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Alphabetical index of all entries. Click on the letter of the index you would like to view.
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Absorbable Dusting Powder (ADP) A powder defined by the United States Pharmacopoeia (USP) consisting of cornstarch cross-linked with chemicals such as phosphorus oxychloride or epichlorhydrin. This alters the powder particles so they become more difficult to break down, enabling them to withstand steam sterilization and hand sweat without degrading into a pasty substance. To this chemically cross-linked powder is added a maximum of 2% magnesium oxide to help prevent caking. The USP requires ADP to withstand 20 minutes of boiling and remain suspended in water for 24 hours without disintegrating or dissolving. Accelerator A chemical used as a catalyst to speed the cross-linking of liquid latex into a usable solid film. Primary accelerators used for making gloves are thiazoles (MBTs), thiurams, carbamates and thioureas. Accelerators are known to be contact sensitizers. Allergy The hypersensitive immunologic response to a substance (allergen) in a genetically predisposed individual. Both Type I and Type IV hypersensitivities are allergies (e.g. Type I = latex protein allergy, hay fever, penicillin allergy; Type IV = chemical accelerators, nickel, poison ivy and certain hair dyes). However, many individuals limit the term to Type I hypersensitivities which are IgE mediated. Anaphylaxis (allergen induced) An immune reaction mediated by IgE antibodies. The reaction results from the release of histamine and other substances (mediators) when the allergen combines with IgE antibodies on the surface of mast cells. Once triggered, blood vessels dilate, letting fluid (not red blood cells) leak out into the surrounding area. This can be local, as seen in the raised surface of a hive (known as localized anaphylaxis), or it may be systemic. If the release of fluids from the circulatory system is systemic, the lost volume results in hypotension (drop in blood pressure). The heart increases its speed to compensate (tachycardia). This systemic form is termed anaphylactic shock and can (though rarely) result in death. Antibody A substance produced by the body in response to an antigen. An antibody has the unique property of combining with the antigen that induced its formation. Antibodies cause Type I hypersensitivity (IgE antibodies) or resistance to infection (IgA, IgD, IgE to parasites, IgG and IgM antibodies). The Ig stands for immunoglobulin and the A, D, E, G, and M are the categories of antibodies, each serving a slightly different function such as protection from specific viruses after having the disease (e.g. chicken pox) or receiving a vaccine for specific bacterium (e.g. Bordetella pertussis/whooping cough). Antigen A toxin or other substance that induces antibody formation or cellular response. Examples include, but are not limited to: grasses, pollen, some foods, bee stings, penicillin and natural rubber latex proteins, antigens that induce IgE antibody formation (Type I allergic reactions); bacteria, viruses and fungi that induce IgG formation; and chemicals, antigens that induce a cellular response (e.g. Type IV allergic reactions) producing T-cells that specifically recognize the inducing antigen. Antigenic protein A protein, capable of inducing antibody formation. All antigens will elicit the formation of antibodies, but not all antigens will elicit an allergic response (IgE antibodies). For example, the body produces antibodies to fight infection. This is not an allergic reaction. Specific types of antibodies, known as IgE antibodies, are produced in some individuals when exposed to antigenic proteins including, but not limited to, pollen, dust or animal dander. The production of IgE antibodies is an allergic response designating the antigen which initiated its creation an allergen. Antioxidant A chemical added to products to prevent or delay deterioration from exposure to oxygen, ozone and light. Antioxidants are added to latex and synthetic gloves to extend the shelf life of the product. Antiozonate Manufacturing chemicals added to products to reduce susceptibility to deterioration from exposure to ozone. Antiozonates help extend the shelf life of products. Asthma A chronic lung condition which has many different causes depending on the individual case. Some are caused by an allergy to specific inhaled substances. Asthma, associated with widespread narrowing of the airways, is characterized by wheezing, coughing and difficulty breathing. Irritant asthma is activated by irritants such as a chemicals or particles. Regardless of the initial or contributing cause for the development of asthma, irritants can trigger a physiological response (“attack”). ASTM American Society of Testing and Materials. ASTM is a not-for-profit non-governmental organization committed to the development of test methods and voluntary standards for materials, products, systems and services. ASTM standards regarding gloves describe the minimum physical properties and several quality requirements of the finished glove. Asymptomatic Without symptoms, or producing no symptoms. Atopic individual A person with an inherited tendency to develop allergies. Often a childhood history of hay fever, asthma, rhinitis, conjunctivitis and/or multiple allergies to substances such as ragweed, cat dander, dust mites, pollens and various foods exists. Atopy An inherited predisposition to produce IgE antibodies when exposed to numerous different allergens. ASTM American Society for Testing and Materials ASTM F 1670 ASTM Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Synthetic Blood. ASTM F 1671 ASTM Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration of Blood-Borne Pathogens Using Phi-X 174 Bacteriophage Penetration as a Test System. Aspiration Accidentally inhaling liquid into the windpipe and/or lungs. Adhesions A fibrous band or structure by which internal parts of the body are bound together abnormally. Alternatively, the fibers may form around structures such as intestines and constrict or block proper function (ex. intestinal blockage due to band formation). Adhesions are initiated by foreign substances, infections, and trauma. Glove powder can induce adhesion formation as well as granulomas. Allergen A substance, usually a protein, that can induce the formation of IgE antibodies in genetically prone individuals and can induce an abnormal response (allergic reaction) in individuals who are allergic to that allergen. Every allergen is a type of antigen but not every antigen is an allergen. The term allergen is sometimes also used to describe chemical contact sensitizers that can illicit Type IV allergic contact dermatitis reactions in those who are sensitized to specific chemicals. In this case, sensitized T-cells (with special receptor sites unique to that chemical) would be produced rather than IgE antibodies. Allergenic protein A protein capable of inducing an allergy in genetically predisposed individuals. An allergy to a protein is almost always a Type I hypersensitivity and thus the allergenic protein induces the production of IgE antibodies. Allergic The descriptor for an individual who has an allergy. The individual experiences symptoms when exposed to a specific allergen. Allergic contact dermatitis (also known as Type IV hypersensitivity, delayed type hypersensitivity or chemical allergy) An allergic reaction associated with specific chemicals called chemical contact sensitizers. Symptoms will occur only when an individual who is genetically capable of developing an allergy to one or more of these specific chemical contact sensitizers has sufficient exposure from repeated contact with the sensitizer to reach his/her symptom threshold. However, symptoms in allergic individuals may not reach their maximum expression until 6 to 48 hours after contact with the chemical allergen(s). |
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Basophil A type of leukocyte or white blood cell comprising 0.5 – 1% of circulating white blood cells in the blood stream. They function in a similar manner as mast cells, which reside in the tissues. See Mast cells. Bloodborne Pathogen final ruling [29CFR 1910] The incorporation of Universal Precautions into regulatory status enforceable by OSHA. The final rule became enforceable in December 1991. Best Practice System An innovative program of products and services from Kimberly-Clark designed to help customers achieve desired clinical outcomes at the lowest cost per procedure. Breathable Impervious Meets ASTM F 1670 and ASTM F 1671 standards, while still allowing moisture vapor to pass through easily, dispelling heat. Bolus Feeding Large amounts of formula delivered through the tube. |
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Contact sensitizer A chemical that can induce a Type IV allergic reaction in genetically predisposed individuals. Of the more than 85,000 chemicals in the world today, more than 2,800 have been identified as contact sensitizers. In glove manufacturing, the primary contact sensitizers are accelerators followed by preservatives, antioxidants and resins. Cross-reactive protein allergens Protein allergens that are very similar and produce IgE antibodies that can react with each other. These are referred to as cross-reactive allergens. The literature suggests cross-reactive (similar) allergens such as avocados, bananas, or kiwis may trigger a reaction in individuals allergic to natural rubber latex allergens and vice versa. While an allergy to recognized cross-reactive allergens is a risk indicator for a potential latex sensitization, having these allergies does not mean an individual is or will become latex allergic. CPSC-1610 Consumer Product Safety Commission test for determining the “Standard for the Flammability of Clothing Textiles.” Constipation Bowel movements (stools) sometimes painful, and difficult to pass. Continuous Feeding Small amounts of formula constantly throughout the day (or night) without interruption. |
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Degradation Deleterious effects that extreme temperatures, ozone, fatigue, chemicals, oil, grease or other substances can have on a product’s physical properties. Obvious signs of glove degradation may include softening, tackiness, brittleness, loss of elasticity, growth or creep of the length of the fingers, and cracking. Delayed hypersensitivity Also known as allergic contact dermatitis or chemical allergy. Genetically predisposed individuals may experience this allergic reaction after repeated contact with specific chemicals called chemical contact sensitizers. This is a delayed reaction with clinical symptoms usually appearing at the contact site within 12 to 24 hours but may vary from 6 to 48 hours. Delayed hypersensitivity has an appearance similar to poison ivy or poison oak. It is characterized by redness, itching, small blisters, thickened skin and oozing lesions. Dermatitis A general term referring to any inflammation of the skin. Dermatitis is characterized by erythema (redness), pain, pruritus (itching), vesicles (tiny blisters) and papules (hard bumps). If the dermatitis continues to occur for a long period of time (becomes chronic), symptoms may expand to include drying, scaling, peeling and keratosis (thickening and hardening of the skin). Draize Test (200 Person Modified Draize Test) 200-person challenge test used to determine irritant or dermal reactions caused by chemicals of a given product. Samples of the test product are patch tested and repeatedly replaced on each of the individuals over a 6-week period. Dyshidrosis A dermatitis manifesting as itching vesicles often along the sides of the fingers. It is a variant form of atopic dermatitis that can be provoked by sweating, infections, dry skin, low humidity, emotional stress, irritants and allergens. Working in wet surroundings is the most important factor causing or aggravating this skin condition. Clinical features include, but are not limited to, redness, appearance of vesicles, scaling and itching. Dyspnea Difficulty breathing; shortness of breath. Diarrhea Frequent, loose, watery bowel movements. |
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Eczema A generic term for a group of inflammatory skin conditions. Causes may be allergic or non-allergic. Atopic individuals often have had periods in their life when they had breakouts of eczema on the hands, legs, inside of the elbows or behind their knees. Clinical features include, but are not limited to, redness, itching, burning, minute papules and vesicles, weeping, oozing and crusting. Chronic eczema may result in scaling, thickening and hardening of the skin. Elongation Measurement in percent of the length a glove material can be stretched before it breaks. Endotoxin Potent inflammatory agents present primarily in the cell walls of gram-negative bacteria. They are capable of causing multiple local and systemic reactions including irritation of the skin and eyes, fever, tissue inflammation, diarrhea, small blood clots, respiratory distress, and endotoxic shock. Endotoxin is not destroyed by steam, ethylene oxide or irradiation sterilization. Endotoxins are also called pyrogens. Enzyme-Linked Immunosorbent Assay (ELISA) A highly sensitive immunoassay for specific antibodies or antigens (including allergens) depending on how the test is set up. Results expressed as microgram per gram or milliliter (ƒÝg/g or mL); parts per million (ppm); allergen units per gram or milliliter (Au/g or mL). Erythema Redness of the skin; inflammation. Esophagus The passage in the throat through which food passes from the mouth into the stomach. |
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Fissure Cracks, furrows, clefts or slits. In irritant dermatitis, fissures appear as horizontal cracks in the skin. Flare A diffuse area of redness on the skin due to increased dilation of the local blood vessels. Flares are usually present surrounding the wheals of a hive, projecting outward like rays. Fomite An inanimate object that serves to transmit or carry an infectious agent from one person to another. A recently used nose tissue from a child with a cold is a fomite. Glove powder particles which transport microorganisms would be referred to as fomites. Feeding Pump A small machine, plug-in or battery powered, that automatically controls the amount of formula being delivered through the feeding tube. Feeding Set Tubing that connects the feeding container to the feeding tube. |
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Genetically predisposed (In the context of our subject matter) a term used to describe an individual with the genetic codes (or DNA) that allow their immune system to form a response (allergic reaction) to a specific allergen (e.g. goldenrod and grasses [hay fever], chemical accelerators, peanuts, seafood and natural rubber latex proteins). Individuals without the genetic code for a specific allergen cannot develop an allergy to that allergen nor have an allergic reaction when in contact with it. (Type I or Type IV). Glutaraldehyde A chemical used most often in a 2% aqueous solution as a cold liquid sterilant, particularly in hospital or medical work for sterilizing instruments including, but not limited to, bronchoscopes, cystoscopes, anesthetic equipment, renal dialysis units. Granuloma Granular-like nodules formed by the body as a protective, walling-off of foreign bodies or chronic inflammatory conditions. Granulomas associated with powder contamination are characterized microscopically by a Maltese cross design when viewed under polarized light. Granuloma (or granulomatous) nodules may remain long after the starch particles at their centers dissolve. Gelbo Lint Test Industry-recognized test used in determining a fabric’s propensity to generate lint particles when in use. Gown Mix The relative proportion of surgical gowns at different protection and cost levels utilized in a surgical environment. G-Tube Gastrostomy tube. A tube that passes through the skin into the stomach. Also call feeding tube. Gastroesophageal Reflux Backing up of formula or gastric juice from the stomach into the esophagus. Gastrointestinal Decompression The removal of gas or fluid from the stomach. (also called “venting”). Gastrostomy A surgical opening (stoma) through the skin into the stomach. Granulation Tissue Fleshy projections formed on the surface of the stoma that will later form fibrous scar tissue. Gravity Drip Formula flows into the stomach by gravity. |
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Histamine A highly vasoactive (acts on the blood vessels) substance liberated in large amounts from basophiles and mast cells during different scenarios including Type I allergic reactions. Histamine release is triggered when allergen attaches to the IgE antibodies on the surface of the cells. Histamine causes dilation of capillaries, a decrease in blood pressure, increased secretion of gastric juice and constriction of the small tubes (bronchi) in the lungs. Hypersensitivity A term used to describe a condition in which the response to a stimulus is excessive. With allergies (Type I or Type IV), repeated exposure to an allergen may cause a genetically predisposed individual to have an excessive (allergic) response. |
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IgE A class of immunoglobulin; also called IgE antibodies. IgE antibodies are the hallmark of a Type I allergy (e.g. pollen, grasses, penicillin, peanut, seafood, natural rubber latex protein allergens). This antibody is produced after contact with an allergen in genetically capable individuals. Once made, IgE antibodies attach to mast cells (in tissues) and basophil cells (in blood) and thereafter mediate allergic diseases such as asthma, hay fever and Type I hypersensitivity. Immediate Type Hypersensitivity For genetically predisposed individuals, IgE antibodies are produced after contact with an allergen. Once made, IgE antibodies sensitize mast cells (in tissues) and basophil cells (in blood) by attaching to the cell surface. Repeated exposure to the protein allergens (or look-a-like cross-reactive allergens) through dermal, mucosal, pulmonary or invasive routes, asymptomatically (without experiencing symptoms) increases the number of sensitized mast and basophil cells until a unique symptom threshold is reached. Once this threshold is attained, symptoms may occur including urticaria, rhinitis, dyspnea, abdominal cramps, headache, hypotension, tachycardia and rarely anaphylactic shock. Individuals who are not genetically predisposed to these specific allergens do not have the capability of forming the IgE antibodies to natural rubber latex allergens. Immunoglobulin Abbreviated Ig; a group of proteins present in blood serum and tissue fluids of all mammals. Some are carried on cell surfaces while others (antibodies) are free in the blood or lymph. There are five classes of immunoglobulin; IgA, IgD, IgE, IgG and IgM. Each mediates a characteristic biological response following antigen binding. Incidence The number of new events of a specified disease or malady in a given population over a specified amount of time. For example, the number of new cases of latex allergy among employees in a specific hospital in the year 2001. Infection Multiplication of organisms in the body that may or may not result in disease. Inflammation Cellular or systemic response to physiological, chemical or biological injury. An extremely dynamic pathological process in which the blood vessels dilate, releasing fluids to the local area. Leukocytes, or white blood cells (WBC), enter, releasing destructive enzymes in their attempt to clean the debris of dead cells. These enzymes cause tissue damage further increasing the inflammation and depleting these cells of their defense weaponry (enzymes). In so doing, they decrease the local area’s resistance to infection. If the body cannot rid itself of the inflammatory agents, a more chronic inflammatory condition sets in. The body tries to wall off the culprits, to protect the rest of the body, by forming granular-like nodules and adhesions. Four fundamental signs of inflammation are: redness, heat, swelling and pain. All may be observed in certain instances but no one of them is necessarily always present. A fifth sign, loss of function, is sometimes observed. Inflammation occurs as a part of irritation, endotoxin, Type I and Type IV reactions and thus can be associated with glove-associated reactions for wearer and patient. Irritant contact dermatitis Inflammation of the skin. Irritant dermatitis may develop when a substance repeatedly injures, physically abrades or otherwise damages the skin. Irritation Also known as dermatitis, irritant dermatitis or irritant contact dermatitis. Irritation is a reversible, non-allergic inflammatory condition that can be experienced by anyone. It is precipitated by contact with substances including, but not limited to, soaps, detergents, shampoos, chemicals, endotoxin, powder, occlusion (no air circulation) and friction. Impervious Meets ASTM F 1670 and ASTM F 1671 standards. Intermittent Feeding Feeding smaller amounts of formula frequently during the day or night. Intermittent feeding supplements night-time continuous feeding. |
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Latex 1: commonly, a milky, usually whitish fluid obtained from over 1,000 species of trees and plants. Relating to gloves, it is natural rubber latex, the raw material produced by the Hevea brasiliensis tree. It contains poly-cis-isoprene, the “rubbery” component of over 40,000 natural rubber latex products. The latex liquid also contains the proteins (allergens) to which latex allergic (Type I) individuals react. 2: a water emulsion of a synthetic rubber or plastic obtained by polymerization and used especially in coatings (such as latex paint) and adhesives Latex allergy General term to describe a Type I, immediate Hypersensitivity to allergenic proteins in natural rubber latex. Latex-free Refers to consumer products and medical devices that have no natural rubber latex components. Latex precautions Refers to measures implemented to reduce the risk of developing latex allergy. Latex-safe Refers to an environment for latex allergic individuals where measures have been taken to minimize exposure to natural rubber latex. LEAP Latex ELISA for Antigenic Protein; a highly sensitive ELISA assay used to detect and quantitate natural rubber latex protein levels. The LEAP assay uses rabbit antibodies made to natural rubber latex proteins. The advantages of this assay include: • Specificity for latex proteins • A heightened sensitivity or detection capability over the Modified Lowry assay, which measures total protein • Detects low levels of natural rubber latex proteins in extracts from latex- containing products • Does not appear to be affected by the presence of interfering substances in glove extracts The disadvantages of this assay includes: • The latex protein allergens measured are those recognized by rabbit IgG antibodies and may or may not be recognized by human IgE • It is not quite as sensitive or robust as the ASTM ELISA Inhibition assay for the detection of NRL antigens (now replacing the LEAP assay). Lowry A test method used to determine the concentration of total protein present in a sample. A Modified Lowry assay was developed for use with latex products. In the Modified Lowry assay (ASTM D5712), latex proteins are extracted from products and purified by acid precipitation. This step diminishes the chemicals present in the product that may interfere with the assay. A protein detection agent is then added that increases in color intensity with increasing amounts of protein. Results are expressed as micrograms (ƒÝg) of total protein extracted, microgram per gram (ƒÝg/g) of sample or microgram per square decimeter (ƒÝg/dm2). The greater the number, the greater the amount of protein present (unless chemicals interfere to give false high or low readings). This is the only method currently accepted by the government to measure the total protein level in latex products. |
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Macrophage Versatile phagocytic cells that bind to microorganisms and foreign products, internalize and destroy them. Macrophages orchestrate much of the body’s immunological activity. Digestion of infectious agents is neat and self-contained (compared to neutrophils that are sloppy and release destructive enzymes onto healthy tissues in the area as well as to the entity they are trying to destroy). Magnesium oxide A very fine, white, odorless powder added to modified cornstarch to prevent caking in the production of USP (United States Pharmacopoeia) absorbable dusting powder – glove powder. No more than 2% is allowed. Mast cell A type of leukocyte or white blood cell residing primarily in the tissues. Mast cells have granules containing a variety of mediators such as histamine. When released during a Type I reaction, mediators produce inflammation in surrounding tissue and control the development of immune reactions. Histamine release is triggered when the allergen attaches to the IgE antibodies on the surface of the cells. Histamine causes dilation of capillaries, a decrease in blood pressure, increased secretion of gastric juice and constriction of the small tubes (bronchi) in the lungs, all adverse symptoms of a Type I allergy. Meningomyelocele (Spina Bifida) A birth defect of the spinal column, characterized by the absence of vertebral arches (top part of the backbone) in some of the vertebrae, through which the spinal membranes may protrude. As a result, this portion of the central nervous system is not adequately protected. Problems experienced by the individual depend on where and how severe the defect is. They may have problems with their legs, urinary tract, etc. For reasons not totally understood, patients with Spina Bifida are generally atopic and at extremely high risk of developing latex-related hypersensitivity (allergy). Modified Lowry assay “Modified Lowry”, is a modification of the original Lowry test developed by the ASTM (D5712) to use specifically for rubber products. The test method explains how the product should be prepared and extracted prior to adding the traditional Lowry reagents to determine total protein levels. (See Lowry). Modulus A measurement of the resistance to stretch. Modulus indicates glove softness. The lower the modulus, the more easily the glove gives during use thereby reducing wearer fatigue. Microporous Consisting of or pertaining to microscopic pores in a material. |
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Natural rubber latex See Latex; consists of small rubber particles harvested for commercial use primarily from rubber tree Hevea brasiliensis. The milky fluid from this tree is harvested by a process called tapping. This milky sap-like substance oozes from the tree when the tree is scored or tapped. It is then collected and used in the manufacture of over 40,000 products. NRL Natural rubber latex Natural Latex Latex containing natural proteins, which are a major cause of allergic reaction for some people. NFPA 702-1980 A much more stringent test than the CPSC-1610, this is the National Fire Protection Association’s test for determining the rate of flame spread across a fabric. Non-Reinforced Gowns Gowns made with a single layer of fabric, offering the lowest protection level. Nonwoven Fabric construction that does not involve the inter-weaving of fibers. Nutrients Food or any substance that nourishes the body – protein, carbohydrate, fat, vitamins, minerals, and water. |
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Ozone Is an extremely reactive unstable gas (O3) produced by the interaction of oxygen and an energy source. Generators, fans, electrocautery units, X-ray machines, etc. produce ozone when running. Ozone can deteriorate several glove materials including natural rubber latex, nitrile, neoprene and Elastryn. |
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Papules Small circumscribed (discrete), solid, elevated bumps in the skin. Scratching them is usually painful. Penetration To pass, extend, pierce, or diffuse into or through something. Permeation To pass through the pores or interstices of; the movement of chemicals through a glove on a molecular level. Data displaying permeation values represent breakthrough times when the glove is under continuous contact with the test chemical. Phi X 174 Also referred to as ĦX174; a stable, non-pathogenic virus. One of the smallest known viruses, it is recommended for evaluation of glove and condom barrier integrity. Powder There are two types. Donning powder on surgical gloves and most examination gloves is composed of USP (United States Pharmacopoeia) modified cornstarch. Donning powder is also referred to as USP absorbable dusting powder. Glove donning powder facilitates donning and absorbs sweat. The literature suggests powder can dry out the skin excessively and function as abrasive particles, immunological activators, and possibly as vehicles for the dissemination of chemicals, proteins and microorganisms. Mold release powder is used to remove gloves from the glove mold during the manufacturing process. This powder generally consists of divalent salts, principally calcium (e.g. calcium carbonate, calcium nitrate). In powder-free gloves, this powder is removed through a manufacturing process called chlorination. Prevalence The number of cases of a disease existing in a given population at a specific period of time or at a particular moment of time. Protein content Regarding natural rubber latex (NRL) products, the measurement of total protein regardless of allergenic potential. The government recognizes the American Society for Testing and Materials (ASTM) D5712 Modified Lowry assay as the method to determine total protein content in natural rubber latex products. Some NRL protein allergens have the potential to elicit Type I, immediate type hypersensitivity reactions in genetically predisposed individuals. For additional information, see Immediate Type Hypersensitivity. JEFF 5.5.02 |
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Radioallergosorbent test (RAST) An in vitro or test tube assay used to identify and quantitate potential allergen-specific IgE antibodies in patient serum or potential allergens from product extracts. There are several ways to conduct this test. Typically, a protein allergen is bound to a surface such as a plastic well. The patient’s serum is added to the well. If the serum contains antibody to the allergen, the antibodies and allergen will attach to each other. The level of attachment is measured and the amount quantified. Alternatively, IgE antibodies are bound to the plate surface. Then an extract of a product, such as a natural rubber latex glove, is added to the plate to determine if allergens are present in the tested product. Rhinitis Inflammation of the nasal mucous membrane (runny nose). Rubber An elastic substance obtained from the cytoplasm of laticiferous cells of many tropical plants. The Hevea brasiliensis (rubber tree) produces the latex used for the production of natural rubber latex (NRL) gloves and most other “latex” and rubber containing medical and consumer products. The term rubber more generally applies to products made from coagulated, compressed, crumbed or dried latex. Products manufactured by dipping or extruding, in which the latex is not solidified prior to processing, are more technically termed latex products. Under this definition, “rubber” products generally have lower extractable protein levels than “latex” products due to the differences in manufacturing processes. Raglan Sleeves A diagonally-cut sleeve inset that allows for increased range of movement. |
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Sensitization The physiological process of developing an allergy. Sensitization is an asymptomatic process until an individual’s threshold level is reached. This requires repeated exposure to the antigen or allergen. Subsequent exposure may elicit allergic symptoms. Sensitize To increase the specific sensitivity of an individual to an antigen or allergen as the result of exposure. In the case of Type I response, the individual is developing IgE antibodies to the allergen in question. Sensitized If IgE antibodies have been detected to the specific allergen in question, the individual is said to be sensitized. Being sensitized does not mean the individual has enough IgE antibodies on mast cells to have an allergic reaction yet. Thus a sensitized individual is not necessarily allergic (having symptoms). Skin Prick Test (SPT) An allergy test used to confirm the diagnosis of sensitivity to a substance including, but not limited to, foods, pollen, grasses, mold, rubber chemicals and natural rubber latex proteins. In this test, a drop of diluted antigenic solution is placed on the skin. The skin is then gently pricked with a lancet. Any remaining solution is wiped away. Normally, a more concentrated solution is then applied and the SPT repeated. A positive response requires the appearance of a wheal-and-flare (hive) observed up to 60 minutes after the test. At this time, the wheal reaction is measured and compared to positive and negative controls. A positive test result is an indication of sensitivity. Spina Bifida (Meningomyelocele) A limited birth defect of the spinal column, characterized by the absence of some of the vertebral arches (top part of the backbone), through which the spinal membranes may protrude. As a result, this portion of the central nervous system is not adequately protected. Problems experienced by the individual depend on where and how severe the defect is. They may have problems with their legs, urinary tract, etc. For reasons not totally understood, patients with Spina Bifida are generally atopic and are at extremely high risk of developing latex-related hypersensitivity. Simplified Gown System A system that, while helping to eliminate staff confusion over which gown protection level to choose, can also streamline a customer’s ordering and stocking process, decrease SKUs, and potentially realize additional cost savings. SKUs Stock Keeping Units (used in reference to product identification and inventory). Standard Gowns Same as Non-Reinforced Gowns from Kimberly-Clark. Strikethrough The passage of blood or other bodily fluids completely through a fabric. Synthetic Latex Latex containing no rubber-tree sap, and therefore none of the proteins that cause allergic reactions. Stoma Surgical opening through which a feeding tube can enter the body. Stomach Residual Contents of the last feeding remaining in the stomach just before the next feeding is to be given. |
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T-lymphocyte (T-cells) A lymphocyte with a wide range of activities. Some control B lymphocyte development and antibody production. Others interact with phagocytic cells and help destroy pathogens. Another set of T lymphocytes recognizes cells infected by virus and destroys them. Some T-cells are responsible for cell-mediated hypersensitivity (Type IV hypersensitivity). These sensitized T-cells have a receptor that recognizes a specific chemical antigen (the chemical contact sensitizer that caused its creation). On subsequent exposure to that chemical, the sensitized T-cell releases lymphokines, which attract macrophages, neutrophils and other white blood cells to the reaction site. Inflammation ensues and can become chronic. This condition, Type IV hypersensitivity, is also known as allergic contact dermatitis, delayed hypersensitivity or chemical allergy. The individual must be genetically prone (have the DNA instructions) to make the sensitized T-cells to specific chemical contact sensitizers. Otherwise, regardless of repeated exposure, no Type IV hypersensitivity will develop. Tachycardia Rapid beating of the heart. Talc Magnesium silicate, Mg3Si4O10 (OH) 2. Often used as a solid lubricant. Talc was banned from use on surgical gloves after it was found to cause severe granulomas and adhesions in surgical wounds. The body treated the talc granules as foreign bodies that needed to be walled off with fibrin and calcium (a.k.a. granulomas and adhesions), a mechanism of protecting the rest of the body from the “invading foreign substance.” The FDA mandated that surgical gloves switch to USP absorbable dusting powder (modified cornstarch) in the 1960s-1970s. Cornstarch glove powder still causes post-surgical complications, but is far better than talcum powder. Tensile strength or strength Measurement of the amount of stretch or pull required to rupture or break the glove material. Type I hypersensitivity Also known as immediate type hypersensitivity; is an allergy involving the immune system and the development of IgE antibodies specific to an allergen. Type I allergic reactions manifest from minutes to an hour or so after exposure and are associated only with genetically predisposed individuals. Symptoms may include, but are not limited to, hives, itching, runny nose, watery eyes, facial swelling, abdominal cramping, diarrhea, nausea, difficulty breathing, rapid heart rate (tachycardia), sudden drop in blood pressure (hypotension), dizziness and anaphylactic shock. Severe cases may be fatal. Examples of Type I allergies include, but are not limited to, allergies to bee stings, penicillin, peanuts, seafood, plants, pollen and certain natural rubber latex proteins. JEFF 5.5.02 Type IV hypersensitivity Also called allergic contact dermatitis, delayed hypersensitivity and chemical allergy; is a cell-mediated allergic reaction associated with specific chemicals called chemical contact sensitizers. This is a delayed reaction that typically takes from 6 to 48 hours for maximum expression of physical symptoms. An individual must be genetically predisposed to have this allergic reaction. Type IV allergic contact dermatitis is characterized by localized skin redness and inflammation (erythema), small skin elevation or blisters (vesiculation), a localized, itchy rash (pruritus) and dry, thickened skin that can peel or crack. The area affected usually spreads, increasing in size from the point of origin, with repeated exposure. Examples include Type IV allergies to: poison oak, nickel, soaps, fragrances and chemicals such as accelerators used in glove manufacturing (thiurams, thiazoles and carbamates). Thermally Sealed Refers to a seam-sealing process which uses heat to bond fabrics together, and which is a more protective sealing process than stitching. |
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Universal Precautions A method of infection control in which all human blood and other bodily fluids are considered infectious for HIV, HBV and other bloodborne pathogens, regardless of patient history. It encompasses a variety of practices to prevent occupational exposure, such as the use of personal protective equipment (ppe), disposal of sharps and safe housekeeping. Universal Precautions were developed by the CDC as guidelines and were not enforceable. Urticaria Hives; an eruption of itching wheals usually of systemic origin. Hives are a symptom of Type I (immediate type) hypersensitivity and may be due to hypersensitivity to foods, drugs, some proteins found in natural rubber latex or other protein sources. |
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Vesicles Small, circumscribed elevation of the skin that contains fluid; small blisters. Vinyl gloves Synthetic gloves made of polyvinyl chloride (PVC). Although intact vinyl is a barrier to microorganisms, vinyl’s non-elastic properties do not allow for maintenance of barrier integrity after extended use or during rigorous procedures. Vinyl is not appropriate when there is risk of infection nor are they appropriate for use in chemotherapy. |
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Wheal A circumscribed transitory swelling of the skin appearing as a hive. Generally, it is slightly reddened, often blanched in the center, changing in size and shape, extending to adjacent areas and usually accompanied by intense itching. Rays of swelling termed flares often encircle wheals. Wheals may be produced in Type I allergic individuals when exposed to substances to which they are allergic. |
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