Laundering to kill Germs: Microbiological Decontamination of Textiles

About this guide

With rises in Healthcare Acquired Infections (HAIs) and antibiotic resistance, understanding possible transmissions routes of bacteria is paramount. One such route could be through textiles.

In the school or nursery environment items such as hand towels shared by children or textiles found in the kitchen environment should also be decontaminated thoroughly as a standard infection control procedure.

This guide presents the findings of an investigation on the ability of bacteria to survive on textile fibres and textiles as a potential cross contamination route for bacteria to other surfaces, hands or people. In addition, the correct parameters for decontaminating textile items via domestic laundering was assessed, the findings could be applied to the decontamination of textiles from healthcare, nursery or school environments.  This guide can also be used to teach secondary students background knowledge about contamination sources of bacteria and infection control practices.

How to use this guide

This guide provides specialist knowledge for:

- students and science teachers in the secondary school

- schools/nurseries to ensure that correct laundering parameters are being used for decontamination of textile items used within the school environment

- families wishing to implement hygienic practices based on research

Research base

The evidence for this guide is based on research conducted at De Montfort University on the ability of bacteria to survive on textiles and effectiveness of different domestic wash cycles to remove bacterial contamination from textiles. The wash parameters investigations conducted have been based on survey evidence on the most regularly used domestic wash cycle, temperatures and detergents by UK NHS nurses.

Resources

Burden, M., Keniston, A., Frank, M. G., Brown, C. A., Zoucha, J., Cervantes, L., Weed, D., Boyle, K., Price, C. & Albert, R. K. 2013. Bacterial contamination of healthcare workers' uniforms: A randomized controlled trial of antimicrobial scrubs. Journal of Hospital Medicine, 8, 380-385.

Department of Health, 2010. Uniforms and Workwear: Guidance on uniform and workwear policies for NHS employers.

Fijan, S. & Turk, S. Š. 2012. Hospital Textiles, Are They a Possible Vehicle for Healthcare-Associated Infections? International Journal of Environmental Research and Public Health, 9, 3330-3343.

Mitchell, A., Spencer, M., Edminston, C. Jr. 2015. Role of healthcare apparel and other healthcare textiles in the transmission of pathogens: a review of the literature. Journal of Hospital Infection,  90(4):285-92

Riley, K., Williams, J., Owen, L., Davis, A., Shen, J. and Laird K. (2017a) The Effect of Low Temperature Laundering and Detergents on the Survival of Escherichia coli and Staphylococcus aureus on Textiles Used in Healthcare Uniforms. Journal of Applied Microbiology, 123 (1), pp. 280-286

Riley, K., Williams, J. and Laird, K. (2017b) Domestic laundering of nurse’s uniforms: how should uniforms be washed and what are the risks? Nursing Times, In Press

Riley, K., Laird, K. and Williams, J. (2015) Washing healthcare uniforms at home: Adhering to hospital policy. Nursing Standard. 29 (25), pp. 37-43.

Riley, K and Laird K. (2015) Antimicrobial Textiles for Medical Environments. In: Sun, G. ed. Antimicrobial Textiles, Woodhead Publishing, pp. 249-262

Laird, K. Riley, K. and Williams, J. (2014) The role of protective clothing in healthcare and its decontamination. In: Walker, J.T. (ed.) Decontamination in hospitals and healthcare. Cambridge: Woodhead Publishing. pp. 398-412

Why is intervention required

With rises in Healthcare Acquired Infections (HAIs) and antibiotic resistance, understanding possible transmissions routes of bacteria is paramount. One such route could be through textiles. It is well reported that microorganisms are able to survive on both inanimate and textile surfaces for extended periods of time (Burden et al., 2013, Fijan and Turk, 2012).  In recent years the focus on textiles as a possible route of infection has increased (Mitchell et al. 2015). In a healthcare environment, this could lead to domestically laundered nurse’s uniforms (as per UK Department of Health policy) being a source of contamination to the environment or patients if they have not been laundered correctly to ensure decontamination of bacteria.

In the school or nursery environment items such as hand towels shared by children or textiles found in the kitchen environment should also be decontaminated thoroughly as a standard infection control procedure.

How to launder textiles to ensure decontamination

  1. To ensure safe, regulated laundering of textiles from the school or healthcare environment a minimum temperature of 60°C should be used in a wash cycle no shorter than 10 minutes, using detergent.
  2. Textile items from the school or healthcare environment should be washed separately to other items to prevent cross contamination to other clothing items or the environment.
  3. If items have come from a healthcare environment where there are known sources of HAI the nurses uniforms/textiles should always be stored separately within the home before laundering and should be laundered after every shift before wearing again to ensure any contamination is removed.

Strength of evidence

The evidence presented here backs up the advice in this guide.

Areas for further research

Minimising bacterial transfer in school settings is an under-researched area. The impact of home laundering of health care professionals’ uniforms is also an under-researched area.

Transferability

This research applies in all countries and is relevant to students as well as families and health care professionals.

Editor's Comments

Awareness of ways of minimising germ transfer is relevant to all.