Current infection prevention strategies and textile management during patient use appear to be adequate in preventing HAIs , provided that every step is taken to maintain the hygienic quality of HCTs before use .” the CDC states that thermal disinfection should be conducted at 71 degrees C for a minimum of 25 minutes , whereas in the United Kingdom , 65 degrees C for ≥10 minutes or 71 degrees C for ≥3 minutes is required for thermal disinfection . However , in both the UK and U . S ., there are no additional recommendations for enhanced decontamination procedures within infection control guidelines during the COVID-19 pandemic .”
Which continues to beg the question , how important is healthcare textile processing and performance in the era of COVID-19 ?
“ In the healthcare setting there should have already been a lot of motivation to prevent the transmission of pathogens so while its important I would probably say COVID-19 has increased awareness in other segments / markets more ,” says Ben Mead of Hohenstein . “ At the same time , the laundry processes that were put in place to control other pathogens should position hygienically clean certified laundry facilities to be great choices for adding an extra layer of assurance around COVID-19 since those pathogens can be pretty easily inactivated through proper laundry processes .”
While the research around SARS-CoV-2 and healthcare textiles grows , Mead notes , “ With SARS-CoV-2 being an enveloped virus , its ‘ envelope ’ can be cracked by detergents for example and is more susceptible than other , non-enveloped viruses . However , the virus still needs to be inactivated and domestic washing does not guarantee that , as washing temperature and detergent concentration are normally not controlled . Most commercial laundry processes should be effective at reducing / eliminating infection risk from coronavirus , especially the processes certified to be hygienic and suitable for healthcare textiles .”
Mead advises healthcare institutions to perform their due diligence around their laundry processes . “ Start by looking critically at the entire process ,” he says . “ Are the garments properly sorted to ensure all HCT are treated with the appropriate wash formula ? Are wash formulas design and evaluated to ensure they will consistent lower pathogen levels to those recommended by Robert Koch Institute ? Does the handling of laundered textiles prevent recontamination prior to reaching the clinical end user ? How is that process assured – self-evaluation or third-party evaluation against a consistently applied standard ? What is the frequency of that assurance ?”
The take-home message , according to Sehulster ( 2015 ), is that “ Current infection prevention strategies and textile management during patient use appear to be adequate in preventing HAIs , provided that every step is taken to maintain the hygienic quality of HCTs before use . Patient-to-patient transmission of microorganisms involving clean textiles has not been demonstrated to date , even though pathogenic microorganisms can survive on textiles . Well-designed studies are needed to determine whether and to what extent healthcare textiles may be a factor in patient colonization . Healthcare epidemiologists would benefit from gaining some familiarity with healthcare textile laundering , facility policies , and procedures for management of hygienically clean healthcare textiles . If an outbreak of HAIs potentially linked to healthcare textiles occurs , it is not enough to conduct microbial sampling of laundered textiles and declare the laundry process as the source of the problem . Each of the distinct operations of the laundry process must be evaluated to pinpoint the root cause of the problem . The greatest risks of diminishing the hygienically clean state of healthcare textiles appear to be associated with inadvertent environmental contamination due to a malfunction of the laundry process or poor storage conditions of healthcare textiles after laundering . A Hazard Analysis and Critical Control Point assessment of all post-laundering tasks should be included in any outbreak investigation of laundered healthcare textiles . Studies to evaluate new developments in laundry processing in addition to current operations are encouraged … Following manufacturer instructions for laundry equipment , laundry chemicals , and fabrics is crucial to the provision of quality service to healthcare facility patients . The provision of hygienically clean healthcare textiles is an important service . Healthcare facilities are responsible for ensuring that laundry contractors provide their service in a safe and effective manner . At least one on-site inspection of the laundry facility by hospital staff on an annual basis is needed to make this determination .”
References :
Association for Linen Management ( ALM ). A Review of the U . S . Healthcare Wash Process for Hygienically-Clean Textiles . www . ALMnet . org
American National Standards Institute ( ANSI )/ Association for the Advancement of Medical Instrumentation ( AAMI ). ANSI / AAMI ST 65:2008 ( R ) 2013 Processing of Reusable Surgical Textiles for Use in Health Care Facilities . Arlington , VA : Association for the Advancement of Medical Instrumentation , 2009 .
Centers for Disease Control and Prevention ( CDC ). Guidelines for environmental infection control in health-care facilities , 2003 .
Honisch M , Stamminger R , Bockm € uhl DP . Impact of wash cycle time , temperature and detergent formulation on the hygiene effectiveness of domestic laundering . J Appl Microbiol 2014 ; 117:1787-97 .
Lena P , Ishak A , Karageorgo SA and Tsioutis C . Presence of Methicillin-Resistant Staphylococcus aureus ( MRSA ) on Healthcare Workers ’ Attire : A Systematic Review . Trop Med Infect Dis . 2021 Jun ; 6 ( 2 ): 42 . doi : 10.3390 / tropicalmed6020042
McLaren K , McCauley E , O ’ Neill B , Tinker S , Jenkins N and Sehulster L . The efficacy of a simulated tunnel washer process on removal and destruction of Clostridioides difficile spores from healthcare textiles . Am J Infect Control . 2019 . https :// doi . org / 10.1016 / j . ajic . 2019.04.180
Mitchell A , Spencer M and Edmiston C . Role of healthcare apparel and other healthcare textiles in the transmission of pathogens : a review of the literature . J Hosp Infect . Vol . 90 , No . 4 . P . 285-292 . Aug . 1 , 2015 . DOI : https :// doi . org / 10.1016 / j . jhin . 2015.02.017
Owen L and Laird K . The role of textiles as fomites in the healthcare environment : a review of the infection control risk . PeerJ . 2020 Aug 25 ; 8 : e9790 . doi : 10.7717 / peerj . 9790 . eCollection 2020 .
Owen L , Shivkumar M , Laird K . The Stability of Model Human Coronaviruses on Textiles in the Environment and during Health Care Laundering . mSphere . 2021 Apr 28 ; 6 ( 2 ): e00316-21 . doi : 10.1128 / mSphere . 00316-21 .
Patel SN , Murray-Leonard J , Wilson APR . 2006 . Laundering of hospital staff uniforms at home . J Hosp Infect 62:89 – 93 . doi : 10.1016 / j . jhin . 2005.06.002 .
Paton S , Spencer A , Garratt I , et al . Persistence of SARS-CoV-2 virus and viral RNA on hydrophobic and hydrophilic surfaces and investigating contamination concentration . bioRxiv . March 2021 . doi :
https :// doi . org / 10.1101 / 2021.03.11.435056
Riley K , Williams J , Owen L , Shen J , Davies A , Laird K . 2017 . The effect of low-temperature laundering and detergents on the survival of Escherichia coli and Staphylococcus aureus on textiles used in healthcare uniforms . J Appl Microbiol 123:280 – 286 . doi : 10.1111 / jam . 13485
Sehulster LM . Healthcare Laundry and Textiles in the United States : Review and Commentary on Contemporary Infection Prevention Issues . Infect Control Hosp Epidemiol . 2015 Sep ; 36 ( 9 ): 1073-88 . doi : 10.1017 / ice . 2015.135 . Epub 2015 Jun 18 .
Tarrant J , Jenkins RO and Laird KT . From ward to washer : The survival of Clostridium difficile spores on hospital bed sheets through a commercial UK NHS healthcare laundry process . Infect Control Hosp Epidemiol . 2018 Dec ; 39 ( 12 ): 1406- 1411 . doi : 10.1017 / ice . 2018.255 . Epub 2018 Oct 16 . DOI : 10.1017 / ice . 2018.255 TRSA . Whitepaper : Handling Clean Linen in a Healthcare Environment .