Microbial Contamination of Medical Staff Clothing During Patient Care Activities: Performance of Decontamination of Domestic Versus Industrial Laundering Procedures.

The efficacy of domestic laundering of healthcare staff clothing is still debated. This study aimed to compare the performance of decontamination of different domestic laundering with that of industrial laundering. Fourteen naturally contaminated white coats of healthcare workers (5 fabric squares from each coat) and fabric squares of artificially contaminated cotton cloth (30 fabric squares per each bacterial strain used) were included. Four domestic laundering procedures were performed; two different washing temperatures (40 °C and 90 °C) and drying (tumble dry and air dry) were used. All fabric squares were ironed. Presence of bacterial bioburden on the fabric squares after domestic and industrial laundering was investigated. None of the naturally contaminated fabric squares resulted completely decontaminated after any of the domestic washes. At 24, 48, and 72 h of incubation, bacterial growth was observed in all the laundered fabric squares. Besides environmental microorganisms, potentially pathogenic bacteria (i.e., Acinetobacter lwoffii, Micrococcus luteus, coagulase-negative staphylococci) were isolated. On the artificially contaminated fabric squares, the bioburden was reduced after the domestic laundries; nevertheless, both Gram-negative and -positive pathogenic bacteria were not completely removed. In addition, a contamination of the fabric squares by environmental Gram-negative bacteria was observed. In both the naturally and artificially contaminated fabric squares, no bacterial growth at all the time-points analyzed was observed after industrial laundering, which provided to be more effective in bacterial decontamination than domestic washes. For those areas requiring the highest level of decontamination, the use of specialized industrial laundry services should be preferred.

Manejo seguro de la ropa e higiene de la piel en pacientes y profesionales sanitarios frente al Covid-19: scoping review / Safe handling of clothing and hygiene of patients and health professionals: Scoping Review

INTRODUCCIÓN: En enero de 2020 aparece en China un brote de neumonía causada por un virus zoonótico (SARS-CoV-2). Se considera que la ruta principal de transmisión es por inhalación de grandes gotas respiratorias, por deposición en las mucosas y las manos o los fómites contaminados. El objetivo es identificar las intervenciones a realizar durante la hospitalización para un manejo correcto y seguro de la ropa e higiene de los pacientes y profesionales sanitarios. MÉTODO: Scoping review realizada sin delimitación cronológica ni de idioma en las bases de datos PUBMED y Cochrane. Rastreo de normas y recomendaciones de entidades gubernamentales nacionales e internacionales para responder a la pregunta de investigación sobre el manejo seguro de la ropa y la higiene de la piel en pacientes y en profesionales sanitarios para evitar el contagio por Covid-19. El análisis de los datos fue realizado en dos etapas: en la primera, identificación y categorización de los estudios, y en la segunda, análisis de contenido como criterio informativo y clasificatorio. RESULTADOS: Se han seleccionado 14 documentos, principalmente de entidades gubernamentales. Las recomendaciones se estructuran en 5 epígrafes sobre manejo de ropa e higiene de la piel de pacientes infectados y profesionales sanitarios en el ámbito hospitalario. CONCLUSIÓN: La ropa de los pacientes y del personal sanitario son vehículos transmisores de la enfermedad. Su correcto tratamiento ayuda a mejorar el control de la misma y a una correcta utilización de los recursos disponibles en estos momentos. La adecuada higiene de la piel, en especial la limpieza de las manos, constituye uno de los pilares básicos para la prevención y el control de la infección. Destacamos la semejanza de algunas de las pautas recogidas y proporcionadas por los diferentes organismos consultados

INTRODUCTION: In January 2020, an outbreak of pneumonia caused by a zoonotic virus (SARS-CoV-2) appeared in China. The main route of transmission is considered to be the inhalation of large respiratory drops, by deposition in the mucosa and hands or contaminated fomites. The objective is to identify the interventions to be performed during hospitalization for the correct and safe handling of clothing and hygiene of patients and health professionals. METHOD: Scoping review carried out without chronological or language delimitation in the PUBMED and Cochrane databases. Tracking standards and recommendations of national and international government entities to answer the research question on the safe handling of clothing and skin hygiene in patients and in health professionals to avoid Covid-19 infection. The data analysis was carried out in two stages: in the first, identification and categorization of the studies, and in the second, content analysis as an informative and classifying criterion. RESULTS: 14 documents have been selected, mainly from government entities. The recommendations are structured in 5 sections on the management of clothing and skin hygiene of infected patients and health professionals in the hospital setting. CONCLUSION: The clothing of patients and healthcare personnel are transmitting vehicles of the disease. Its correct treatment helps to improve the control of the same and the correct use of the resources available at the moment. Proper skin hygiene, especially hand cleansing, is one of the basic pillars for infection prevention and control.We highlight the similarity of some of the guidelines collected and provided by the different agencies consulted

Capturing microfibers - marketed technologies reduce microfiber emissions from washing machines.

Microfibers are a common type of microplastic. One known source of microfibers to the environment is domestic laundering, which can release thousands of fibers into washing machine effluent with every wash. Here, we adapted existing methods to measure the length, count and weight of microfibers in laundry effluent. We used this method to test the efficacy of two technologies marketed to reduce microfiber emissions: the Cora Ball and Lint LUV-R filter. Both technologies significantly reduced the numbers of microfibers from fleece blankets in washing effluent. The Lint LUV-R captured an average of 87% of microfibers in the wash by count, compared to the Cora Ball which captured 26% by count. The Lint LUV-R also significantly reduced the total weight and average length of fibers in effluent. While further research is needed to understand other sources of microfiber emissions, these available technologies could be adopted to reduce emissions from laundering textiles.

A pilot study: Exploring the musculoskeletal risk exposure associated with drying laundry using the public housing pipe-socket system amongst women in Singapore.

BACKGROUND: The biomechanics of homemakers has been minimally studied. The way laundry-drying is performed in Singapore public-housing, using the pipe-socket-system (PSS), could expose the homemakers to musculoskeletal disorder risk. OBJECTIVE: This study aims to quantify the musculoskeletal risk exposure (MRE) associated with laundry-drying amongst female homemakers using the PSS in Singapore public-housing. METHODS: Using snowball sampling approach, five female homemakers familiar with the described laundry-drying method were recruited. The postures of the participants were analysed from video-recorded data and scored using the Rapid Entire Body Assessment (REBA). RESULTS: This pilot study revealed very strong evidence (p = 0.001) that the participants were exposed to medium risk (REBA score 4.3) when performing this housework task. CONCLUSIONS: Extreme awkward postures and repetitive motions were observed from the participants during the analysis. High REBA scores were frequently associated with the awkward postures adopted due to constraints of physical work space.

¿Es adecuado el lavado de la ropa laboral de los profesionales de las ambulancias de urgencia en España? / Emergency Ambulance Professionals in Spain, Is The Working Clothes Washing Appropriate?

Introducción: Según el estudio EPINE-EPPS del 9 de Noviembre de 2017 realizado en 313 hospitales españoles y estudiado a 61.673 pacientes, de ellos 1493 ya la tenían antes del ingreso. Objetivo: Valorar si el personal de urgencias extrahospitalarias limpia correctamente su uniforme ya que es muy común que laven esta ropa en sus domicilios. Material y Métodos: Consistió en estudio descriptivo de las variables cerradas, con una población de estudio de 126 profesionales. Se les encuestó a través de una aplicación de formulario Google. El tiempo que permaneció abierto el acceso a la encuesta fue de Junio a Noviembre de 2017. Los datos se analizaron con el programa informático R y ha consistido en la obtención de tablas de frecuencias absolutas y relativas. También para cada par de variables, se han realizado los contrastes de independencia exactos de Fisher y para todas aquellas tablas de contingencia 2x2, se ha calculado el Odds Ratio junto a su intervalo de confianza a nivel 95%. Resultados: Tipo de servicio en el que se trabaja y cuestión sobre si la empresa lava la ropa (p-valor = 0.00). El Odds Ratio muestra que la razón de encuestados cuya empresa lava la ropa en el tipo de servicio público es 17,53 veces la razón en el servicio privado. Conclusiones: Más de la mitad de los encuestados lava la ropa laboral en su domicilio todos los días que trabaja con el consiguiente riesgo que eso genera de que los microorganismos se queden en su lavadora. Además, desconocer también qué tipo de lavado es el adecuado disminuye su vida útil

Introduction: According to the EPINE-EPPS study of November 9, 2017 carried out in 313 Spanish hospitals and studied 61,673 patients, 1493 of them had already it before admission. Objective: To evaluate if the outpatient emergency staff clean their uniform correctly, since it is very common to wash these clothes at home. Material and Methods: Consisted in a descriptive study of closed variables, with a study population of 126 professionals. They were surveyed through a Google Form application. The time for getting access to the survey remained open from June to November 2017. The data was analyzed with the computer program R obtaining tables of absolute and relative frequencies. Also for each pair of variables, the contrasts of Fisher’s exact test of independence have been made, and for all those 2x2 contingency tables the Odds Ratio has been calculated together with its 95% confidence interval. Results: Type of service in which it is being worked and the question about whether the company washes clothing (p-value = 0.00). The Odds Ratio shows that the ratio of respondents whose company washes clothes in the public service type is 17.53 times the ratio in the private service. Conclusions: More than half of the respondents wash their working clothes at home every day they work, causing the consequent risk that the microorganisms can remain in their washing machine. In addition, not knowing what type of washing is also the most appropriate will decrease its useful life

Infection control implications of the laundering of ambulance staff uniforms and reusable mops.

There is a lack of published studies on laundering in ambulance services. We performed bacterial culture on soiled and unsoiled uniforms and reusable mop heads artificially contaminated with Escherichia coli, Staphylococcus aureus, and Clostridium difficile spores. Current laundering processes used for routine cleans in the ambulances appears, from our simulations, to be effective at reducing vegetative pathogenic bacteria to undetectable levels, <3.398log10 colony-forming units (S. aureus and E. coli). Reduced levels of C. difficile were still detected after laundering but the risk this poses for infection is unknown, as background levels of these spores in the environment are unknown.

Laundering Methods for Reusable Surgical Scrubs: A Literature Review.

Surgical site infection is one of the most frequent and serious postoperative complications. Surgical site infections may be precipitated by high bacterial loads introduced into the operating room setting. The most common microorganisms contributing to infections are Staphylococcus, Streptococcus, and Pseudomonas. The potential for scrub uniforms to carry bacteria has been shown in several studies. Recommendations for surgical scrubs worn by operating room personnel and specific laundering techniques remain debated in evidenced-based research. There exists a variance in perception and a lack of consensus among providers regarding the concept of where and how to launder surgical scrubs. The purpose of this literature review is to determine if facility-laundered surgical scrubs are superior in the prevention of surgical site infections for patients undergoing surgery over home-laundering methods, to evaluate the appropriateness and safety of surgical staff laundering scrub uniforms at home, and to provide recommendations for the laundering of reusable surgical scrubs.

Decontamination of laundry exposed to Microsporum canis hairs and spores.

OBJECTIVES: The objective of this study was to determine the efficacy of decontamination of fabric exposed to Microsporum canis hairs and spores by mechanical washing using hot or cold water with or without a sodium hypochlorite additive, and to field test a washing protocol for terry cloth and denim exposed to M canis via direct contact with infected cats. METHODS: Cotton, terry cloth and denim fabric swatches were contaminated with isolated infective spores and hairs and then washed in water at temperatures of 30°C and 60°C, with and without a sodium hypochlorite additive, and with and without mechanical drying. Terry cloth and denim were contaminated by direct contact with infected kittens and washed at 30°C until culture-negative. RESULTS: All prelaundering samples had >300 colony forming units (cfu)/plate. Experimentally contaminated fabrics were culture-negative, regardless of fabric type, water temperature, the presence or absence of sodium hypochlorite, or tumble drying after one wash. After one wash, 22/34 (65%) of terry cloth towels and 12/20 (60%) denim fabric squares were culture-positive, but the infective load was minimal (1-5 cfu/plate). After two washes in cold water there was no detectable contamination of fabric. The rinse water was not contaminated with spores. The laundry tub was easily decontaminated via mechanical cleaning followed by use of a disinfectant. CONCLUSIONS AND RELEVANCE: Washable textiles exposed to M canis can be decontaminated via mechanical washes in cold water without the addition of bleach. Two washes are recommended to ensure removal of spores. Laundry can be effectively decontaminated by washing twice in cold water on a long wash cycle (for ⩾14 mins). It is important to ensure maximal agitation (ie, the machine should not be overloaded).

Laundering habits of student nurses and correlation with the presence of Staphylococcus aureus on nursing scrub tops pre- and postlaundering.

Little is known about student nurse laundering practices. Student nurses swabbed their scrub tops after clinical and after laundering, and they completed a laundry survey; 13.5% of students wore the same scrub more than once, and few followed recommended guidelines by using hot water (20%) or bleach (5.6%) when laundering scrubs. After clinical shifts, 17% of swabs tested positive for Staphylococcus aureus; however, laundering eradicated it from 64.3% of positive samples. This was not statistically significant.

Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues.

Healthcare professionals have questions about the infection prevention effectiveness of contemporary laundry processes for healthcare textiles (HCTs). Current industrial laundry processes achieve microbial reductions via physical, chemical, and thermal actions, all of which result in producing hygienically clean HCTs. European researchers have demonstrated that oxidative laundry additives have sufficient potency to meet US Environmental Protection Agency benchmarks for sanitizers and disinfectants. Outbreaks of infectious diseases associated with laundered HCTs are extremely rare; only 12 such outbreaks have been reported worldwide in the past 43 years. Root cause analyses have identified inadvertent exposure of clean HCTs to environmental contamination (including but not limited to exposure to dust in storage areas) or a process failure during laundering. To date, patient-to-patient transmission of infection has not been associated with hygienically clean HCTs laundered in accordance with industry process standards. Occupationally acquired infection involved mishandling of soiled HCTs and failure to use personal protective equipment properly. Laboratory studies of antimicrobial treatments for HCTs demonstrate a wide range of activity from 1 to 7 log10 reduction of pathogens under various experimental conditions. Clinical studies are needed to evaluate potential use of these treatments for infection prevention. Microbiological testing of clean HCTs for certification purposes is now available in the United States. Key features (eg, microbial sampling strategy, numbers of textiles sampled) and justification of the testing are discussed.

Laundering uniforms at less than 60°C may increase risk of HCAIs.

More than 40 per cent of ward staff are not washing their uniforms at high temperatures, leading to concerns about infection prevention, a study reveals.

Washing uniforms at home: adherence to hospital policy.

Infection control is a priority for all hospitals to reduce the spread of healthcare-associated infections (HCAIs). Textiles especially uniforms, are a possible route of HCAI transmission. There are protocols to ensure hospital laundry services meet accepted standards, however healthcare uniforms are laundered by staff at home and variations in practice occur. A questionnaire was used to conduct a service evaluation at four hospitals in different NHS trusts to determine how closely healthcare staff followed hospital guidelines on laundering and aftercare of uniforms at home. Responses showed that not all staff followed these guidelines; 44% of staff washed their uniforms below the recommended temperature of 60°C, which presents a potential route for cross-contamination and infection.

Structuring of manual of orientations and technical information for laundries of industries of animal products origin.

This study looked for to lift information regarding laundries inserted in industries of animal products origin, to understand the activities developed in the section and to structure a Manual of Planning and Technical Information for laundries to industries of animal products origin, with the intention of subsidizing the planning, structuring and control of this work place, because norms or regulations that supervise don't exist or aid their managers and workers as for the operation of this work place.