDA [1991]. FDA medical alert: allergic reactions to latex-containing medical devices. Rockville, MD: Food and Drug Administration, MDA 91-1. 2. Korniewicz D, Garzon L, Seltzer J & Feinleib M. Failure rates in non-latex surgical gloves. Am J Infect Control. (2004) 25 (8): 656-663. 3. ISO 12243:2003, Medical gloves made from natural rubber latex – Determination of extractable protein using modified Lowry method. 4. ASTM D6499-03, Standard test method for the immunological measurement of antigenic protein in natural rubber and its products. 5. The Rubber International Magazine, Volume 4, No.45, p. 37-42, September 2002. 6. T.C.Q. Noakes, T.C.Q., Surface Treatment of Natural Rubber for Reduced Friction, Proceedings International Rubber Technology Conference, Penang, Malaysia, p. 288-305, 1988. 7. Ichikawa, N., Miyamoto, Y., Hayashi, M., Low allergenic natural rubber and method of preparing low allergenic natural rubber latex, August 31, 2004, US Patent 6,784, 281. 8. Schloman, Jr., W.W. 2002. Surfactant treatment reduces both allergen content and cure efficiency of Hevea latex. P. 245-249. In: J.Janick and A. Whipkey (eds.), Trends in new crops and new uses. ASHA Press, Alexandria, VA. 9. Allmers, H., Schmengler, J., Skudlik, C., John, S. M., Current state of the art in Natural Rubber Latex Allergy Prevention, Infection Control, p 63 – 66, 2005.
Page 1 and 2: DEVELOPMENTS IN NATURAL RUBBER LATE
Page 3: Chart 1 shows how the allergen cont

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