PURPOSE: The results of a study to help identify the best glove protection for health care professionals frequently exposed to cytotoxic agents are reported.
METHODS: The permeation of 17 cytotoxic drugs through different glove materials and glove combinations was studied under the conditions of simulated dynamic contact (e.g., friction, stretching), a temperature of 37 °C (normal body temperature), different exposure times (30 and 60 minutes), and a 15-minute pretreatment with 70% alcohol or isopropyl alcohol. For 6 drugs, permeability was further evaluated at a temperature of 43 °C with different double-gloving combinations in order to assess the risk of health care worker exposure during the administration of hyperthermic intraperitoneal chemotherapy (HIPEC). All evaluated glove products were provided by one manufacturer. Analytical measurements were performed in triplicate using chromatographic and spectrometric techniques.
RESULTS: None of the gloves exhibited permeation exceeding European standard EN 374-3 (1000 ng/cm(2)·min) or American standard ASTM F739-07 (100 ng/cm(2)·min); for a few drugs, glove permeation exceeded ASTM D6978-05 (10 ng/cm(2)·min). The highest permeation rates (66.5 and 36.3 ng/cm(2)·min) were observed with two natural rubber latex products exposed for 60 minutes to carmustine. None of the evaluated double-gloving combinations displayed any detected permeation at 43 °C, confirming that they can be used safely during HIPEC.
CONCLUSION: Gloves evaluated with a dynamic permeation testing device at 37 °C after pretreatment with alcohol or isopropyl alcohol showed permeation rates by selected cytotoxic drugs of <100 ng/cm(2)·min after 30 or 60 minutes of drug exposure. Undergloves alone and glove-glove and glove-underglove combinations showed no detectable permeation in tests performed at 43 °C.
