healthcare textiles & laundry
By John Scherberger, FAHE
Healthcare Laundry
Processes and COVID-19
A
ccording to current evidence, SARS-CoV-2 virus is
primarily transmitted between people through respiratory
droplets and contact routes. Transmission of the SARS-CoV-2
virus can occur by direct contact with infected people and
indirect contact with surfaces in the immediate environment or
with objects used on the infected person such as stethoscopes,
thermometers, or healthcare textiles).
In a communication from Michael Bell, MD, deputy
director of the Division of Healthcare Quality Promotion
in the CDC’s National Center for Emerging Zoonotic and
Infectious Diseases, Bell notes, “Launderable textiles should
be handled and laundered according to normal healthcare
facility procedures, and in accordance with local regulations.
No special treatment or chemicals are indicated for laundering
linens after use by a COVID-19 patient. As always, handling
should be done to minimize agitation of soiled textiles, they
should be contained in appropriate laundry bags and hand
hygiene should be performed promptly after handling.”
A virus, particularly a coronavirus, can be removed from
the healthcare environment by using time-honored processes:
the use of healthcare-grade ultra-microfiber (aka micro denier)
microfiber infection prevention textiles in conjunction with
EPA-registered hospital-grade disinfectants (EPA List N), proper
collection and bagging techniques for used healthcare textiles
(HCTs), proper functional separation of clean and soiled/
contaminated HCTs, and laundering soiled/contaminated
HCTs according to CDC Guidelines for Environmental Infection
Control in Health-Care Facilities (2003), Laundry and Bedding.
Commercial laundries have consistently provided hygienic
HCTs to healthcare facilities, particularly in the U.S., with very
rare exceptions. Commercial laundries are expected to follow
the CDC laundering processes referenced above, follow
manufacturers guidelines for all chemicals used in processing
HCTs, ensure staff adhere to the use of PPE in handling both
soiled/contaminated and cleaned/hygienic HCTs, and transport
hygienic HCTs to healthcare facilities in a manner that ensures
the textiles remain hygienic and assure delivery to facilities
following functional separation of textiles. In addition to the
CDC guidelines, all local, state, provincial, and municipal
statutes and requirements are followed.
Accredited laundries ensure their staff follows best
practices during the entire process, from picking up laundry
at the facilities, to delivery to the laundries, and returning of
hygienic HCTs. This includes ensuring that the equipment
and transportation used is properly maintained, cleaned,
and disinfected.
In the U.S., healthcare textiles are disinfected through the
use of chemicals and thermal processes. The use of surfactants,
disinfectants, and hot water and drying temperatures ensures
that HCTs are processed to the highest possible standard
attainable. When laundries choose to use low-temperature
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water, additional steps and different chemicals are used that
provides hygienic results. HCTs that require sterilization
are processed in the same manner as are all HCTs with an
added step, typically taken by the hospital sterile processing
department.
Accredited and certified laundries assure hospitals that
their HCTs are properly collected, sorted, processed, packaged
and delivered according to the highest hygienic standards.
Following evidence-based practices and scientific principles
that include following the current CDC guidelines, ensures
a reduction or elimination of microorganisms, including
SARS-CoV-2.
Commercial healthcare laundries incorporate the
following components in the laundering process:
➊ Commercial washing machines that ensure time,
temperature, agitation, dilution of soils and contaminants
to facilitate loosening of bioburdens trapped in textiles, and
sufficient rinses based upon load content. CDC guidelines
also mandate water temperatures of greater than or equal
to 160 degrees Fahrenheit. Low temperature water of 71
to 77 degrees Fahrenheit (22-25 degrees Celsius) with a
125-part-per-million (ppm) chlorine bleach rinse is also an
effective way to process laundry.
➋ Proper pH chemicals – both high pH (alkaline) and
low pH (acid) – to deactivate organisms and viruses. Proper
introductions of chemicals at the proper time for the proper
amount of time negatively affects both dirt and bioburdens.
Controlling the pH levels also ensures that HCTs have a
neutral pH and present no issues to sensitive patient skin.
➌ Proper oxidation agents also kill and/or destroy
pathogens. Commercial laundries have the expertise and
chemicals to produce desired results, unlike home washing
machines or coin-operated machines for those inclined to
launder their scrubs and uniforms at home.
➍ Rinsing is a vital step in proper laundering of HCTs
and cannot be stressed enough. Rinsing ensures that
contaminants are deposited into the waste drain.
➎ The final step in the laundering process includes drying
HCT at a temperature that exceeds 160 degrees Fahrenheit
at the dryer exhaust. That means that the internal drying
temperature will far exceed the temperature needed to
deactivate or kill any pathogens that potentially have
survived the washing cycles. Additionally, flatwork textiles
are exposed to the heat of a flatwork ironer that typically
is 365 degrees Fahrenheit, depending upon the equipment
manufacturer’s recommendations and the best practices of
the laundry facility.
Commercial healthcare laundries have been and continue
to be significant partners with hospitals and other healthcare
facilities. Their processes ensure hygienic HCTs and they are
up to date with the latest CDC guidelines.
John Scherberger, FAHE, is the owner of Healthcare Risk
Mitigation in Spartanburg, S.C.
may 2020 • www.healthcarehygienemagazine.com