Gloves during orthodontic procedures and latex allergy

July 3, 1997

Robert Chavez, D.D.S., M.S.
[Recipient address omitted]
Dear Dr. Chavez:

Thank you for your letter dated May 8, regarding concerns about the Occupational Safety and Health Administration's (OSHA) standard for Occupational Exposure to Bloodborne Pathogens. In your letter you have stated an objection to wearing latex gloves while performing procedures in your orthodontic practice. You state that there is no contact with the teeth, gums or salvia of a patient in many of your procedures.

As you know, the standard requires that employees use gloves in the dental setting when there is hand contact with blood or "other potentially infectious material" (OPIM) which includes saliva in dental procedures as well as any body fluid that is visibly contaminated with blood. The use of gloves for examination of mucous membranes (including the mucous membranes of the mouth) was first recommended by the Centers for Disease Control and Prevention (MMWR, 1988; 37:379). Based on this recommendation, OSHA included this provision in the final standard. At a minimum, gloves must be used where there is reasonable anticipation of employee hand contact with blood or OPIM, or non-intact skin.

A section of the standard requires that employers provide gloves in the appropriate size. You state that "cheap, ambidextrous latex gloves" has caused two problems, allergic reactions to latex and carpal tunnel syndrome. Using the correct sized glove would help to eliminate some of the discomfort and help to promote employee participation. Some employees are allergic to latex. The alternatives to latex gloves include vinyl gloves, hypoallergenic gloves, glove liners, and pow[d]erless gloves.

Employees who are allergic to the gloves should be provided with one of these alternatives. The U.S. Food and Drug Administration (FDA) is finalizing a new labeling regulation to address the allergen problem with latex gloves in the health care setting. The use of gloves as means of protecting employees in the dental setting is not a new concept. According to the information provided to OSHA during the rulemaking, disposable gloves were in use by 96% of the direct patient care workers in dentists' offices before the standard became final.

We hope this information is responsive to your needs. If you have further questions, please feel free to call [the Office of Health Enforcement at (202) 693-2190].

Sincerely,

John B. Miles, Jr., Director
Directorate of Compliance Programs

[Corrected 12/6/2024]

[Requester letter reproduced on OSHA page; omitted here.]