Milking Management and Gloves: A Historical Perspective on Use

Historical Background on 'Glove Use' as a Strategy to Reduce Infection Transfer

I'm currently working on several fact sheets for National Mastitis Council (NMC) meetings which are coming up in early February and am also preparing for winter workshops that will be held on 'Milking Management' (see December blogs). As part of the process, I'm reviewing lots of research to trace origin of why certain procedures and control methods are recommended. I thought I'd share some of the highlights of my findings.

It is recommended by NMC, that strong but thin disposable gloves, similar to what surgeons and health professionals wear in the hospital, be worn by all folks doing the milking on-farm. It is also recommended that these gloves be sanitized periodically or changed as needed. Gloves should be thrown away at a minimum after each milking and new gloves worn at the start of the next milking. The rationale for wearing gloves and potential impact on disease control may seem pretty obvious but we still have many farmers and employees who refuse to consider wearing gloves for various reasons. I've also found over the last 3-years of field work that many farms save gloves used at one milking and reuse them at the next to 'save money'.

My thought was that maybe there is some 'ammunition' in the research data to convince folks to wear gloves, and to encourage quick replacement or sanitizing of  'gloves at risk'. This 'ammunition' would then be used in education to persuade and overcome feelings by some farmers and employees that 'gloves are uncomfortable', 'cost too much', and/or 'affect ability to effectively palpate the udder or otherwise perform tasks that require 'feeling' or tactile senses needed when milking and diagnosing problems with the udder'.

Where and Why Did Glove Use in the Medical Profession Originate?

The 'data' or 'validation' will follow in upcoming blogs but this blog shares a historical perspective from the medical literature and which I think is both interesting and 'fun'.

The first article I found on rationale or initiation for glove use was in the medical literature in a British Medical Journal published in 1933. My thought was that if I could find the original rationale or reference, this may be helpful to get more dairy producers and their employees to wear gloves while milking and thereby reduce risk of spreading mastitis from infected cows to healthy cows.

So how did glove use start? Basically, glove use was initiated to protect a woman's hands from an unsightly rash and chemical reaction and because of a romance between this assistant and the doctor in charge. Glove use initially expanded partially due to ego. Health care professionals felt they looked more like 'experts' when wearing gloves. Glove use then expanded and continued based on a desire by health professionals to protect themselves from disease and also to protect transfer of diseases from diseased patients to healthy patients (albeit immunocompromised - e.g., in hospital for another ailment). Research provided the cause and effect or rationale. Hands harbor bacteria. Gloves, when used properly, may reduce the chance or risk of transferring bacteria. AIDS has probably been the number one reason for expanded glove use in the medical profession. It is possible, when one's own health is at stake, health care professionals are more likely to adhere to a particular protocol - like wearing gloves.

There are still plenty of  instances or examples in the medical literature where health care workers forget to fully cleanse gloved hands or replace used gloves and where bacteria are transferred via gloved hands or non-gloved hands from diseased patients to healthy patients. The presence of Methicillin Resistant Staph. aureus (MRSA) in hospitals and impact, especially in immunocompromised patients, may be reinforcing and expanding adherence to glove use by health care workers. Regardless, even when their own potential health is at stake, folks have to be continually reminded through 'data' and other means, that hands - even with glove use, - are a major means of transferring disease from one patient to other patients.

The actual historical quote of how glove use started

The original story is attributed to Dr. F.L. Reichert, and related to an event in 1891. Enjoy!

"(Dr.)W.S. Halstead of Baltimore introduced the use of rubber gloves as a protection both for patient and for surgeon in 1891. Halstead first introduced rubber gloves into his theatre a year or so earlier, in the winter of 1889-90 for a slightly different purpose. The nurse in charge of the operating room had complained to him that the solution of mercuric chloride used in sterilizing the hands had caused dermatitis on her forearms and hands. In Halstead's own words: "As she was an unusually efficient woman, I gave the matter my consideration and one day in New York requested the Goodyear Rubber Company to make as an experiment two pairs of thin rubber gloves with gauntlets (e.g., a dress glove extending over the wrist). On trial these proved to be satisfactory (so) that additional gloves were ordered."  Later the assistant in charge of instruments was given gloves. The operator wore them at first only when making exploratory incisions into joints. After a time men who had grown accustomed to wearing gloves as assistants came to wear them habitually as operators, because they felt more expert with gloves than without."

"It is interesting that the use of rubber gloves in surgery was not the result of an inspiration to eliminate the hands as a source of infection during the operation. Their use was a matter of slow evolution, first as a protection for the hands of the assistants from irritating solutions, then as an added precaution on the part of the operator in exploring joints, later as an aid to the operative dexterity of those accustomed to gloves as assistants, and finally as a regular adornment to be worn invariably in all cases, clean and septic, by the operator and all members of the operating team." "The unusually efficient woman" for whom it all began in due course became Mrs. Halstead".

More actual data to follow.... ;-)