Protective gloves in Swedish dentistry: use and side-effects

Background During the 1980s routine wearing of gloves in dentistry was reco mmended by health authorities in several countries. However, prolonged glov e use is associated with side-effects of irritant and allergic origin. Objectives To investigate the extent of glove use and self-reported glove i ntolerance reactions among Swedish dentists, and to examine how far IgE-med iated allergy to natural rubber latex (NRL) occurs in subjects who report r apid itching when in contact with protective gloves. Subjects/methods A postal questionnaire was answered by 3083 of 3500 licens ed dentists, a response rate of 88%. Of the dentists who reported rapidly o ccurring itching of the hands from gloves, 131 of 170 attended a clinical e xamination including a skin prick test (SPT) and a serological examination (RAST) for IgE-mediated allergy. Results Seventy-three per cent of the dentists reported daily glove use of more than 2 h, 48% more than 6 h a day, and 6% reported no use. NRL gloves were used most frequently (P < 0.001) and were the main material that elici ted symptoms (P < 0.001). Female dentists reported more frequent glove use than males, as did young dentists (P < 0.001) compared with older ones. Fem ales also preferred vinyl gloves. Glove intolerance reactions were reported by 723 (23%) dentists, [females 28%, males 21% (P < 0.001)] and were more common in younger dentists. Of the 417 dentists with reported hand eczema d uring the previous year, 54% reported glove intolerance, compared with 20% of the dentists without hand eczema (P < 0.001). A logistic regression anal ysis including hand eczema, age, sex and atopy showed that all these factor s contributed significantly to the risk of glove intolerance, and that hand eczema was a stronger factor than atopy. In 15 of 131 (11%) dentists exami ned for reported glove-related itch, latex allergy was verified by SPT and/ or RAST. Glove-related conjunctivis, rhinitis and asthma, in contrast to sk in symptoms, showed a significant association with IgE-mediated allergy to NRL. Conclusions Swedish dentists show good compliance with the recommendations for routine glove use. Intolerance reactions are frequently reported, espec ially by dentists with hand eczema, which emphasizes the need for preventiv e skin care programmes. Glove-related symptoms from mucous membranes showed a higher association with IgE-mediated allergy to NRL than reported itchin g of the skin, a fact that should be considered when composing screening qu estionnaires for NRL sensitization.