Study indicates nitrile, latex gloves beat out vinyl

Rego A, Roley L. In-use barrier integrity of gloves: Latex and nitrile superior to vinyl. Am J Infect Control 1999; 27:405-410.

As hospitals seek to address the risk of latex allergy among health care workers, the use of synthetic gloves is growing. But before switching, hospitals and their employees need to feel confident that the new gloves provide the same level of protection against bloodborne pathogens.

Researchers in California compared latex, vinyl, and nitrile gloves both out of the box and after manipulating them to simulate clinical use conditions. (Note: One of the researchers is with Safe-skin Corp. in San Diego, a manufacturer of nitrile and latex gloves that were included in the study.)

A total of 800 latex gloves, 800 vinyl gloves, and 400 nitrile gloves were graded on a pass-or-fail system for leaks as defined by the American Society for Testing and Materials standard D5151, Standard Test Method for Detection of Holes in Medical Gloves.

When tested directly out of the box, the gloves performed similarly, with failure rates of 1% to 5% (although one vinyl glove brand had a 12% failure rate). But when put through 20 minutes of manipulations, the failure rates of the latex and nitrile stayed roughly the same, while the vinyl failure rates rose as high as 61%.

Researchers attributed the difference to the chemical and physical properties of vinyl. They noted that stretch vinyl gloves performed better (with failure rates of 12% to 20% after manipulation) than standard vinyl gloves (with failure rates of 26% to 61% after manipulation), but still more poorly than latex and nitrile.

"Glove failure rate results in this study demonstrate that both nitrile and latex gloves are far less susceptible to material breakdown and leakage than vinyl during in-use conditions," the authors concluded. "There is a correlation between tensile strength, elongation, and durability. Vinyl gloves, with a required tensile strength almost 40% lower than latex, do not maintain durability under stresses of use conditions."

The selection of medical gloves should be based on the type of activity required and the level of protection needed, the researchers stated.

"On the basis of the results of this study, nitrile and latex gloves provide better barrier protection than vinyl gloves," they said. "The barrier protection afforded by vinyl gloves is compromised more often during use than is either latex or nitrile. Whereas vinyl is an appropriate barrier for nonrigorous, low-risk procedures of short duration, nitrile or latex should be the glove of choice for high-risk situations, including exposure to bloodborne pathogens.

"It should be emphasized that glove material selection should include the assessment of material durability during use, the rigorousness and duration of the procedures being performed, the potential of exposure to infectious microorganisms or other hazardous substances, and, ultimately, the safety of the user," the researchers concluded.