I am an Environmental Chemist. My work involves exposure to toxic and/or corrosive chemicals. Prior to my current professional position, I worked at the University of Victoria teaching first year students in their first university laboratory course. As a Professional Chemist now, and an academic Chemist then, the very first thing I teach/taught my staff/students is/was how to correctly use personal protective equipment (PPE). In my last post I wrote about one type of PPE (face masks) this post is about gloves.
Glove safety is a particular bugbear of mine. The reason for this is personal. During my graduate studies a colleague had a nasty accident thanks to not following glove protocol and because of that I spend a lot of time enforcing good glove protocol with my staff. In this blog post I want to share some of the lessons I have learned about glove use and provide some suggestions about the use of gloves during the Coronavirus pandemic.
Gloves can be your friends but you don’t need them for most tasks
Almost every health official on the planet has repeated the same refrain: good hand hygiene is an important way to protect ourselves from the Coronavirus. Virtually every public surface may be covered in virus and good hand hygiene will help protect you from the virus. As the Centers for Disease Control points out you need to:
perform hand hygiene (e.g., handwashing with non-antimicrobial soap and water, and alcohol-based hand rub if soap and water are not available) after having contact with respiratory secretions and contaminated objects/materials.
But in some situations, good hand hygiene is not good enough, that is when you should wear gloves. A good (intact) pair of nitrile or latex gloves provides an excellent barrier from Coronavirus. But gloves are not a panacea and used incorrectly gloves can hurt rather than help.
From what I have seen to date, most people are using gloves incorrectly and in doing so are putting themselves, their families and the people they encounter at increased risk. In the next sections I want to emphasize some of the rules you should consider when wearing gloves.
Always assume the outside of your glove is contaminated
The most important thing I want everyone who reads this post to understand is that you always have to treat your gloves as if they are contaminated. You cannot see the Coronavirus so you have to assume that the outside of your glove is covered with the virus. That means if you touch something with that glove you will have contaminated that surface with Coronavirus.
Yesterday I was waiting to pay for my groceries behind a couple wearing gloves. This couple had done all their shopping wearing these gloves [I had noticed them earlier] and they were at the cashier paying. They insisted on paying with cash (much to the dismay of the cashier) and the gent proceeded to touch every single bill with his gloved hands. Before that I watched the gent pull his wallet out of his back pocket with his gloved hand. He then collected his wife’s purse, once again using the same gloved hand and then pulled out her wallet to get change.
This gent was oblivious to the fact that every object he touched would be exposed to whatever was on the outside of his gloves. His pocket, his wallet, his wife’s purse, her wallet, all these surface were now potentially exposed. By wearing gloves and not following strict glove protocol he potentially contaminated himself, his wife and potentially his kids in countless ways.
What really offended me was that by handling the cash with his gloves and giving it to the cashier, who was not wearing gloves, he put her at added risk. Had he, instead, used one of the Lysol wipes handed out at the door, and not worn gloves, he could have protected himself, his family AND THE CASHIER. That sort of bad citizenship frustrates me to no end. This brings me to my next rule:
Never touch with your glove anything that you may want to touch without your glove
This rule is simply a follow-up on the first rule. If you are going to wear gloves then don’t touch anything with the glove that you want to later touch without your gloves.
In the office I am always all over my field staff about this. The classic example is their pens. My field technicians are constantly writing field notes and have pens everywhere; and where do a lot of people store pens when their hands are full?…their mouths of course. I teach my lab technicians that if they have to touch a pen with a gloved hand, then they should mark that pen and never touch it again without gloves. This rule leads to the obvious next rule
Don’t wear your gloves (or do work requiring gloves) in common areas or in areas where others will be working without gloves.
If you decide to wear gloves for your protection, you need to establish “glove-only” and “glove-free” zones. These areas should be clear and and you should acknowledge others by not wearing gloves in common areas or areas where others will be working without gloves. If you don’t follow this rule then you put unwitting people at risk. We share spaces with others and part of sharing spaces with people is protecting them. This is simply good manners and good citizenship.
In a similar vein, never wear gloves in your vehicle that you wore out of your vehicle. One exception to this can be where you are wearing “clean” gloves to protect an area from unclean hands.
This is often the case, for me, when I am coming home from the field and I cannot be sure that I was able to get my hands clean before getting in my vehicle. In that case I will wear clean gloves in my car, but in this case it is to protect the car from my hands and not the other way around. Once I am home I turn on the water in my sink and then take off my gloves and wash my hands immediately because in this case the INSIDE of the gloves represents the contaminated surface and I want to protect my family from my contaminated hands by wearing clean gloves.
Replace gloves regularly and remove them using correct technique
Since we have to assume the outside of our gloves are contaminated, we should change them regularly and need to ensure they are removed correctly. There is a correct technique to removing gloves, as depicted in the graphic below. If you don’t remove your gloves correctly then you will, once-again, defeat the purpose of wearing gloves.
Notice how in the graphic the outside of the glove is only touched by glove and the inside only touched by skin. This is incredibly important because, as we remember, we have to assume the outside of your gloves are contaminated.
Wear the right glove for the task
Another important thing to remember is that nitrile/latex gloves are designed to protect you from exposure to germs and some chemicals. They are not designed for heavy use. If you plan on doing heavy work then wear appropriate gloves.
For our work, our field technicians are dealing with glass jars that can break and cause cuts, so they wear cut-resistant gloves underneath their nitrites. This allows them to get the protection both from cuts and from contamination. If you know you will need to use multiple gloves to complete a task then wear multiple layers of gloves.
Sometime when I know I am going to be jarring multiple soil samples, I will layer on 3-4 layers of nitriles. That way I can pull off one layer and still have gloved hands to handle the next sample.
Gloves only work if you are paying attention
A critical thing to remember is that PPE only works for people who remain aware of the reason they are wearing PPE. Remember that lab accident I talked about from my youth? In that case my colleague was working with organic solvents wearing all the right PPE when his eye got itchy. He reached under his safety glasses, with his gloved hand, and etched his cornea with the organic solvent contaminating his glove.
He had forgotten the most important rule of PPE. PPE is your last line of defense not your first. PPE is there to protect you because every other level of planning and procedures has failed. If you are relying on PPE then you planned your task incorrectly. Figure out how to do the job without PPE, then wear the PPE as a back-up, not the other way around.
To conclude, if you avoid touching things you don’t need to touch; wash your hands regularly; practice social distancing; and avoid places where crowd are accumulating you will do more to reduce your risk to Coronavirus than you will get by wearing gloves or a mask.
Because of my work, I have a box of nitrile gloves in my car and throughout this Coronavirus epidemic I have put on a nitrile glove twice. Both times were to put gas in my car because I have a bad habit of spilling gas from the nozzle onto my hand.
As a safety professional, I trust my good planning and good habits to protect me from Coronavirus, not unnecessary layers of PPE. By doing so I am not emulating that family from my grocery shopping. Their incorrect use of gloves put themselves, their families and that shopping clerk at risk. Gloves will only protect you if you follow good glove protocols. If you don’t you will simply lull yourself into a false sense of security while putting yourself, your family and the people you encounter at increased risk.