A study of clinicians' views on medical gloves size in Iran: A challenge and solutions

Mehdi Jahangiri; Alireza Choobineh; Mina Salehi; Asma Zare

doi:10.4103/iahs.iahs_153_20

ORIGINAL ARTICLE

Year : 2021 | Volume : 8 | Issue : 1 | Page : 20-23

A study of clinicians' views on medical gloves size in Iran: A challenge and solutions

Mehdi Jahangiri¹ , Alireza Choobineh², Mina Salehi³, Asma Zare⁴
¹ Department of Occupational Health Engineering, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
² Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
³ Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
⁴ Department of Occupational Health Engineering, Student Research Committee, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

Date of Submission	07-Dec-2020
Date of Decision	02-Jan-2021
Date of Acceptance	03-Jan-2021
Date of Web Publication	31-Mar-2021

Correspondence Address:
Dr. Asma Zare
Department of Occupational Health Engineering, Student Research Committee, School of Health, Shiraz University of Medical Sciences, Shiraz, P. O. Box: 71645-11
Iran

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/iahs.iahs_153_20

Abstract

Aims: Glove fitting is an essential factor that affects health-care workers' performance. This study aimed to evaluate health-care workers' opinion about medical gloves fitting. Materials and Methods: This study was conducted on 525 health-care workers in the hospitals of five cities in Iran (response rate was 95.45%). The Medical Gloves Assessment Tool was used for collecting the required data. The data were analyzed using the SPSS 22 software. Results: The results showed that the health-care workers were not satisfied with the size of medical gloves in different areas of fingertips, between fingers, and the wrist. Accordingly, more than 70% of the participants were <50% satisfied with medical gloves fitting. Conclusion: Due to the importance of medical gloves fitting and the lack of sufficient information in this field, it is necessary to check the compatibility of hand dimensions of the Iranian health-care workers with the existing glove size systems. If necessary, a glove sizing system should be developed based on the anthropometric dimensions of health-care workers in Iran.

Keywords: Fitting, health-care workers, medical glove, size

How to cite this article:
Jahangiri M, Choobineh A, Salehi M, Zare A. A study of clinicians' views on medical gloves size in Iran: A challenge and solutions. Int Arch Health Sci 2021;8:20-3

How to cite this URL:
Jahangiri M, Choobineh A, Salehi M, Zare A. A study of clinicians' views on medical gloves size in Iran: A challenge and solutions. Int Arch Health Sci [serial online] 2021 [cited 2021 Apr 18];8:20-3. Available from: http://www.iahs.kaums.ac.ir/text.asp?2021/8/1/20/312705

Introduction

An essential glove design feature that affects performance is fitting to hand dimensions.^[1],[2],[3] The undesirable size of protective gloves not only reduces the performance of this equipment in protecting the user but it may also cause the person to reduce or even eliminate its use. The large size and width of the glove are one of the most common problems in designing gloves in delicate jobs.^[4] If the glove is large or loose, the person may experience a decrease in hand skills and grasping ability.^[5],[6] Not wearing gloves is as important as wearing gloves for safety. Evidence has indicated that 70% of hand injuries reported by industrial workers occurred when gloves were not used.^[6] Nonfitting of gloves may encourage people not to use them.

Glove sizing systems (GSS) are used to determine the appropriate glove size based on hand dimensions obtained from large anthropometric studies.^[7] For example, Kwon et al. identified hand length and hand circumference as the key dimensions for glove-sizing systems.^[8] Lee et al. also used these two dimensions in their proposal to improve the coverage rate of a glove-sizing system.^[9] In fact, manufacturers typically use one or at most two dimensions among hand length, hand circumference, and handbreadth,^[9] and hand length and breadth are the most usual dimensions employed as the relevant metrics for designing gloves.^[10]

European standards,^[11] International Organization for Standardization (ISO) standard for medical examination gloves (ISO 11193-1), and American Society for Testing and Materials (D 3578) have provided dimensions for different glove sizes.^[12],[13] In Iran, the dimensions presented in the ISO standard have been accepted as the standard ones.^[14] However, no study has examined whether these dimensions are suitable for the Iranian society or not. Due to the importance of the issue and the lack of reviews on the size of gloves available in Iranian hospitals, the present study aims to explore health-care workers' opinions about the size of medical gloves.

Materials and Methods

Study design and participants

This is a cross-sectional study that was conducted in five cities of Iran including Shiraz, Tehran, Isfahan, Tabriz, and Ahwaz. Using convenience sampling, 550 health-care workers were selected from 10 hospitals. As the study instrument was an electronic questionnaire, the nurses responded to the questionnaire if they had access to the electronic platform. Furthermore, the incomplete questionnaires were excluded from the study.

To prevent the COVID-19 outbreak through droplets and contact, online software was used to design an electronic web-based questionnaire for collecting the data. The questionnaire was available to the participants through social media. The questionnaire was divided into two different parts, the first of which included the participants' demographic data (sex, age, education level, and work experience). The Medical Glove Assessment Tool developed by Zare et al. was used for evaluating health-care workers' opinions regarding the size of medical gloves in the second part of the survey.^[15] This tool has six domains including tactile sensation, dexterity, grip strength, fitting, reliability, and hand hygiene. The Cronbach's alpha coefficient was 0.82. The fitting domain of the tool was used for this study. The participants were asked to present their opinions on a five-point Likert scale receiving 0, 1, 2, 3, or 4 scores (0 means 0% and 4 means 100% satisfaction). It should be noted that the participants were asked to answer questions about the most appropriate size of the gloves they used.

Participation in this study was voluntary. The consent we obtained from study participants was written. The consent was placed at the beginning of the web-based questionnaire. If the participants chose the “I agree” option, they would enter the first part of the questionnaire.

Data analysis

The data were analyzed using the SPSS 22 software (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp). Descriptive statistics were used to describe the quantitative and categorical variables. Continuous variables were expressed as mean ± standard deviation (SD). The data set was checked for normality using the Shapiro–Wilk test. Then, ANOVA and t-test at the 0.05 significance level were used to compare differences between the study groups.

Results

Out of 550 questionnaires sent to the participants, 525 questionnaires were completed (the response rate was 95.45%). Out of the 525 respondents, 380 (72.38%) were female. The mean (SD) age and work experience of the participants were 36.42 (5.31) and 9.83 (6.17) years, respectively. Concerning the education level, 21 participants (4%) had high school diplomas or lower degrees, more than half of them (71%) had associate's or bachelor's degrees, and 25% had master's degrees.

The participants' self-report opinions about the medical gloves size are presented in [Table 1]. Accordingly, the scores of different aspects of glove size were <2 (<50% satisfaction). More than 55% of the participants did not have access to different sizes and had to choose gloves from a limited number of sizes. The percentage of the participants' general satisfaction with medical gloves size is depicted in [Figure 1]. As seen, 23.2% of the participant were not satisfied with the size of medical gloves and 72.4% of the scores were <2 (<50% satisfaction).

Table 1: The participant's mean scores to medical gloves size

Click here to view

Figure 1: The percentage of the participants' general satisfaction with the medical gloves size

Click here to view

The results revealed no significant differences between the participants with different education levels ( P = 0.882), job titles ( P = 0.778), ages ( P = 0.061), job experiences ( P = 0.370), and sexes ( P = 0.448) regarding satisfaction with gloves size. Therefore, the demographic characteristics of the study population had no confounding effect on the participants' views.

Discussion

The study results indicated that the Iranian health-care workers were not generally satisfied with the medical gloves fitting in different areas of fingertips, between the fingers, and the wrist. Accordingly, more than 70% of the health-care workers are <50% satisfied with the size of medical gloves. Moreover, almost half of the health-care workers did not have access to different sizes and had to choose gloves from limited sizes, which led to risks associated with unsuitable equipment size and a negative attitude toward the use of personal protective equipment from the public's viewpoint.^[16],[17]

Dissatisfaction with the size of protective gloves has been investigated in limited studies. The National Institute for Occupational Safety and Health conducted a study in 2014 and found that 30% of male and 62% of female American firefighters were dissatisfied with the loose and ill-fitted fire gloves.^[5] In the present study, however, gender did not have a significant effect on satisfaction with gloves size and males were just as dissatisfied with the unsuitable size of the medical gloves as females, which could be due to the differences in the nature and function of the two types of gloves. In another study by Mylon et al., health-care workers in British hospitals complained about the size of medical gloves. The participants reported that their manual dexterity decreased due to the unsuitable size and that they preferred to remove gloves when performing certain tasks, such as finding a pulse, which could increase the risk of transmission of infection and microbial agents.^[18],[19]

Given the dissatisfaction of a large number of health-care workers with the size of medical gloves, the lack of a complete range of gloves sizes in Iran, and the results of several studies reporting significant differences in anthropometric dimensions of hands in different communities,^{[20],[21],[22]} it seems that the use of global sizing systems for different societies, including Iran, is not correct. As in some countries such as South Korea,^[8],[9] the United States,^[5],[23] Japan,^[24] and Spain,^[25] efforts have been made to develop separate systems for determining the size of gloves.

Conclusion

Based on the findings of the present study, the importance of medical safety gloves fitting with the hand dimensions, and the lack of sufficient information in this regard, it is necessary to examine the compatibility of hand dimensions with the existing GSS in the Iranian clinical community. If necessary, a glove sizing system should be developed based on the anthropometric dimensions of health-care workers in Iran.

Acknowledgments

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.

Financial support and sponsorship

This article was extracted from a dissertation written by Asma Zare, Ph.D. candidate of Occupational Health Engineering, and was financially supported by Shiraz University of Medical Sciences, Shiraz, Iran (No. 20843).

Conflicts of interest

There are no conflicts of interest.

References

1.	Zschernack S, Stack J. The Effect of Glove Fit on Task Performance. In: Advances in Human Factors, Ergonomics, and Safety in Manufacturing and Service Industries. Rhodes University, South Africa: CRC Press; 2010. p. 141-9.
2.	Zare A, Choobineh A, Jahangiri M, Malakoutikhah M. How do medical gloves affect manual performance? Evaluation of ergonomic indicators. Int J Ind Ergon 2020;81:1-8.
3.	Mirzaei Aliabadi M, Naderi G, Shahtaheri SJ, Forushani AR, Mohammadfam I, Jahangiri M. Transport properties of carboxylated nitrile butadiene rubber (XNBR)-nanoclay composites; a promising material for protective gloves in occupational exposures. J Environ Health Sci Eng 2014;12:51.
4.	Dianat I, Haslegrave CM, Stedmon AW. Design options for improving protective gloves for industrial assembly work. Appl Ergon 2014;45:1208-17.
5.	Hsiao H, Whitestone J, Kau TY, Hildreth B. Firefighter hand anthropometry and structural glove sizing: A new perspective. Hum Factors 2015;57:1359-77.
6.	Torrens G, Campbell I, Tutton W. Design issues in military footwear and handwear. In: Advances in Military Textiles and Personal Equipment. Woodhead Publishing: Elsevier; 2012. p. 139-64.
7.	Robinette KM, Daanen H, Paquet E, editors. The CAESAR Project: A 3-D Surface Anthropometry Survey. Second International Conference on 3-D Digital Imaging and Modeling (Cat No PR00062). Institute of Electrical and Electronics Engineers; 1999.
8.	Kwon O, Jung K, You H, Kim HE. Determination of key dimensions for a glove sizing system by analyzing the relationships between hand dimensions. Appl Ergon 2009;40:762-6.
9.	Lee C, Mo J, Shin S, Lee K. The grid rotation method and its application to the glove sizing system. Hum Factors Ergon Manuf Ser Ind 2015;25:58-65.
10.	Jee SC, Yun MH. An anthropometric survey of Korean hand and hand shape types. Int J Ind Ergon 2016;53:10-8.
11.	EN 420: Protective Gloves. General requirements and test methods, European Committee for Standardization (ECS); 2003. www.en-standard.eu.
12.	ISO. ISO 11193-1: Single-Use Medical Examination Gloves. Specification for Gloves Made from Rubber Latex or Rubber Solution. ISO; 2008.
13.	ASTM. Standard Specification for Rubber General Purpose. Household or Beautician Gloves. West Conshohocken: ASTM International; 2015.
14.	Iran IoSaIRo. ISIRI 9552-1: Single-use Medical Examination Gloves-Part 1: Specifications for Gloves Made from Rubber Latex or Rubber Solution. Iran IoSaIRo; 2009.
15.	Zare A, Choobineh A, Mokarami H, Jahangiri M. The Medical Gloves Assessment Tool (MGAT): Developing and validating a quantitative tool for assessing the safety and ergonomic features related to medical gloves. J Nurs Manag 2020;1:1-11.
16.	Flynn MA, Keller B, DeLaney SC. Promotion of alternative-sized personal protective equipment. J Safety Res 2017;63:43-6.
17.	Rose A, Rae WI. Personal protective equipment availability and utilization among interventionalists. Saf Health Work 2019;10:166-71.
18.	Mylon P, Lewis R, Carré MJ, Martin N, Brown S. A study of clinicians' views on medical gloves and their effect on manual performance. Am J Infect Control 2014;42:48-54.
19.	Manhart J, Hausberger A, Maroh B, Holzner A, Schaller R, Kern W, et al. Tribological characteristics of medical gloves in contact with human skin and skin equivalents. Polym Test 2020;82:1-7.
20.	Oviedo-Trespalacios O, Martínez Buelvas L, Hernández J, Escobar J. Hand anthropometric study in northern Colombia. Int J Occup Saf Ergon 2017;23:472-80.
21.	Mirmohammadi SJ, Mehrparvar AH, Mostaghaci M, Davari MH, Bahaloo M, Mashtizadeh S. Anthropometric hand dimensions in a population of Iranian male workers in 2012. Int J Occup Saf Ergon 2016;22:125-30.
22.	Pourtaghi G, Valipour F, Sadeghialavi H, Lahmi MA. Anthropometric characteristics of Iranian military personnel and their changes over recent years. Int J Occup Environ Med 2014;5:115-24.
23.	McLain TM. The use of factor analysis in the development of hand sizes for glove design. 2010. University of Nebraska at Lincoln (Master of Science thesis):20-22.
24.	Kouchi M, Miyata N, Mochimaru M. An Analysis of Hand Measurements for Obtaining Representative Japanese Hand Models. SAE Technical Paper, Report No: 0148-7191; 2005.
25.	Vergara M, Agost MJ, Bayarri V. Anthropometric characterisation of palm and finger shapes to complement current glove-sizing systems. Int J Ind Ergon 2019;74:1-9.