Professionally qualified

In the UK, the HSE imposes strict guidelines when it comes to protecting the safety of employees. With regards to clothing, it provides the following information: Non-disposable PPE, for example, laboratory coats, overalls or aprons, must be stored appropriately, checked and kept clean and, if faulty, repaired or replaced. If PPE may be, or has been, contaminated by blood or other body fluids, it must be removed safely before leaving the workplace and kept apart from uncontaminated PPE and ‘street’ clothes. It should be cleaned and decontaminated or, if necessary, disposed of safely.

Uniforms are not PPE as defined by the COSHH regulations but protective clothing, such as aprons, may be worn over uniforms or normal clothing to control the risk of contamination. Risk assessment should identify how uniforms or protective clothing could become contaminated and how decontamination will be carried out.

There are no clear HSE guidelines on the washing of workwear but the Department of Health provides comprehensive guidance for linen processors. The NHS does provide washing guidelines for nurses’ uniforms but does not enforce or monitor them.

RABC

The Department of Health provides guidance for linen processors via the implementation of European standard EN 14065. This standard describes a Risk Analysis and Biocontamination Control (RABC) system designed to enable linen processors to continuously assure the microbiological quality of the processed linen. It is a useful application for laundries that handle textiles used in hygiene-sensitive environments, where the elimination of the bacterial load is essential. ‘Hygiene-sensitive’ environments include:

• Kitchens and food-processing
• Healthcare
• Elderly care
• Pharmaceutical area
• Cleanrooms

Justin Kerslake, operations director at Christeyns UK confirms: “Laundries meeting the strict RABC requirements can easily fulfil the needs of these hygiene-sensitive environments”.

Risks of washing at home Cross-contamination

One of the major risks in processing laundry is cross-contamination. To avoid cross-contamination of the workwear during handling, drying, folding, transport and storage and in compliance with RABC requirements, professional laundries strictly separate dirty and clean areas. The removal or limitation of manual activities after the washing process also guarantees the protection of the cleaned workwear. In a few cases where employees could come into contact with the linen, hygiene is guaranteed through hand washing protocols.

Washing at home, however, involves more risk as employees simply cannot meet these strict RABC requirements. A study by intelligence platform and consulting service GfK showed that 98% of the respondents washed their work clothes and personal laundry in the same washing machine. In addition, there is no physical separation between clean and dirty laundry areas, temperature controls are often unreliable and there is also no fixed hand washing protocol. In this context, microbes or bacteria can contaminate the personal laundry and can then end up in a working environment, where it can have an enormous impact on health safety.

Hand hygiene, surface and textile disinfection are key factors to avoid cross-contamination. In this context, European Textile Services Association (ETSA) published on its website the general recommendations from hygiene chemical and disinfection specialist Christeyns on how to minimise the risks of contamination.

Disinfection

Disinfection of textiles can be carried out thermally, chemically and chemo-thermally. Thermal disinfection is carried out at higher temperatures, the effect achieved depends on the temperature and time of action.

Chemical and chemo-thermally procedures include inorganic and organic disinfectants, peroxyacids, alkali, oxidants, halides, alcohols, organic and inorganic compounds with metal ions, phenols, aldehydes, quaternary ammonium compounds, etc. The combination of chemical and thermal disinfection procedure is the most desirable method for textiles which cannot be washed at higher temperatures.

In theory, domestic washing machines could disinfect textiles but in practice, this is difficult as the wash performance is not guaranteed. To kill or inactivate bacteria, yeasts, fungi and viruses the following actions should be taken:

• Programming the temperature setting at 90C in order to achieve a real temperature of about 80C inside the washing drum
• Achieving a sufficiently long holding time at high temperature (without falling below the holding temperature)
• Correct concentration of detergents
• Correct loading of textiles (kg) and water levels (ltr) in the washing machine and
• Proper handling of the textiles after washing and drying

In a domestic setting, one or more of these conditions are often not fulfilled.

Moreover, domestic washing machines vary greatly as does washing load to washing load, even with the same machine. Tolerance thresholds cannot be determined or are within a broad range, it is therefore impossible in practice to validate a washing procedure in a household washing machine.

Professional laundries, on the other hand, implement validated disinfecting washing procedures and control management systems to ensure textile disinfection, using professional machines with validated settings. RKI listed processes are often referred to, where chemical disinfection processes based upon peracetic acid are compliant with EN 14476 for viricidal activity at temperatures usually between 40C and 70C. For example, Cool Chemistry by Christeyns is an RKI-listed disinfecting wash process validated at 60C.

Reliability

Household washing machines offer a preprogrammed choice of washing programs, often based on temperature and time. However, energy saving measures in modern washing machines mean that, the required 60°C is often not reached, nor maintained sufficiently long enough, which makes textile disinfection impossible.

If a temperature of 60C is not actually reached inside the washing drum or varies, a safe disinfection is not possible.

The diagrams on the facing page show the temperature over time of two different 60C programs of two regular household washing machines as examples.

Professional laundries adhere to strict European and international parameters in relation to temperature, type and dosing of laundry detergents, the nature of the soiling and contamination and the composition of the material. Disinfection is mostly achieved chemo-thermally (for temperatures usually between 40C and 70C). This will ensure the optimum killing of bacteria and viruses.

Ecological aspect

It is also worth noting, that in addition to the high hygiene levels professional laundries offer, they also have high standards when it comes to environmentally friendly washing.

ETSA’s research has shown that when compared to washing at home, the sector saves 73% on water, 85% on laundry products and 52% on energy consumption. Professional laundries use about 4 litres per kg of linen on average when compared to the average of 15-20 litres per kg of household washing machines, where no type of water reuse or filtration is available.

In conclusion

With the outbreak of Covid-19, the requirements for general and hygienic cleanliness have increased. Textiles used in the food industry as well as in other hygiene-sensitive environments now need to fulfil certain hygiene standards. National and international authorities and experts in many European countries are increasingly asking for professional processing of textiles and advise clearly against washing laundry at home.

FOLLOW THE DEBATE IN LCN

LCN has been following the debate about washing healthcare uniforms in domestic washing machines. You may be interested to see these pieces from LCN:

https://www.laundryandcleaningnews.com/features/featureuniform-concerns-7525170/

https://www.laundryandcleaningnews.com/news/newsdmu-study-coronavirus-can-surviveon- healthcare-uniforms-for-three-days-8541589/

https://www.laundryandcleaningnews.com/news/newstsa-asks-could-clean-healthcareuniforms- be-covid-19-carriers-8150939/

https://www.laundryandcleaningnews.com/news/newsscientists-advise-government-nohealthcare- uniforms-should-be-washed-at-home-7896675/

https://www.laundryandcleaningnews.com/news/newsinfection-risks-come-under-thespotlight- 6138277/

BIBLIOGRAPHY AND REFERENCES

[1] HSE https://www.hse.gov.uk/biosafety/ blood-borne-viruses/personal-protective-equipment. Htm

[2] Department of Health, Health Technical Memorandum 01-04 Decontamination of Linen for health and social care

[3] Bloomfield SF., Exner M., Nath KJ., Scott EA., Signorelli C.

The infection risks associated with clothing and household linens in home and everyday life settings, and the role of laundry.

International Scientific Forum on Home Hygiene (IFH), National electronic Library of Infection City eHealth Research Centre http:// www.ifh-Homehygiene.org/IntegratedCRD.nsf/ IFH_Topic_Infection_Transmission?OpenForm, April 2011

[7] Consumer Behavior while washing workwear at home, GFK, 2012, P107.

[8] Bellante, S., Engel, A., Hatice, T., Neumann, A., Okyay, G., Peters, M., Vossebein, L.

Hygienische Aufbereitung von Textilien in Privathaushalten - eine Studie aus der Praxis

HygMed 2011; 36 [7/8]: 300–305

[9] Heintz M., Krämer J. und Vossebein L.

Risk Analysis and Biocontamination Control - Hygiene Measures in Commercial Laundries.

Tenside Surf. Det. 2007 44 (5):274-280.