FEATURE ARTICLE — November 1999
THE DANGERS OF LATEX GLOVES
By Pat Fish
A potential threat to the health of all working tattoo artists lurks in latex gloves; the very item we now think of as our first line of defense against cross-contamination with blood borne diseases. When I began my tattoo career 15 years ago, I was immediately instructed in the sterile field concept and the many ways that a tattoo artist must maintain constant vigilance in their working environment. My mentor, Cliff Raven, was ahead of his time in his awareness of medical concepts, and, as a result, wearing gloves has always been a part of my tattoo experience. It is important to note how recently latex gloves have become a part of tattooing and how ubiquitous their presence is now. Practically every conscientious tattoo artist or piercer uses them. And so did I. But, after five years or so, I started to notice that I would get a rash on the back of my hands if I used latex gloves for long hours in hot weather. This is called contact dermatitis, caused by direct contact with an irritant. These little bumps are called comedomes, and, if scratched, they become tiny open sores; perfect portals for the entry of a virus. When I learned that Vaseline (commonly used to maintain the stencil on the skin) is capable of breaking down the latex, causing it to become porous (which is why they advise NOT to use petroleum products with latex condoms), I started changing gloves every 20 minutes and making sure I let my hands cool off in between.
Eventually, I started hearing rumors of latex allergy, which I heard was caused by the powder in the gloves. So, at a cost almost double that of powdered gloves, I switched to powder-free latex, marketed for the electronics clean room industry. Things were fine for the next decade or so. No rashes, except I did notice that I coughed when I ate kiwi fruit, which is said to be an indicator of increasing sensitivity to latex. I figured, okay, how often do I eat kiwi? Then, this last February I worked at the Mad Hatter's Tea Party in Portland, Maine, one of my favorite conventions. I worked a very intense three-day event in a room full of artists and fans, and immediately afterwards I developed a weird, barking cough. At the time, I thought it was some sort of virus or fungus I'd caught on the flight in. I laughed with my friends about how the airlines never change the filters in the planes, and that we are all lucky not to get Legionnaire's disease when we fly. But the cough didn't go away, and it developed into something that felt like asthma. I was running on reduced oxygen, feeling like I was pre-pneumonial, and very tired all the time. Then one day, it hit me: Maybe I had developed a latex allergy. I went to my Macintosh and spent the next three nights reading many of the over 1,000 Web sites devoted to and discussing latex allergy. What I found out scared me a lot, and I am writing this article not as a medical expert but as a person who is immediately affected—to warn the rest of the profession that this problem is waiting to affect us all.
My theory is that working in that room where most of the artists were using powdered gloves pushed me over a chemical-toxicity limit and caused me to develop a greater sensitivity to latex than I had previously experienced. On one Web site I saw a photograph of a powdered glove being taken off, and the lighting is arranged to show the three-feet-across cloud of powder filling the air around it. It is barely visible to us under normal circumstances, but it is a real problem. The powder in the gloves had bonded to proteins in the latex, and, once they are airborne, they go into the lungs. This is how the allergic reaction develops. Once enough of this protein-bonded powder gets inhaled, it causes the body to develop immunities, and the response is like asthma or a hay fever allergy. But it doesn't stop there. If exposure to the allergen continues, the reaction becomes more severe. Several of the Web sites are dedicated to the memory of doctors and nurses who have dropped dead of heart attacks or anaphylactic shock because of this. Many medical professionals have had to leave their chosen careers because of it and cannot even enter a hospital. Many wear Medic-Alert bracelets warning of latex allergy, because, if emergency treatment is given (say, after a car crash) with a latex tube for intravenous fluids, they could go into shock and die.
Scared yet? How about not being able to be in rooms with freshly painted latex paint walls or to never again touch a rubber band? The average home or workplace is filled with things made from natural rubber latex, a fascinating substance whose discovery led to a host of products utilizing the unique qualities of this natural polymer (a chain of molecules that can be stretched out and then retain its shape). You can see that this can get serious. Working around latex, once you have the allergy, could have disastrous consequences. And latex-free living could get very confining. No elastic in underwear! No pencil erasers! Think about it. Fortunately there is a way to use an alternative product in the tattoo studio, and I am very pleased to say that within a week of converting my shop over to nitrile gloves, a synthetic polymer, all my symptoms are gone. My employee, Andreas Gutow, had been experiencing mild breathing problems and chest constriction for years, but hadn't really thought it was work-related. He also noticed the difference as soon as we switched to nitrile. The symptoms vanished.
Nitrile was developed many years ago, but, until just a few months ago, a patent made it the closely held product of only one supplier. The cost was prohibitive, and, as a result, few artists have experimented with it. Nitrile gloves are commonly blue or white. You may have seen a trendy few at conventions wearing them and wondered if this was a fashion preference. I predict they are going to be an important key to the preservation of many careers that could otherwise be cut short.
I e-mailed 40 companies who listed themselves as suppliers of nitrile. I asked them all for samples. (A breakdown follows that shows the results of my small bit of consumer testing.) Then I bought a case from my usual glove supplier, Jeff of J.W. Distributors, who accepted back for trade my two cases of powder-free latex that I had in the shop. He is very knowledgeable about the inside workings of the glove industry, including the worldwide trading frenzy involving Malaysian raw materials, production and international supply routes. I sorted through the Web and got a deeper understanding of the problem. It seems that, since the advent of AIDS, the worldwide demand for latex gloves has skyrocketed, but not all the factories overseas keep to the medical-grade standards of production that are crucially necessary. Some companies do not thoroughly rinse the latex gloves during manufacture, generating even more proteins on the surface. These cheaper gloves will quickly bring on an allergic reaction. If they use a cheap grade of powder, ditto. It is these same companies that are now switching to the production of nitrile gloves. They have the factories in place, the technology is similar, and, most importantly, they have the international distribution routes. Quite often, gloves are brought in from Malaysia in containers on cargo ships. Hopefully, they are inside the ship as it makes the 40-day journey across hot tropical seas. If the container is on the top deck, entire cases of gloves can be damaged through overheating. The mystery of why some batches of gloves break easily or stick together is solved.
It is quoted on numerous Web sites that 18% of the medical personnel in America is now experiencing some form of latex allergy. Johns Hopkins University Teaching Medical Center will soon become the first hospital to go completely latex-free. Ask any nurse or doctor, they will tell you personal stories of coworkers and patients being affected. For me, I feel extremely lucky to have had the flash of inspiration to self-diagnose this in time, and also that the cost of nitrile gloves has dropped to a manageable price (just double that of latex). I consider it a small price to pay to continue in the occupation I love. But I won't be working any more conventions, because I can't risk a recurrence of another major sensitizing event. I can't afford to get any more allergic. As much as I don't want to make myself into the poster child for this problem, informing my fellow tattoo artists of this very real threat to their continued ability to remain within this industry is very important to me. If this article saves a few people some illness and allows them to continue their work, I've done my bit.
Here are the URLs for the two best latex allergy information Web sites:
Latex Allergy Education Services: http://www.latexallergyrn.com/laes.html
Understanding Latex Allergy and Glove Chemistry: http://www.Immune.com/allergy/rubber/nr3.html
NITRILE GLOVE COMPARISON
I e-mailed all 40 distributors of gloves who have a Web site listing nitrile glove availability (using the <www.dogpile.com> search engine) with this message:
"I am a tattoo artist experiencing the first symptoms of latex allergy. I would like to receive samples of size XL powder free nitrile gloves."
I received nine envelopes of samples. I have listed them in alphabetical order.
SUPPLIER: AMIS International Enterprises Inc.
LOCATION: San Carlos, California
PHONE NUMBER: (650) 802-2899
WEB SITE: http://www.amis-intl.com
Brand name sent: Health+Aid
Number of sample gloves sent: 4
Correct size sent?: Yes
Other type glove sent: No
Mil thickness: 4.0 mil
Textured fingertips?: Yes
Overall fit: Good
Color: Blue
Country of origin: Malaysia
Labeled EXAM grade: Yes
Price per box of 100: $10.50
Comment: Okay
SUPPLIER: Braintree Scientific, Inc.
LOCATION: Braintree, Massachusetts
PHONE NUMBER: (781) 843-2202
WEB SITE: http://www.braintreesci.com
Brand name sent: N-Dex
Number of sample gloves sent: 4
Correct size sent?: Said not available in XL
Other type glove sent: No
Mil thickness: 4.0 mil, felt too thin, unfinished cuff
Textured fingertips?: No
Pverall fit: N/A
Color: Blue
Country of origin: USA
Labeled EXAM grade: No
Price per box of 100: $19.50
Comment: I prefer XL
SUPPLIER: Conney Safety Products Inc.
LOCATION: Madison, Wisconsin
PHONE NUMBER: (800) 356-9100
WEB SITE: http://www.conney.com
Brand name sent: N-Dex and Ultimate N-Dex
Number of sample gloves sent: 8
Correct size sent?: Yes, in both 9.5-inch and 11-inch lengths
Other type glove sent: No
Mil thickness: Two thicknesses; 4.0 mil and 6.0. Thicker is better
Textured fingertips?: No
Overall fit: Too tight, felt like balloons, unfinished cuff
Color: Blue
Country of origin: USA
Labeled EXAM grade: No
Price per box of 100: $26.15
Comment: One ripped pulling it on
SUPPLIER: Dover Medical
LOCATION: Medfield, Massachusetts
PHONE NUMBER: (800) 600-3158
WEB SITE: http://www.dovermed.com
Brand name sent: Health+Aid
Number of sample gloves sent: 8
Correct size sent?: Yes
Other type glove sent: No
Mil thickness: 4.0
Textured fingertips?: Yes
Overall fit: Good
Color: Blue
Country of origin: Malaysia
Labeled EXAM grade: No
Price per box of 100: $11.20
Comment: Okay
SUPPLIER: J.W. Distribution
LOCATION: Foothill Ranch, California
PHONE NUMBER: (800) 938-9500
WEB SITE: http://www.jwdistribution.com
Brand name sent: Alpine
Number of sample gloves sent: 12
Correct size sent?: Yes
Other type glove sent: Powdered nitrile
Mil thickness: 4.0 mil
Textured fingertips?: Yes
Overall fit: Excellent, fingers snug and hand looser
Color: Blue
Country of origin: Malaysia
Labeled EXAM grade: Yes
Price per box of 100: $12.50
Comment: My personal preference
SUPPLIER: Ohio Latex/Chagrin Safety Supply
LOCATION: Hollywood, Florida
PHONE NUMBER: (888) 227-0468
WEB SITE: http://www.ohio-latex.com
Brand name sent: N/A
Number of sample gloves sent: 8
Correct size sent?: Yes
Other type glove sent: Vinyl stretch elastomer
Mil thickness: Thin
Textured fingertips?: No
Overall fit: Too tight
Color: Blue
Country of origin: China
Labeled EXAM grade: Yes
Price per box of 100: $15.50
Comment: Poor fit
SUPPLIER: Pine Environmental Services
LOCATION: Cranbury, New Jersey
PHONE NUMBER: (800) 301-9663
WEB SITE: http://www.pine-environmental.com
Brand name sent: Best
Number of sample gloves sent: 4
Correct size sent?: No. Sent size small, powdered
Other type glove sent: No
Mil thickness: 4 mil
Textured fingertips?: No
Overall fit: N/A
Color: Blue
Country of origin: USA
Labeled EXAM grade: No
Price per box of 100: $18
Comment: One sample had a hole, one was torn
SUPPLIER: Quantum Labs Inc.
LOCATION: Minneapolis, Minnesota
PHONE NUMBER: (800) 328-8213
WEB SITE: http://www.quantumlabs.com
Brand name sent: Kid Gloves Nitrile
Number of sample gloves sent: 8
Correct size sent?: Yes
Other type glove sent: Powdered nitrile
Mil thickness: 4.5 mil
Textured fingertips?: Yes
Overall fit: Excellent snug fit down to the cuff
Color: White
Country of origin: Indonesia
Labeled EXAM grade: Yes (supplied OSHA MSDS data)
Price per box of 100: $10.95
Comment: Supplied info about latex allergy
SUPPLIER: Shamrock Marketing Co. Inc
LOCATION: City of Industry, California
PHONE NUMBER: (888) 680-4762
WEB SITE: http://www.smcgloves.com
Brand name sent: Shamrock
Number of sample gloves sent: 10
Correct size sent?: Yes
Other type glove sent: Synthetic PVC
Mil thickness: 4.0 mil
Textured fingertips?: Yes
Overall fit: A little too tight
Color: Blue
Country of origin: Indonesia
Labeled EXAM grade: Medical grade (sent MSDS specifications)
Price per box of 100: ? / minimum of 12 cases
Comment: Sells only to distributors
—Pat Fish
Tattoo Santa Barbara
Santa Barbara, California