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Why hospitals are moving to a non-latex environment

Natural rubber latex (NRL) allergies continue to be a prevalent risk in healthcare settings today even though healthcare worker (HCW) allergy incidence has decreased since the introduction of powder- free gloves. These NRL-related allergic events in hospitals can be avoided for both healthcare workers and patients alike by moving to a non-latex environment. Despite many hospitals around the world already using only latex-free gloves, the use of NRL gloves is still prevalent.

The prevalence of NRL sensitisation for the general population varies from 1 to 6%. 1,2,3 In the U.S. alone, the number of atopic individuals (those prone to allergies) is currently estimated at more than 50 million people.4 However, the sensitisation and allergy rates for some surgical populations, such as paediatric, have a higher incidence than the general population, with some children having multiple surgeries presenting sensitization levels of up to 50%.1

For HCWs, the risk of sensitization depends on the degree of exposure. For staff working outside the operating room, the incidence rate is reported to be from 0.8 to 3%. However, for staff working in the O.R., it reaches 10-17%.5,6,7 It is important to understand that some sensitized individuals may not present clinical signs or be aware of their sensitised status, however, they are at risk of developing clinical allergic symptoms.

In order to address this safety issue, many hospitals have opted to provide non-latex surgical gloves to those HCWs or patients requiring a non-latex environment because of a known latex allergy, rather than switching completely to non-latex surgical gloves. This approach addresses those HCWs or patients with known latex allergies, but does not provide a primary prevention strategy that will minimise the risk for other HCWs or patients from developing sensitisation, or latex allergies which have a serious impact on quality of life. This selective product offering option also does not avoid unexpected reactions by people not aware of their latex allergy status.

Moving to non-latex surgical gloves

Some hospitals are converting to only non-latex gloves and eliminating the use of NRL gloves. The main reason for the switch is the elimination of adverse events due to glove-related latex allergies, and the consequential loss of time and productivity together with the cost of the treatment if a patient or HCW develops a clinical allergic response.

However, there are other hospitals that are reluctant to change completely to non-latex gloves, despite the clinical data available to support the efficacy of primary prevention. This is mostly due to the perceived cost increase to a non-latex conversion and the difficulty of O.R. product changes, together with some perception that non-latex gloves are not as comfortable or do not provide as good of a barrier as NRL surgical gloves.


Cost implications

Today, the cost of non-latex gloves is close to NRL gloves, especially when the cost savings that a non-latex environment generates is taken into account.

The main cost saving associated with the elimination of latex is the avoidance of NRL allergic adverse events and the associated cost of lost time and productivity plus the cost of treatment if a patient or HCW develops a clinical response. For HCWs, this could result in increased sick leave, which can create extra costs on agency replacement staff and employee turnover. In addition to this, there are other advantages to consider such as decreased O.R. turnover time for a latex-allergy patient surgery and the elimination of time and product waste when surgery is cancelled/postponed if a patient’s allergy is discovered at the last minute, requiring a teardown of the O.R. There are also logistical advantages such as the consolidation of lines, simplified ordering, and more space available in the O.R. store room due to the reduced number of products required. This move will also minimize the development of any future NRL allergy by HCW or high-risk patients such as children requiring multiple surgeries.
 

 NON-LATEX GLOVE USAGE BENEFITS

 1

 Elimination of latex allergy adverse events caused by NRL gloves

 2

 Elimination of loss of time and productivity of the team in the event of a glove related latex allergy incident

 3

 Elimination of cost of latex allergy event treatment

 4

 Elimination of or decrease in sick leave, extra cost on agency replacement staff, and employee turnover

 5

Primary prevention of latex sensitisation and latex allergy development by HCWs and/or patients 

 6

Decrease in the O.R. turnover time for a latex-allergy patient surgery 

 7

Elimination of time and product waste when a surgery is cancelled/postponed due to latex allergy 

 8

Product consolidation 

 9

More storage space available in O.R. 

 10

Simplified ordering 


These costs can vary, due to a variation of severity, which make it difficult to estimate, but they can be quite significant:
 

For an anaphylactic episode, the treatment costs that may arise vary between US$5,000 and 25,000.8,9 The costs are higher for more severe anaphylactic reaction complications as they may lead to an extended length of stay and transition to intensive care.

The USA Mayo Clinic has reported that the HCW latex allergy cases have declined from 150 to 27 per 100,000 healthcare workers since 1993 after the implementation of non-latex gloves.10

The cost associated with a decrease in the O.R. turnover time for a latex-allergy patient will depend on the time the O.R. is idle, which affects the O.R. efficiency. It is estimated that the cost of an idle O.R is US$26/minute, US$1,560/hour excluding staff and other costs.11

In the event surgery is cancelled/postponed at the last minute, there can be product waste as all disposable items must be discarded and reusable items re-sterilized. USA Rockford Memorial Hospital estimated losses due to contaminated O.R. disposables at US$30,000 per year ($300 per case with 100 teardowns recorded).11

The move to non-latex has associated benefits such as product ordering consolidation, which will bring benefits for the organization including more space in the O.R.

All these changes can significantly minimize the cost difference between NRL and the non-latex alternatives.

If you would like more information please contact your local PEI hospital representative or call PEI at +353 1 4196900.

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