How do medical gloves affect manual performance? Evaluation of ergonomic indicators
Introduction
In almost all industrial tasks, the use of gloves is essential to protect the hands against such factors as sharp edges of tools, extremely cold or hot environments, and chemical and microbial agents (Aliabadi et al., 2014). Medical gloves have been considered a barrier that can prevent the transmission of microorganisms between healthcare workers and patients (Goldman et al., 2016). Therefore, the main consideration in glove evaluation has rightly been barrier integrity. However, it seems that manual performance is affected by gloves and this effect has been recently begun to be explored (Shih et al., 2001).
Numerous studies have been conducted on the effect of gloves on task performance (Gnaneswaran et al., 2008; Mylon et al., 2016a; Wells et al., 2010; Cabeças and Milho, 2011). The findings on industrial and other gloves have been clear, revealing a decrease in strength and other performances. However, the results with thin gauge gloves like medical ones have not been consistent. For example, Branson et al. measured hand dexterity performance and reported that manual dexterity was not affected by medical gloves (Branson et al., 1988). Moreover, Mylon et al. used two different pegboard tests to evaluate medical gloves. The results showed a significant loss of dexterity when donning gloves compared to bare hand performance (Mylon et al., 2016b). Johnson et al. also studied the tactile performance of five different types of medical gloves. There were statistically significant differences in touch sensitivity for all nerve distributions, with all glove types resulting in less sensitivity compared to a bare hand (Johnson et al., 2013). Furthermore, Moore evaluated the tactile sensitivity of latex gloves, and indicated that latex gloves did not affect tactility (Moore, 1994).
The effect of using gloves on grip strength is relatively constant as gloves reduce the strength (Buhman et al., 2000). This reduction is a feature associated with the glove material properties (Cochran et al., 1988; Larivière et al., 2004). The decrease in grip strength has been justified by the fact that gloves reduce the pressure between the fingers and change the feedback from the hands and fingers (Batra et al., 1994). However, the effect of gloves on torque has not been fully understood; some studies have shown improved performance (increased torque), while some others have shown reduced performance (reduced torque) (MITAL et al., 1994; Shih and Wang, 1996). The key question is why performance changes when using gloves. One answer may be that gloves reduce the range of motion capabilities, reduce touch sensitivity, and increase the effective size of objects for grip (Mylon et al., 2017). The decrease in motor ability and tactile sensitivity is expected to be affected by the appropriate size of the gloves, the mechanical properties of the gloves, and the characteristics of their constituents (Mylon et al., 2016b).
One thing that all clinical staff agree on is that performance affects safety. Gloves with undesirable friction properties increase the likelihood of tool slipping and the incidence of error when performing sensitive tasks. The stress levels are also likely to increase when trying to make up for a mistake. Moreover, people who cannot feel the underlying bumps while wearing gloves are less likely to wear gloves and be at risk of infection (Mylon, 2012). Another important issue is the mental and subjective dimensions of performance that should be considered. In this context, the clinical staff's convenience may affect their concentration and consequently their ability to perform different tasks over time.
In summary, the decrease in manual function due to wearing medical gloves is very important among medical staff. The ergonomic indicators of manual performance should be sufficient to provide appropriate performance for individuals since hospital tasks such as medical examination, finding a pulse, inserting a needle into vessels, suturing, working with surgical razors and sharp tools, and using scissors and syringes are very sensitive and too risky. If the tools and the protective equipment used by healthcare workers (including medical gloves) fail to provide good manual function, it can put a person at risk. On the other hand, errors due to improper manual performance of healthcare workers can endanger patients’ safety. Furthermore, studies that have measured performance effects of thin gauge gloves have not reported consistent results. Therefore, the present study aims to assess the effects of medical gloves on human hand performance and the related ergonomic indicators.
Section snippets
Method
The present cross-sectional study was performed on the medical staff of a hospital in Shiraz, south of Iran in 2019. According to the previous studies, a suitable sample size of 40 was considered (Mylon et al., 2016a; Allahyari et al., 2014; Hatzfeld et al., 2018). Each participant was compared to oneself in different situations. The participants had to be generally healthy and suffer from no known sensorimotor deficiencies. The participants participated in the experiments voluntarily and
Results
This study was conducted on 40 right-handed female hospital clinical staff with the mean age (SD) of 27.35 (2.36) years and the mean work experience (SD) of 8.1 (1.83) years. The results of the tests for various ergonomic indicators are as follows:
Discussion
In the present study, ergonomic indices including manual dexterity, tactile sensitivity, and grip strength were investigated using validated tests. The results were in line with those of the previous studies (Mylon et al. (2016b) and Moore (1994)), which found that ungloved manual performance was significantly better compared to gloved performance. However, gloves had different effects on ergonomic indicators.
Performing a task quickly and correctly is an important skill in clinical practice
Conclusion
The ergonomic features related to manual performance, including manual dexterity, tactile sensitivity, and grip strength, were quantitatively examined in the present study. Despite reducing the quantity of these indicators, single gloves were generally more acceptable in comparison to double gloves or inappropriate size gloves. Another important point was that double gloves had a significantly negative impact on touch sensitivity and the participants preferred not to use this type of gloves in
Author statement
Asma Zare: Methodology, Formal analysis, Investigation, Resources, Writing – original draft, Writing – review & editing. Alireza Choobineh: Conceptualization, Methodology, Supervision, Project administration, Funding acquisition. Mehdi Jahangiri: Writing – review & editing, Visualization, Formal analysis, Mahdi Malakoutikhah: Validation, Formal analysis
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgment
This work was supported by the National Institute for Medical Research Development (NIMAD) under grant number 982754. Hereby, the authors would like to acknowledge the support and assistance provided by all participants. They would also like to thank Ms. A. Keivanshekouh at the Research Improvement Center of Shiraz University of Medical Sciences for improving the use of English in the manuscript.
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