In 2024, PhD student Navisha Weerasinghe received Canada Graduate Scholarship-Doctoral from the Social Sciences and Humanities Research Council (SSHRC) in support of her exploratory study on single use products in health care settings and their impact on climate and health, specifically the use of gloves.
In healthcare, gloves are used as part of infection prevention and control (IPAC) practices when there is a risk of potential exposure to blood or bodily fluids or for specific isolation protocols, but Weerasinghe says, gloves are also frequently used even when they are not clinically necessary.
Over-use of gloves
The over-use of gloves can pose potential harm Weerasinghe adds, not just to patients and care workers, but also the environment. Gloves create a perceived sense of safety and have been seen as a barrier to less frequent hand hygiene practices, creating an additional risk of cross contamination if gloves are not used properly.
“Gloves provide a visual physical barrier, but they also have micropores which means if care providers are not also performing hand hygiene, they are putting themselves at potential risk,” says Weerasinghe.
Single use gloves also have a huge impact on the environment because of the extended amount of time – close to 200 years – that it takes for them to break down in a landfill.
“When you think of the accumulation of how many single-use gloves are being used and now sitting in landfills, the environmental harm is significant,” Weerasinghe says. “I was struck by this paradox that in health we are to do no harm, but through the increased use of single-use products such as gloves, we are contributing to CO2 emissions that can also lead to climate related illness.”
Gloves-Off Campaign
In 2009, the World Health Organization released a guideline on glove use, that inspired a national “Gloves Off” campaign here in Canada in 2023 for healthcare institutions to implement. Though the pandemic increased the use of PPE among all health workers, “Gloves Off” campaigns have continued to gather momentum in various countries around the world signaling that many health workers are beginning to think critically about the environmental impact of single use products.
To understand different perspectives on glove use in health care, Weerasinghe is conducting a critical qualitative study that includes participant interviews with clustered groups of individuals, those involved in IPAC in hospital systems, those involved in selling or procuring gloves, those who have important knowledge on the environmental impacts of single-use products and gloves, and any point of care worker involved in a “Gloves Off” campaign or who may have valuable insights around glove use in the hospital setting.
Her research also includes an ethnographic field study that has Weerasinghe attending IPAC and environmental conferences speaking to industry representatives and health care providers about their perspectives on glove use and the promotional materials advertising glove use both inside and outside of acute care settings that have implications on practice.
“It has been interesting to hear about the incremental use of gloves over time including after the HIV/AIDS epidemic, and how donning gloves has become almost second nature to health care workers. Many participants I spoke with have also noticed an increased shift in glove and PPE use following the COVID-19 pandemic, which may speak to the lasting impacts of infectious related events in practice” says Weerasinghe.
Her research, which is focused on Ontario, will also take into consideration how risk is perceived by point of care workers across healthcare and how the pandemic has shaped those perceptions.
Weerasinghe also stresses that glove use is not a single organizational issue, it is a shared dominant practice across healthcare, and its environmental impact includes the production, transportation, use, and disposal of the product.
“A lot of these changes need to be policy driven, they cannot solely be on the point of care worker to solve,” says Weerasinghe. “I hope that my research will continue to drive critical thinking around the tensions between safety, infection control, and the environment, and offer meaningful contributions to evolving practices and policies.”