Can you offer assured disinfection?

There have been major changes for large commercial and public sector laundries serving both the hospitality and healthcare sectors. These are well controlled, both nationally and internationally and processes which give assured disinfection (including destruction or removal of viruses such as Covid-19) are now in widespread use.

But where does this leave the small, on-premises laundry in a care home or hotel or on a cruise liner? Not all countries have national standards for these sectors that cover either bacteria or viruses! This month we look at the challenges facing those responsible for delivering clean and disinfected linen to elderly care home residents, hotel guests and cruise line passengers.

What are the challenges?

The demands placed on-premises hotel and care home laundries are now very similar. They both need to:

• deliver textiles which are disinfected with respect to bacteria and critical viruses such as Covid-19.
• maintain or improve upon historical productivity, so as to produce fresh textiles in a timely fashion as and when required.
• maintain or improve upon product quality with respect to stain removal, whiteness, odour and surface handle.
• maintain or extend textile life so as to minimise textile purchase costs.

Historically, some on-premises laundry operators might have concealed a real can of worms! Some could well have no recognised or controlled system for disinfection, either for bacteria or viruses. This is often because the hotel or care home hot water system has been inadequate for implied thermal disinfection and no lower temperature replacement process has been employed.

Productivity is critical in some organisations (such as a care home which employs its laundry team for only, say, four hours per day) which has sometimes resulted in universal use of 40C wash processes because these are the shortest and they have minimum heating up times! Cooler, shorter processes generally result in poor soil and stain removal, residual odours and surface greying, unless they have been specifically designed to mirror the results achievable at higher temperatures.

Putting heavily soiled or stained textiles through traditional cooler, shorter processes often demanded excessive dosing of de-stainers, just to maintain whiteness, leading to significantly reduced textile life and high textile injection costs.

How can these challenges be met?

Every leading supplier of laundry chemicals has now produced products and processes which not only enable assured disinfection in line with national guidelines, but also produce assured destruction or removal of Covid-19. However, these are all reliant on accurate and consistent time and temperature control in the hot wash. If this is a few degrees too cool, then the process assurance is worthless. Most also rely on good control of load factor, which means correctly weighed loads with no overloading.

Control of wash time is down to the launderer; it calls for ensuring appropriate processes in the computer controller and occasional checks on the achievement of the times which are programmed. Control of load factor might be more difficult (especially in organisations where overloading has become endemic) and this may have to be tackled strongly, by thorough explanation and re-training.

Control of wash temperature then becomes critical and reliance on the local hot water supply may well be inadequate, especially as accuracy and consistency can rarely be guaranteed. In the new climate, where assured disinfection is becoming essential, the best solution might be a small, dedicated in-house laundry hot water system. Instead of relying on a large storage calorifier, with significant space and capital requirements, a small in-line system should be capable of meeting the demand immediately and economically. One type of system designed to meet the criteria now required in a small onpremises laundry was described in last month’s LCN1. This avoids any reliance on electric elements in the washers (which are too slow) or the need for steam injection (which would need a steam generator).

After an initial sluice (where required, for heavily fouled work), the next important stage in the process is the pre-wash. This should be around 38C ±2C and run for 4 minutes, to achieve rapid softening of protein soiling and staining, so that these all come away completely in the main wash. This wash should then be controlled to the temperature and accuracy specified by the chemicals’ supplier. This will usually be above the pre-wash temperature, so the in-line generator of on-demand hot water should be set to deliver this temperature in the washer, with a simple blending valve to mix with cold water to meet the pre-wash requirement. A simplified sketch of one possible arrangement is shown in the diagram.

Certification

Hotel management and care-home staff are getting increasingly cautious about liability for cross-infection and a few laundries are seriously considering copying the large healthcare laundries serving every type of hospital. These have instituted simple management systems to enable independent certification to EN14065, which provides internationally recognised assurance that disinfection is being consistently achieved to the required standard. This is a powerful marketing tool and in the hospital sector it has quickly become a pre-requirement for commercial operation in this area. It could be argued that this is a barrier to entry into this market, but in practice obtaining certification to EN14065 is not difficult or unduly expensive. It relies largely on common sense and is probably the cheapest route to offering meaningful and assured disinfection.

Making certification to EN14065 a prerequisite for healthcare laundering has virtually eliminated the risk of low-cost competitors offering poor or non-existent disinfection in order to win business at very low prices. There is a reasonable expectation that this will now spread to the hotel and restaurant market and even more importantly, the care-home sector and cruise liner fleets. This can be expected to result in a significant decrease in the level of micro-organisms, of every type, surviving the wash and being recycled onto clean linen going back into use.

Implications for the operators of on-premises laundries

There are two big implications for carehome operators, on-premises hotel laundries and cruise line operators who want to transition to the delivery of laundered linen with assured disinfection:

They will need laundry processes for their main classifications which guarantee (if operated correctly) disinfection to a recognised standard (such as a 5log reduction in microbial contamination) and control of pathogens such as Covid-19. This will require detailed discussion with chemicals’ suppliers.

Control of laundering parameters will need to be much more precise in the future. This might call for metering pump dosage, accurate load weights and fine temperature control.

Getting the right chemicals will need management time and not every supplier will have suitable products immediately available. However, all leading chemicals’ suppliers have devoted much time and financial investment in this area and there are a range of certified processes now available, covering a range of wash temperatures and prices. Those wanting to maximise their green credentials will go for 40C processes, so they can continue to minimise heat energy consumption and cost. This would also minimise the size and cost of an in-line, instantaneous generator of water at consistently the correct temperature. Getting textiles clean and disinfected at 40C is much more difficult than at 75C, so there would probably be trade-off in chemicals’ cost.

Modest capital investment may be required to achieve the necessary control of those parameters which are fairly and squarely the responsibility of the launderer. This could involve purchase of simple weigh scales in order to ensure correct load factors. It might involve purchase of metering pumps for accurate dosage, although the chemicals’ supplier might agree to finance these. The largest investment might be for an instantaneous supply of water at consistently the right temperature.

Once these basics have been established, the laundry should be producing linen of the right quality – disinfected, odour-free, stain-free and with no greying. This can be used as a USP straight away. Obtaining the necessary certification can then become a longer-term task, spread over several months.

All of these points apply equally to cruise liner laundering. This sector suffers from a relatively closed environment, so bugs, brought aboard by passengers at various points of call, circulate easily amongst passengers and crew. Instantaneous generation of hot water at exactly the right temperature is probably best achieved using a small in-line water heater that uses steam condensation as its heat source. The leading international chemicals’ suppliers, available to cruise fleet operators at major points of call, all have processes suitable for the control of infections, including Covid-19, so it should just be a question of implementing these. This should enable the use of effective processes without reducing laundry productivity.

Conclusion

The care-home resident and the hotel guest probably believe that freshly laundered bedlinen, towels, napkins and garments are already bug-free, but, in reality, this is unlikely to be the case. Destroying infections calls for the laundering skills outlined in this article and it does not come automatically. It is not called for in the national legislation in most states! This is all set to change in the present climate of justified concern about Covid-19 in the coming winter.

If legislation does change and the affected sectors are not ready for it, then the small commercial laundries will probably see this as a golden opportunity to expand their market into care-homes, with the offer of professionally delivered services that include assured and certified disinfection to the tough standards now required. In the market serving those hotels which presently have on-premises laundries, it is the low-cost high-volume textile rental operators who will see the sales opportunity. If steps are not taken now to prepare, then the days of the on-premises laundry could well be numbered and presage yet another change set at the door of the Covid-19 pandemic!