Original Post: When you get admitted to a hospital, one of the questions that they ask is if you have any allergies to latex. Some people do and as I look at boxes of latex exam gloves, I was wondering if anyone out there has addressed this concern for EMS and 1st responders. The Purple Nitrile gloves do not present the same allergic reaction possibilities and when you look at the chemical resistivity for the nitrile, they beat any of the others hands down. Where to do stand on this topic? Any advise?

UPDATE: Thank you for your responses and insight. The below information provides a basic summary and overview for the selection of EMS related gloves.

EMS Glove Style Information

Latex - Latex gloves are still the most popular because they offer strength, elasticity, slip resistance and comfort and of course cost less than Nitrile Gloves. They are supple and fit comfortably around your skin and have become the industry standard for years based on availability and cost alone. The downside is that they are made from natural latex rubber, a protein-based compound known to cause allergic reactions and irritations in some people. The major issue with latex is that some patients and providers have latex allergies; therefore the need for a latex-free environment needs to be provided.

According to the National Institute of Allergy and Infectious Diseases, up to 6 percent of Americans are estimated to have some type of latex allergy. Since Nitrile is a synthetic rubber, it doesn't create the same irritations and allergic reactions as natural latex rubber.

Synthetic - Synthetic gloves offer the same benefits of latex without any of the allergic risks because they are latex-free. These gloves are made from polyvinyl chloride. These gloves are looser around the cuff, which allow for more air circulation around the skin, dissuading EMS providers from using these because of the increased risk of exposure to the rescuer.

Vinyl - Vinyl gloves are the most economical choice. Also made from polyvinyl chloride, these gloves are soft and comfortable. The history of this glove type tearing easily, the difficulty of use, reduced tactile sense and not providing the same manual dexterity as Nitrile dissuades EMS providers from using this style of glove.

Nitrile - Nitrile gloves don't contain natural rubber latex proteins, so there are no latex allergy concerns. Because of the cross-linking of the Nitrile polymers, they don't puncture easily. Nitrile gloves are manufactured using synthetic latex, which provides three times more puncture resistant than natural rubber. They offer superior resistance to punctures and abrasions and are also used for protection against a variety of chemicals. Nitrile material also has a naturally low coefficient of friction, making them easy to don (put on). They are more resistant against chemicals like solvents, greases, oils and alkali solutions. The synthetic Nitrile polymers in the gloves respond to your body temperature and essentially mold the gloves to the shape of your hands.

Below are some of the reasons why Nitrile gloves would be chosen over latex or vinyl gloves.
No Protein Allergen
Anti Static Behavior
Good Chemical Resistance
High Puncture Resistance
High flexibility
Solvent Resistant

Powdered Nitrile Gloves - Cornstarch is often added to nitrile gloves to make putting on the glove as smooth as possible.

Glove Costs - All of these gloves come in powder and powder-free. The costs can vary dependent upon supplier, quantities ordered, etc. Here’s some general glove cost estimates to provide a means of comparing one to the other. This is not to be considered absolutely accurate and should be researched through your local vendors to get you the costs. Nitrile gloves last longer, are latex free and they fit better but they cost as much as 16% more. The benefits far outweigh the increased costs

Glove Cost Estimates / General Cost Comparison (*Estimates Only - Not Accurate)

Gloves (Powder Free / Box of 100)

Latex $ 9.00
Vinyl $ 9.10
Nitrile $10.70
Synthetic $ 4.00

Gloves (Powdered / Box of 100)

Latex $ 5.20
Vinyl $ 6.80
Nitrile $ 7.00
Synthetic $ 3.65

Glove Purchasing - Before purchasing any type of glove, whether it be latex, nitrile, or vinyl, you have to ask yourself a few things...

What amount of protection are you looking for?
Are you allergic to any materials that the glove is made from?
The quality of the glove and how it's made?
Powdered or Unpowdered?
The comfort of the glove?
The size of the glove?

Standardized Glove Measurement Scale - If protection is your major concern, there a few things you should know about the manufacturing of Latex, Nitrile, and Vinyl gloves. There are three standard measures that protective gloves are scaled upon.

Medical Grade - For medical use. Highest grade of protection. These gloves are thoroughly tested to pass FDA requirements and exceed a broad range of demanding specifications.

High Risk - For use in the emergency medical services fields. High levels of testing are required to assure proper requirements.

Utility Grade - Not intended for medical use and not tested for FDA specifications. These gloves are great if detail is a necessity. Normally used for painting and general hand protection. They are manufactured to ASTM (American Society for Testing and Materials) specifications.

Here is a table covering the strengths and weaknesses of certain gloves:

Latex Nitrile Vinyl
Protection 4 4 2
Allergy 2 4 3
Comfort 4 3 2
Elasticity 4 3 2
Price 4 3 4
Durability 3 4 1

How to Determine Your Glove Size - Most gloves are available in XS, small, medium, large, and XL sizes. Gloves can be manufactured with different cuff lengths, textures, thickness and other characteristics. Use the bullet list below to determine the size you'll need.

A. Use a tape measure to determine your correct hand circumference in inches. Measure at the widest part of the hand.
B. The chart below shows you how to find the glove size closest to the hand measurements in inches.
C. Sizes may vary among manufacturers and styles.

Hand Size Measurements = Glove Size

7" - 8" = Small
8" - 9" = Medium
9" - 10" = Large
10" - 11" = X-Large

Glove Safety Considerations

Expiration Dates - Gloves have expiration dates. You should discourage the use of expired gloves. Look for an expiration date on the individual packages of gloves.

Physical Inspections - Do not store gloves in direct sunlight; dispose any gloves that show any signs of discoloration, leakage or deterioration.

Latex Allergies - For providers using only latex gloves, you need to provide alternative gloves to workers and / or patients (6% of the total population) who are at more risk of developing latex allergic reactions.

Hazmat Glove Selection - Nitrile has been used for years now as an inner glove for hazmat incident entry teams donning Level A, B and C PPE. The chemical resistibility and permeation data alone support the use of Nitrile gloves for a variety of chemicals.

Nitrile Glove Storage - Make sure not to store nitrile gloves under conditions of excess heat or light, since this will cause more rapid rubber degradation.

TCSS, Mike : )