Going latex-free: Hospital takes it step by step

Eliminating latex gloves from a hospital may seem daunting. They may be used by housekeepers, food handlers, physicians conducting physical exams, surgeons in the operating room, or obstetricians in the delivery room.

The University of Maryland Medical System in Baltimore decided to phase in less allergenic products, with the goal of having a completely latex-free environment in three to five years, says Mary Beth Bollinger, DO, director of allergy and assistant professor of pediatrics at the University of Maryland.

At each step, doctors, nurses, and other employees were involved in evaluating alternative gloves. The hospital began using only powder-free exam gloves in the fall of 1999, and switched to powder-free surgeon’s gloves in January. Next will come latex-free versions, Bollinger says. "It’s a gradual transition to a latex-restricted hospital," she says.

The University of Maryland’s latex allergy task force analyzed the cost implications of the phase-in, expecting to spend an extra $100,000 a year on the powder-free and latex-free gloves. But by reducing the number of glove types and focusing business on one manufacturer, the hospital actually saved $80,000, says Bollinger.

Meanwhile, the hospital discovered that six cases of latex allergy in 1997 involved an average of 50 lost work days per case. "It was very easy [to justify a switch] from a financial point of view, if you look at all the issues," says Bollinger.

An important aspect of the university’s program has been a system of screening for latex allergy. All new employees — from accountants and clerks to nurses and technicians — are screened for latex allergy using serologic tests. Current employees who exhibit possible symptoms or who transfer from one clinical area to another also are screened.

Skin tests are used to confirm a serologic test or to follow up if an employee has symptoms but a negative test result.

Baseline data show that 5.6% of employees entering or engaged in non-patient care services are sensitized, compared with 8% to 10% in patient care services. The hospital will track sensitization data that may reveal more about the rates of allergy and the impact of the hospital’s latex program.