Mayo Clinic Minute: How to use an asthma inhaler

Glove Selection

First: Determine the Hazard

What is the main hazard? Are you concerned with protection from hazardous chemicals, biological materials, radioactive materials, sharp objects, or a combination of these? Also, consider the length of exposure.

Second: Glove Selection

In general nitrile gloves are by far the most common gloves used In research laboratories. Standard latex exam gloves are cheap and do provide protection for biological and aqueous radioactive hazards, but can cause latex allergies in some people. While disposable nitrile gloves do provide protection from some chemical hazards, it is important to know that they do not protect against all chemicals.

Chemical Hazards: Look at glove selection guides listed below. Gloves are rated for degradation, breakthrough, and permeation rates. Choose a glove that provides the best resistance to the chemical being used. For some hazards double gloving may be needed. (For example, now the recommended gloves for dimethyl mercury are a highly resistant laminate glove (Silver-Shield or 4H), which has no abrasion/cut resistance, worn under a pair of long cuffed unsupported neoprene, nitrile, or similar heavy-duty glove.)

Biological Hazards: Protection from biological hazards may be simple or complex dependent on whether the biological material is immersed in something other than water.

Radioactive Hazards: Gloves provide a necessary personal protection barrier and help prevent scatter contamination. Glove selection is based on the carrier material (i.E. Water, toluene, etc.). (Radioiodination procedures require double gloving.)

Sharps Hazards: Chemical compatibility guides may not indicate susceptibility to abrasion or cuts. You will need to check Manufacturer or Supplier for this information.

Combination Hazards: Selection guides normally list gloves by the protection they provide from one "pure" chemical, not a combination. In this case selection should be based on the component with the shortest breakthrough time.

The following guide is a general guide for glove selection in relation to chemicals handled. The information presented here is believed to be accurate; however, we cannot guarantee its accuracy. Many factors affect the breakthrough times of glove materials including, but not limited to:

Thickness of glove material

Concentration of the chemical worked with

Amount of chemical the glove comes in contact with

Length of time which the glove is exposed to the chemical

Temperature at which the work is done

Possibility of abrasion or puncture.

Some Common Sense Rules for Glove Use

Select gloves which are resistant to the chemicals you may be exposed to. Consult the relevant Material Safety Data Sheet (MSDS) which may recommend a particular glove material.

Select gloves of the correct size and fitting; gloves that are too small are uncomfortable and may tear whereas overlarge gloves may interfere with dexterity. In some cases, such as use of HF, it may be advisable to select gloves that can be removed very rapidly in an emergency.

Before use, check gloves (even new ones) for physical damage such as swelling, shrinking, cracking, discoloration, tears or pin holes and for previous chemical damage: this is especially important when dealing with dangerous materials such as HF. Always check out the expiration date and never use expired gloves.

When working, it may be advisable to wash the external surface of the gloves frequently with water.

Some gloves, especially lightweight disposables, may be flammable: keep hands well away from naked flames or other high temperature heat sources.

When removing gloves, do so in a way that avoids the contaminated exterior contacting the skin.

Wash hands after removing gloves.

Dispose of contaminated gloves properly.

Do not attempt to re-use disposable gloves.

Always remove gloves and wash your hands before leaving the laboratory, or when using telephones, computer keyboards, etc.

To summarize, protective gloves are not equally effective for every hazardous chemical. Some chemicals will "break through" the glove material in a very short time. Therefore, glove selection must be based on the specific chemical being used. Glove selection criteria can be found in the following documents:

 

Signs And Symptoms Of Allergies

Some of the most common signs and symptoms of allergies are sneezing, coughing, and itchy eyes. Allergies are caused by the body's immune system mistaking a normally harmless substance as something dangerous, causing an unnecessary reaction.

The substance that causes the reaction is called an allergen. Common allergens include latex, pollen, pet dander, mold, dust mites, insect venom, and certain foods, plants, and medications. Here's what you need to know, including when it's best to see a healthcare provider.

Design by Health

Allergies can be difficult to identify because they can have various symptoms. Some symptoms are common across different allergens, including: Allergies can cause hives, rashes, and trouble breathing in severe cases. Severe allergic reactions can lead to anaphylaxis, a potentially life-threatening condition, if not treated promptly. Some symptoms of allergies can be characteristic of the type of allergen that's triggering the reaction. The different allergens range from certain foods to medications. Food Allergy Food allergies are most common in children, but adults can also have them. It's important to know the signs of a food allergy so you can take steps to stay safe.  Allergies to certain foods tend to run in families. Younger siblings are likely to be allergic to peanuts, for example, if the oldest child has a peanut allergy. You still cannot always predict if you or your child will have an allergy. Any food can cause an allergy. Around 90% of all food allergies come from: Cow's milk and other dairy products Eggs Fish Peanuts Sesame Shellfish (most commonly, crustaceans like shrimp, lobster, and crab, and less commonly, mollusks like scallops, oysters, clams, and mussels) Soy Tree nuts (e.G., almonds, cashews, pecans, pistachios, walnuts, hazelnuts, and Brazil nuts) Wheat Food allergy reactions can affect the gut, heart and blood vessels, lungs, or skin. Common symptoms include: A swollen tongue Frequent cough Hives (urticaria), or a rash characterized by itchy bumps called wheels Stomach cramps Vomiting Wheezing, or a whistling sound when breathing These are not all the symptoms that can occur. Reactions can occur within several hours of ingestion, and many times, they occur within minutes. Everyone's reaction to a food allergy is different. It's important to see an allergist (who specializes in allergic conditions) for proper diagnosis and treatment if you think you or your child may have a food allergy.  Environmental Allergy Allergens that arise from your everyday surroundings can cause environmental allergies. These include: Animal dander: This is made up of dead skin cells found in fur or feathers. Household pets like cats or dogs can be a common source of dander. Washing your pet, reducing contact, and washing your hands after petting them can help reduce symptoms. Cockroaches: These insects thrive in damp, dark places with food waste. Cockroach feces is the main allergen that can lead to allergies. Keeping an indoor space free of excess moisture and uncovered food can reduce cockroach infestations, along with hiring an exterminator if needed. Dust mites: These are microscopic bugs that live in dust. The fecal matter of dust mites contains a type of digestive protein called peptidase 1, which is the main allergen. Dust mites can travel through indoor air and trigger an allergy. Mold: Not all types of mold can lead to allergy. Some people may be allergic to certain molds found in damp indoor places such as basements, bathrooms, and around windows. Common types of mold that could trigger an allergy include Alternaria, Aspergillus, Cladosporium, and Penicillium. Pollen: Grass, trees, and weeds produce pollen, which can circulate in the air at varying levels throughout the seasons. You will likely have common allergy symptoms if you have an allergy to one of these. Some people may also have: Itchiness in the nose, mouth, or throat Mucus in the throat, particularly for mold allergies Nasal and sinus congestion Rash Watery or burning eyes Latex Allergy Latex, also called natural rubber latex, is a flexible material made from the sap of rubber trees known as Hevea brasiliensis. Some gloves, bandages, and other items may be made from latex. Certain proteins in natural rubber can trigger a latex allergy. An allergic reaction can happen when latex makes direct contact with your skin, is inhaled from latex particles in the air, or comes into contact with mucus membranes, like your mouth or eyes. People with allergies to latex can either have an immediate reaction or a delayed skin reaction. Common latex allergy symptoms usually include: Itching or swelling of your mouth or tongue after a dental exam involving latex gloves Itchy or swollen skin after contact with a latex bandage, gloves, condom, or vaginal diaphragm  Red, swollen lips after blowing up a balloon Severe allergic reactions to latex can cause additional symptoms, such as: Hives Red, swollen, pain, or blurry vision in the eyes (eye inflammation) Runny nose and sneezing Trouble breathing Using certain products can help reduce the likelihood of latex allergies. Look for ones labeled "not made with natural rubber latex." Insect Allergy Insect allergies can cause a range of symptoms, depending on the severity of the allergic reaction and the type of insect. Insect stings contain venom, for example, which can trigger an allergy in some people. Common culprits of insect sting allergies are bees, wasps, hornets, and fire ants. Bites, such as those from mosquitoes, bed bugs, and fleas, can trigger other allergies. Insect bites or stings can cause common symptoms like pain, stinging, redness, and mild swelling around the affected area.  You might have more severe symptoms like difficulty breathing, swelling, and nausea if you're seriously allergic to insect stings or bites. Severe symptoms are typically more common after insect stings and are considered rare for insect bites. Medication Allergy Antibiotics, or drugs used to treat bacterial and some fungal infections, are commonly reported with drug allergies. Only about 2% of reported drug allergies at hospitals tend to be allergic reactions. Some people might develop side effects from a drug or complications from a current infection. Penicillin, a type of antibiotic, is one of the most widely reported drug allergies, with up to 10% of people claiming they're allergic. Less than 1% of the general population actually turns out to be allergic when tested. Medication allergies can range from mild to severe and life-threatening. Some symptoms may include: Abdominal pain Coughing Diarrhea Hives Itching Swollen eyes or lips Trouble breathing Vomiting Allergies can be very serious and even life-threatening in some cases. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can affect several organs in your body. Symptoms can develop quickly and may include: Difficulty breathing Dizziness Faintness Hives Nausea Swelling of the face, tongue, and throat Wheezing Get help right away and call 911 for anaphylaxis, even if you use epinephrine. Anaphylaxis needs to be treated promptly with a shot of epinephrine, or a hormone that's also called adrenaline. This treatment is highly effective at slowing or stopping an allergic reaction and can be life-saving. You might be tempted to self-diagnose your allergy symptoms, but it's important that you see an allergist if you have any concerns. Allergists know how to best diagnose and treat allergies and can provide you with better insight into the root cause of your symptoms. Ask a healthcare provider for help if your allergies are not getting better or are worsening. Reach out to an allergist if you have sudden symptoms you can't explain or if your symptoms last more than a week for a diagnosis and treatment plan. Talk to a healthcare provider about getting epinephrine auto-injectors for a history of allergies. Allergens that more commonly lead to anaphylaxis include peanuts, tree nuts, fish, crustacean shellfish (e.G., shrimp, lobster, or crab), fish, insect stings, and latex. You can still be at risk of anaphylaxis even if you have a history of mild allergic reactions. You are at high risk of anaphylaxis if you have a history of severe allergic reactions to a known allergen. An allergist can show you how to administer an epinephrine auto-injector in case of an emergency. Common allergy signs and symptoms may include red and itchy eyes, sneezing, coughing, runny nose, and skin rashes. More severe reactions, such as difficulty breathing, tightness in the throat or chest, and fainting, require immediate care. See a healthcare provider right away for a proper diagnosis if you experience any of these signs or symptoms after contact with a certain food, substance, or other allergen. They can also assist you with the right treatment plan.

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Allergies To Dental Materials

Suspected allergies in dentistry should be confirmed by an allergy test conducted by a dermatologist or allergist, due to the potential for a life threatening allergic reaction or the development of a long-term occupational disability. When an allergy test to a certain dental material is found to be positive, the dental team should take appropriate precautions to eliminate the use of the offending allergen by using alternative materials, for example, latex-free gloves or nickel-free alloys.

Research demonstrates that there are numerous potential allergens in everyday dental practice. However, currently there is not enough evidence to indicate that use of popular dental materials should be discontinued. Nevertheless, the dental team should remain vigilant and acutely aware of the potential of the many available dental materials and products to cause allergic hypersensitivity within the mild to severe range, both intra-orally and at unrelated parts of the body. Materials that warrant particular awareness include latex, nickel, methacrylate, eugenol and polyether impression materials.

References available from the author on wiltshir@cc.Umanitoba.Ca.

Box 1: Test yourself

1. What proportion of orthodontic patients with pierced ears is allergic to nickel?

A. 60% B. 20% C. 30%

2. When did latex allergy become more common?

A. 21st century B. 1980s C. 1940s

3. A Type IV reaction is:

A. Delayed B. Immediate C. Fatal

ANSWERS: 1C, 2B, 3A.

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