• As Mitchell , et al . ( 2015 ) summarize , “ The literature illustrates that healthcare textiles , including uniforms or apparel , are a vector for transmission of microorganisms that cause infections and illnesses in healthcare workers , patients and the community .
Honisch , et al . ( 2014 ) investigated the effect of temperature and duration of the laundering process with and without activated oxygen bleach ( AOB ) -containing detergent on the hygienic effectiveness of laundering . They found that it is possible to compensate for the loss of hygiene effectiveness of laundering at lower temperatures using detergents with activated oxygen bleach or by extending the wash cycle time . Cotton test swatches were contaminated with Staphylococcus aureus , Enterococcus hirae , Pseudomonas aeruginosa , Candida albicans and Trichophyton mentagrophytes and were washed in a household washing machine using temperatures between 20 degrees C and 60 degrees C and different wash cycle times . The logarithmic microbial reduction factor and cross-contamination were used to indicate the hygienic effectiveness of the washing process . For all tested microorganisms , the temperature needed for decontamination depended on washing time and detergent type . Hygiene effectiveness of laundering was enhanced by inclusion of AOB even at lowest temperatures , except for C . albicans , which was virtually unaffected by AOB . The use of AOB-containing detergents as well as high washing temperatures reduced cross-contamination to sterile swatches included in the load . The researchers concluded that , “ Depending on the type of organism , longer wash cycle times or the use of AOB-containing detergents can be used to enhance the hygiene effectiveness of laundering .”
As Honisch , et al . ( 2014 ) explain , “ It is commonly recommended to wash hygienically sensitive textiles such as underwear , bed linens , towels and dish cloths at high temperatures and with a detergent containing activated oxygen bleach to reduce potential infection risks in private households … To obtain the same washing performance as at higher laundry temperatures , lower laundry temperatures must be compensated by enhancing other factors . Increasing the wash cycle time is known to be an effective means of compensating lower washing temperatures in terms of stain removal . To what extent this also applies to hygiene effectiveness regarding eliminating potentially pathogenic microorganisms , which are present on washables , is not sufficiently well known .”
In general , Honisch , et al . ( 2014 ) found that hygiene effectiveness was increased by increasing the wash cycle time , but the extent of this effect was variable depending on temperature and strain type , and no consistent relationships could be determined . For example , for Staph aureus , at the lowest wash temperature ( 20.5 degrees C ), the log reduction values were in the same range for all cycle times . At higher temperatures , a longer wash cycle time led to higher reduction values ; for example , a 5-log reduction could be reached with the 15-minute program at 46.7 degrees C , or with the 90-minute program at 32.3 degrees C . For T . mentagrophytes , the same level of decontamination that was reached at 46.7 degrees C in the 15-minute program , was obtained at 37.2 degrees C in the 90-minute program .
Regarding the impact of using detergent with AOB compared with a non-AOB detergent , Honisch , et al . ( 2014 ) found that , for all test organisms except C . albicans , the addition of AOB led to higher reduction values for any given time / temperature combination . For Staph aureus and Ent . hirae , whereas using non-AOB detergent , temperatures of 46.7 , 41.8 and 32.3 degrees C were required to achieve 5 or more log reduction at wash cycle times of 15 , 45 and 90 minutes , respectively . Using AOB detergent , the same log reduction was achieved using wash cycle time of 15 minutes at 32 degrees C , and 45 minutes at 20 degrees C . For both non-AOB and AOB detergents , the conditions required to produce a 5-log reduction were 46.7 degrees C for a 15-minute cycle , 41.8 degrees C for a 45-minute cycle and 37.2 degrees C for a 90-minute wash cycle . In the case of Ps . aeruginosa , no detectable survivors were obtained on all swatches for all temperatures and wash cycle times , which means that the impact of using an AOB could not be determined .
According to the researchers , a cross-contamination event was recorded when one or more of the test strains were detected at the end of the cycle on the sterile swatch included in the test load . Cross-contamination was observed in three of 32 test runs using AOB detergent , while using non-AOB detergent , cross-contamination was detected in 19 of 40 runs . All cross-contaminations events occurred at temperatures lower than 52 degrees C .
Bloomfield et al . ( 2013 ), who conducted a comprehensive review of studies of effects of temperature , wash conditions and detergent formulation on the hygiene effectiveness of laundering , found a lack of standardization of test conditions and the inconsistency in the published data which makes it difficult to propose performance standards for home laundering with confidence .
From their studies of the hygiene effectiveness of laundering , Lucassen , et al . ( 2013 ) concluded that , for naturally contaminated towels , a wash temperature of 50 degrees C led to sufficient decontamination of bacteria . Lichtenberg , et al . ( 2006 ) concluded that laundering of normally soiled washables at low temperatures with AOB-free detergent is also sufficient to obtain adequate hygiene , if there are no special hygienic requirements such as infections of skin or intestines . By contrast , from a study with naturally contaminated laundry items , Terpstra , et al . concluded that the hygiene performance of washing processes at low temperatures ( 15 degrees C and 30 degrees C ) leaves something to be desired .
Chiereghin , et al . ( 2020 ) aimed to compare the performance of decontamination of different domestic laundering with that of industrial laundering . Fourteen naturally contaminated white coats of healthcare workers ( five 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 degrees C and 90 degrees C ) and drying ( tumble dry and air dry ) were used . All fabric squares were