Permeation of Cancer Chemotherapeutic Drugs Through Glove Materials under Static and Flexed Conditions

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Abstract
Gloves are the most common protective measure against contamination with antineoplastics. However, there is no consensus about which glove material offers the best protection. There are few data on the permeability of gloves to this group of potential carcinogens. All studies have been conducted under static conditions, with no attempt at simulating the flexing and stretching that may be present in the occupational setting. Flexing has been shown to increase the permeability of glove materials to certain chemicals. To investigate the effects of flexing on permeation by antineoplastics, a permeation cell apparatus was modified so that glove materials could be flexed during testing. Surgical latex, exam latex, and polyvinyl chloride (PVC) gloves were tested with four drugs: cyclophosphamide, doxirubicin, methotrexate, and 5-fluorouracil. Utilizing radiolabeled compounds and liquid scintillation counting for a direct and sensitive analytical technique, gloves were tested at times representative of occupational exposures. Tests were run up to 24 hours to determine normalized breakthrough times, permeation rates, and diffusion coefficients. Unexpectedly, flexing did not significantly increase permeation by most of the drugs. Cyclophosphamide was the only drug to permeate any of the glove materials consistently. With cyclophosphamide, no significant difference was found between mean normalized breakthrough times for any of the glove materials under static and flexed conditions. There were, however, significant differences between glove materials: the exam latex glove offered significantly less resistance to permeation than either the surgical latex or PVC glove. Steady-state permeation was observed for cyclophosphamide, for all glove materials under both static and flexed conditions; the other three drugs did not achieve steady-state permeation. When diffusion coefficients for cyclophosphamide permeation were compared, significant differences were observed only between static and flexed exam latex. Even though there was no significant difference between mean normalized breakthrough times for exam latex under either condition, diffusion coefficients indicated that, following breakthrough, the drug permeated the flexed glove at twice the rate of the static glove. Based on these results, we do not recommend that exam latex gloves be used for handling antineoplastics.