The debate about the risks involved in allowing nurses and other healthcare staff to wear their uniforms outside work and to wash them at home has been going on for many years.

Despite reports that have concluded that professional laundering would reduce any risks of contamination and help to protect public health, the Department of Health (DH) has so far declined to support this view in its guidelines.

DH insists that home washing is safe and that the link between uniforms and infection has yet to be proved.

Textile Services Association argues otherwise, saying that home washing cannot meet the requirements for strict hygienic cleaning and disinfection.

Domestically, low temperature washing at 40C has been the norm for some time. Now High Street retailers such as Marks & Spencer are selling garments with care-labels that urge washing at 30C.

The TSA’s recently published investigation (reviewed on p09) marks the start of a further campaign to change official thinking.

It examines practices in Europe, where countries such as Austria and Germany insist that nurses change into and out of uniform at the hospital, leaving these work clothes to be professionally cleaned and decontaminated.

The argument here is that while there may not be a proven link between uniforms and infection, if you wait until there is, it may be too late.

But the debate is not really about certainties, it’s about risks and possibilities. The link between infection and uniforms may never be proved beyond reasonable doubt. The question the Department of Health should be asking is: ”Isn’t it better to take preventative action that reduces the risk of a serious outbreak of infection than to wait until disaster occurs?”

The food industry already bases its regulations on risk assesment and prevention, surely those concerned with keeping the nation as healthy as possible should do the same.

One obstacle to the TSA’s arguments is cost. This is a time of reduced Government spends and cuts in public services. NHS trusts are under orders to reduce their spends and home washing is undoubtedly the cheap option. Taking on a professional laundering service would would incur service costs. In many cases suitable changing rooms would have to be provided.

Recognising the reality, TSA proposes that Trusts should try a rental service and see how it works. The association suggests that Trusts should look the areas where the risk is highest, such as acute wards, and consider installing a service on a trial basis. Talk to rental providers about any problems, they will probably be able to find a solution.

It sounds a sensible and practical idea.

Janet Taylor–