Massage & Bodywork

MAY | JUNE 2016

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• Gloves: Nonsterile medical gloves are made of latex, vinyl, or nitrile. Latex gloves are inexpensive and easily available. They are also the most likely to cause unpleasant or even dangerous allergic reactions in practitioners or clients. People with a long history of medical procedures are at the highest risk for latex allergies. Gloves are often the most practical way to limit contamination risk. WHAT GLOVES CAN'T DO It is important to remember that using gloves is only one part in the effort to reduce the risk of disease transmission. Gloving is one step, and not even the most important one (that would be effective handwashing). Gloves may have minute defects or tears. Pathogens may be released when gloves are removed carelessly; it is important to use appropriate safety protocols when putting on and taking off gloves. Using gloves does not remove the risk of transferring pathogens from one location to another—if we touch a contaminated surface with a gloved hand, and then touch a vulnerable spot like an open wound, we are perfectly capable of spreading disease. Gloves also don't eliminate the need to wash hands. Sadly, many health-care providers forget this; some research suggests that the use of gloves leads to increased carelessness in high-risk environments. WHEN YOU HAVE TO GLOVE Some circumstances call for the use of gloves regardless of the relative health of the therapist or client. OSHA's standards call for it when faced with "reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties." This includes intraoral work, if this is within your scope of practice. The nature of our work is also a risk factor for skin damage. Many massage therapists develop hand dermatitis after long-term exposure to some massage lubricants, or it may be related to frequent handwashing. The only way to work safely with this kind of compromised skin is to use gloves until the skin is healthy again. Many oncology clinics require massage therapists to always use gloves—not because of body fluid contact, but to reduce the risk of infection for their immune-compromised patients, and to minimize the exposure to any chemotherapy drugs that may be expressed in the patients' perspiration. It is safe to say that most massage therapists would prefer not to have to use gloves, but when it is necessary, a few guidelines are important to remember: 1. Don't assume that using gloves means you can take shortcuts in the rest of your hygienic practices. Wash your hands before and after each session, clean your surfaces, and ensure that nothing touched by one client is touched by another until it has been cleaned. 2. Experiment to find the glove and fit you like the best. If you don't like one product, don't give up; there may be another brand, another material, or a different fit that works better for you and your clients. 3. Communicate clearly with your clients about why you use gloves. Some people will interpret their use as a judgment, that they are somehow dirty or unworthy of being touched skin-to- skin. Alternatively, they C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 43 PATHOLOGY PERSPECTIVES may have anxiety about cleanliness, and using gloves may aggravate this worry. Explain exactly what circumstances led to the decision; this exchange can go a long way toward enlisting the client as a partner in the process. Ruth Werner, BCTMB, is a former massage therapist, a writer, and an NCBTMB-approved provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2016), now in its sixth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com.

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