A new observational study offers evidence of a link between glove use among health care workers and fewer injuries from needles and other sharps.
The study, which appeared in the September issue of the Journal of Infection Control and Hospital Epidemiology, used a case-crossover methodology involving telephone questionnaires with 636 health care workers in the United States and Canada who had experienced sharps injuries.
In the context of the study, sharps included solid or hollow bore needles, suture needles, intravenous (IV) catheters, scalpels, scissors, IV catheter guide wires or broken test tubes, says senior author Dr. David Fisman, an associate professor of epidemiology at the Dalla Lana School of Public Health at the University of Toronto.
Health care workers know that they should be wearing gloves “when they’re dealing with sharp devices and blood and body fluids,” Dr. Fisman says. When workers fail to do so, he suggests it is often because they believe “it makes them clumsier and they can’t feel things as well, so they think they’re more likely to stick or poke themselves with needles or sharp devices.”
Dr. Fisman estimates that among non-scrubbed-in employees – those not working in an operating room or procedural setting – glove use was associated with an 80 per cent reduction in injury risk. “If you have a glove on, even though it’s not a hugely strong barrier, oftentimes people have sort of glancing or indirect contact with a sharp device or jagged surface, and the glove might be the divider” as to whether or not skin is broken, he explains.
Dr. Allison McGeer, an infectious disease consultant at Mount Sinai Hospital in Toronto, notes that while the study’s findings suggest an association between glove use and a lowered risk of sharps-related injuries, she does not believe the relationship is causal. “You’re handling very sharp needles. Gloves are very thin,” Dr. McGeer points out.
“The gloves are not causal, but they’re very tightly associated, because all of the things that make you not wear gloves in settings where you would normally wear gloves are also things that increase your risk of injury,” she says. “People are less likely to wear gloves when they’re in emergency circumstances; when they’re tired, when they’re in a hurry – these are things we know that increase risk of injury.”
For operating room surgeons, the study determined that double-gloving was associated with a reduction in injury. “This finding appears to refute the belief that using two pairs of gloves may compromise tactility and dexterity, and [that doing so] may result in an increased likelihood of percutaneous puncture,” researchers report.
Dr. McGeer argues that safer technology, as opposed to focusing on behavioural change, is more likely to produce benefits for workers. “All of the moves that we’ve been making to safer needles, those are the first and most important things,” she contends.
Emily Landau is editorial assistant of OHS CANADA.