Factors influencing the skin exposure to diphenylguanidine in surgical gloves

Background: For health care personnelhandhygieneandwearing appropriate protective gloves are compulsory. We have noticed an increase of hand eczema caused by contact allergy from rubber chemicals such as diphenylguanidine (DPG) in synthetic rubber gloves used by surgeons and surgical nurses. The exposure time to surgical gloves as well as the number of gloves used per day vary. Furthermore surgery very often includes the use of skin disinfectants before glove donning. Objectives: Does the exposure time influence the amount of DPG released from the gloves? Does the exposure of skin disinfectants before glove donning influence the release of DPG? Methods: Using synthetic sweat, the amount of DPG released from the inside of the gloves at different timeswas measured by HPLC. The remaining extractable DPG was estimated by washing the inside of the gloves with ethanol (50% in water) for 10min. The amount of DPG found on the hands exposed to 3ml skin disinfectant allowed to dry prior to glove donning was compared to the amount found on unexposed hands. After wearing gloves for 60 min the handswerewashedwith ethanol and the amount of DPG recovered was analysed with HPLC. Results: After 10, 30, 60 and 180 min approximately 73%, 79%, 82%, 87% of the total amount of DPG was released. For all comparisons the amount of DPG released was higher on the hand exposed to disinfectants compared with the unexposed hand. Conclusions: A comparatively short exposure time to gloves (10min) implies a substantial exposure to DPG. Thus, repeated usage of glovesmight enhance skin exposure to this rubber chemical. Skin disinfectants does increase the amount of DPG released from the gloves. Thus, possibly the components of the disinfectant remaining on the skin or some othermechanism add to the exposure to DPG