In recent years, many health care institutions have ramped up efforts to promote sanitary conditions. Traditionally, this has mostly been about the cleaning of caregiving equipment, facilities, and hands. But the problem of infections spread by clothing remains a largely under-attended concern.
Growing concerns about drug resistant bacteria and the clothing of nurses, doctors, and other health care personnel have been getting more attention- but the attention has been sporadic and passing. And the problem of clothing-borne pathogens has not improved at a steady rate.
Infection control experts have written extensively on the research surrounding the benefits of washing hands, sterilizing equipment, changing bed pads more frequently, and sanitizing hospital spaces- still woefully little is known about the role that coats, sleeves, ties, and worn scrubs play in the spread of infections.
After a number of false starts and relapses, the issue was reintroduced when the British National Health Service imposed their “bare below the elbows” policy. As the name suggests, the rule prohibits sleeves extending beyond the elbows. This prevents hanging fabrics that absorb liquids and hold on to germs from making contact with the work of the hands leaving easy to wash bare skin exposed.
But over the years, the focus on the role of clothing in the spread of infection tends to fade. When we think of preventing infection, we tend to have a bias that favors covering up. Long sleeves feel more sanitary. Over the course of a day, a long sleeve is more sanitary for the person wearing them. Germs accumulate on the fabric and are kept from the wearer long enough to make it to the laundry room. All the while, however, the health care worker is spreading germs via sleeve contact with surfaces and patients. Conversely, a person not wearing long sleeves will tend to come into more direct contact with germs and pathogens.
But more research has been coming in with results concerning the bacteria spreading effects of clothing- particularly, long sleeves. A study published in the American Journal of Infection Control claims that over 60% of the uniforms worn by health care workers tested positive for pathogens at a higher rate than the clothing of non-medical staff. The pathogens found on their uniforms include those that cause pneumonia, staph, and MRSA.
The study followed 60 doctors and 75 registered nurses at a university based hospital. More than 50% of the samples taken tested positive for at least one potentially dangerous pathogen. Of those, 11% were drug resistant pathogens.
Dr. Yonit Wiener-Well of the Shaare Zedek Medical Center, a lead researcher in the study said, “The data suggests personnel attire may be a route by which pathogens are transmitted to patients.”
Registered nurse, Ramona Conner told NBC News, “We know that antibiotic-resistant organisms have been found to survive for extended periods of time on hospital materials including clothing and linens.”
One of the latest widespread developments has been growing interest in keeping men’s scrubs. For many years, it has been common for hospital staff to wear their scrubs out in public when on breaks.
Conner said, “Since we know pathogens are present on clothing, our job is to reduce exposure to as much as possible.”
It would take a significant effort to prevent medical staff from wearing scrubs in public. Facilities would have to be altered to encourage workers to change before going out of a facility and to change again on their way in. The work of laundry staff would become more intensive, and emergency personnel might be slower to respond. Still, it’s an avenue toward infection prevention that is worth exploring.
