Many papers in the medical literature advocate replacement materials to avoid the risk of allergic reactions either to staff or patients. In many cases the suggested replacements may be ineffectual barriers and/or the materials may pose fresh health hazards either during use or during disposal. It is frequently proposed that greater use should be made of polyethylene or polyvinyl chloride gloves, but tests show these to be ineffective barriers against pathogens. One series of tests¹⁸ showed that polyethylene and polyvinyl chloride gloves had failure rates of 40% and 22%, respectively. Following exposure to the common disinfectant, 70% ethanol, these failure rates increased to 94% and 56% for polyethylene and polyvinyl chloride gloves, respectively. Latex, although permeable to ethanol, was penetrated by virus less than 1% of the time regardless of whether the latex had been pre-exposed to disinfectant or not.

Safeskin¹⁹ sponsored a comparative study of latex, vinyl and nitrile gloves. The batches of latex and nitrile gloves had allegedly similar failure rates: 0-4% for latex and 1 to 4% for nitrile. The best performing batch of vinyl gloves, conversely, had a failure rate of 12%, a rate which rose in some batches to as high as 61%. It would seem that the wearing of vinyl gloves would serve little purpose within a medical context. Nevertheless, this study concluded that "vinyl is an appropriate barrier for non-rigorous, low-risk procedures of short duration": one is tempted to wonder what type of procedure is envisaged - reading patient records, perhaps?

Many of the suggested materials are known allergens: polychloroprene^20-28 has an extensive literature on allergic reactions to the accelerators used to cure it, and PVC is also liable to induce skin reactions. The phthalate plasticizers used in PVC are also considered to be hazardous. Of the competitive materials, only polyurethanes are unlikely to lead to problems. Polyurethanes are widely used inside the human body and now have a long history of use in close proximity with the human body in fibres.

Both acrylonitrile^29-31 and polychloroprene are based on potentially carcinogenic monomers and it is possible that widespread use in close bodily contact during surgical procedures may introduce new hazards. Most of the competitive materials lead to hazardous fumes, if incinerated. These include dioxin in the case of PVC and has led to restrictions on its use in Scandinavia. Recent information from the Malaysian Rubber Board³² contrasts the biodegradable nature of natural rubber gloves with the persistent qualities of polychloroprene and vinyl glove materials when buried in soil.

References
¹⁸Klein, R.C., Party, E. and Gershey E.L., Virus penetration of examination gloves. Biotechniques, 1990, 9 (2),196-9.
¹⁹Safeskin, Rubb. Plast. News, 1999,
²⁰Corazza, M. and Virgili, A., Allergic contact dermatitis due to nickel in a neoprene wetsuit. Contact Dermatitis,1998, 39,257.
²¹Goette DK., Raccoon-like periorbital leukoderma from contact with swim goggles. Contact Dermatitis, 1984, 10,129-31.
²²Stern, E.B. et al, Neoprene splinting: dermatological issues. Am. J. Occup. Ther., 1998, 52, 573-8.
²³Thomson, K.F., Wilkinson, S.M., Chalmers, R.J. and Beck, M.H. Allergic contact dermatitis from a neoprene elbow splint. Contact Dermatitis, 1998, 38, 179.
²⁴Johnson, R.C. and Elston, D.M., Wrist dermatitis: contact allergy to neoprene in a keyboard wrist rest. Am. J. Contact Dermat., 1997, 8, 172-4.
²⁵Boehncke, W.H., Wessmann, D., Zollner, T.M. and Hensel, O. Allergic contact dermatitis from diphenylthiourea in a wet suit. Contact Dermatitis, 1997, 36, 271.
²⁶Villarreal Balza de Vallejo, O. Contact dermatitis from diphenylthiourea in a knee brace. Contact Dermatitis, 1997, 36, 166-7.
²⁷Fowler, J.F. and Callen, J.P. Facial dermatitis from a neoprene rubber mask. Contact Dermatitis, 1988, 18, 310-11.
²⁸Masmoudi, M.L. and Lachapelle, J.M. Occupational dermatitis to dihydroxydiphenyl and diphenylthiourea in neoprene gloves. Contact Dermatitis, 1987, 16, 290-1.
²⁹Leonard A. et al. Mutagenicity, carcinogenicity, and teratogenicity of acrylonitrile. Mutat Res., 1999, 436, 263-83.
³⁰Benn, T. and Osborne, K. Mortality of United Kingdom acrylonitrile workers--an extended and updated study. Scand. J. Work Environ Health, 1998, 24. Suppl 2:17-24
³¹Woutersen RA., Toxicologic profile of acrylonitrile. Scand. J. Work Environ Health, 1998, 24. Suppl 2: 5-9.
³²Ikram, A. Environment-friendly natural rubber gloves. Kuala Lumpur: Malaysian Rubber Board, 1999.