Environmental Contamination from Glove Disposal Practices

Abstract

Purpose: Personal Protective Equipment (PPE) provides a barrier between health professionals and pathogens. Misconceptions related to PPE and its role in environmental contamination, may lead to risky behaviors and/or perceptions in healthcare professionals due to broken barriers of protection. Evidence suggests that doffing and disposal of used PPE can lead to environmental contamination. The purpose of this study was to ascertain the potential for environmental contamination when medical gloves are flung, tossed, or thrown; while using a harmless PR772 bacteriophage and fluorescent dye tracers. The objectives of this study were to 1) measure the overall spread of bacteriophage and fluorescent dye from glove disposal to the surrounding environment; 2) determine the contamination along the glove flight path and the distance from the health professional; and 3) compare the occurrence of bacteriophage and fluorescent dye in the vicinity of glove disposal. Methods: Fifteen Health Professionals flung, tossed, or threw PR772 and fluorescent dye contaminated gloves into a wastebasket, located 1.22 m away. Twenty designated sample areas were set up along the glove flight path, along a wall behind the wastebasket and outside the flight path that represented equipment within a patient room. Following each glove disposal trial, designated Sample Areas were: 1) visually inspected with a blacklight to quantify the fluorescent dye stains and 2) swabbed with a 3M Letheen Broth sponge to quantify PR772. Results: The mean of PR772 contamination from all sample areas was 4.22 log10 PFU/mL. The area closest to the participant (<0.30 m) had the highest PR772 concentrations (mean = 2.61 log10 PFU/mL; range -0.3 to 6.32 log10 PFU/mL). The sample areas within the first 0.61 m of the health professional were statistically higher (p< 0.05) than ≥0.61 m for PR772 and all sample areas, < 0.61 m, were positive for both tracers. Based on the fluorescent dye’s ability to predict the presence absence of viral tracers, it was found to be an appropriate surrogate when used as a teaching tool for PPE disposal scenarios. Conclusion: Among medical personnel, gloves are used every workday and have the potential to contaminate the surrounding surfaces during improper disposal practices. Therefore, proper disposal techniques are required to minimize pathogen transmission. Due to limited education/training, and non-compliance with glove disposal recommendations, health professionals flinging gloves into the wastebasket can contribute significant pathogen contamination within 0.61 m around themselves, with a possibility of contaminating up to 1.52 m. Establishing industry-wide policies, adequate training and education to health professionals on appropriate glove disposal can reduce the spread of microbial contaminants and reduce exposure risks to patients and personnel.