UK
Experts from De Montfort University (DMU) in Leicester warned earlier this year that healthcare workers who wash their uniforms at home could unknowingly be contributing to the spread of antibiotic-resistant infections. Current NHS guidance allows staff to wash uniforms at home if washed at 60°C with detergent, however researchers found that only half of the six domestic washing machine models tested met the required standard.
The team from De Montfort University, led by Professor Katie Laird, Professor of Microbiology and Deputy Director at the Leicester Institute for Pharmaceutical and Health Innovation, also grew common bacteria in detergent over several cycles, and found that some became more tolerant to the detergent and less sensitive to antibiotics. This cross-resistance means that improperly laundered uniforms could play a role in the spread of antibiotic-resistant infections.
Professor Katie Laird, who is calling for the NHS to revise its laundry guidelines for healthcare workers and consider using on-site industrial machines or commercial laundry services, has provided her six top tips to help safely launder uniforms at home:
1. Separate uniforms from household laundry – Always wash your uniform separately from family clothes and linens to avoid cross contamination.
2. Avoid quick or eco cycles – Short and eco-friendly wash cycles, which are commonly used to save time and reduce energy costs, were shown to be particularly poor at removing harmful pathogens.
3. Don’t overload your washing machine – Piling too much into the drum reduces heat penetration and detergent distribution. To get the best possible results, fill no more than half a drum load.
4. Clean your washing machine regularly – Domestic washing machines can harbour biofilms – layers of bacteria that stick to surfaces – in detergent drawers and rubber door seals. Biofilms can survive regular cleaning and potentially re-contaminate laundry during each wash. Harmful bacteria such as Pseudomonassp, Acinetobacter sp, and Mycobacterium sp were found to be living in the machines, which can cause infections, particularly in people with weakened immune systems. To clean the machine, run it on its highest heat setting with an empty drum and specialist cleaner. Make sure you also wipe the detergent drawer and doors seals to remove biofilm build-up.
5. Replace your machine every 3-4 years – As washing machines age they are more likely to have a build-up of bacteria biofilms in hidden areas such as pipes, drawers and seals. They are difficult to remove and may re-contaminate freshly washed uniforms.
6. Use industrial or NHS-supplied laundering, where possible – Commercial-grade or onsite NHS laundry machines are specifically designed to meet healthcare hygiene standards and consistently reach the high temperatures required to safely decontaminate clothing.
Professor Laird said: “Our research showed that domestic washing machines often fail to disinfect textiles properly and allow antibiotic-resistant bacteria to survive. We hope that providers and policymakers take note of these findings and review current guidance to consider safer options, such as on-site or professional laundry services. Until then, it’s important for healthcare workers to be equipped with all the necessary steps they can take to try and prevent contamination.”
Following the study from De Montfort University that proved that domestic washing machines do not reach the required parameter for infection control, the Textile Services Association (TSA) has worked alongside the team at DMU to carry out further tests in industrial laundries using the same test methodologies. Laundries carried out tests on their standard healthcare wash programme and test pieces were analysed by Professor Laird’s team. The results showed that industrial washing achieved a 100% pass rate.
Professor Laird added: “The main difference between domestic and industrial washing machines is that all industrial machines have process validation built in, so both time and temperature are constantly monitored throughout the process. This is normally not the case in domestic machines.”
David Stevens, CEO at Textile Services Association (TSA), said: “We weren’t surprised by DMU’s results as our members spend millions of pounds designing healthcare laundries to ensure they manage process control and are audited in line with international standards (BS EN 14065). The new test methodology developed by DMU now enables healthcare facilities to test the efficiency of their laundry process to kill pathogens.
“For healthcare and care home managers, the message is clear: the onus of properly disinfecting uniforms should not be put on healthcare workers to take care of at home. This is not a safe practice, particularly if there is a vulnerable person in the household. At the TSA, we’re lobbying the Government that all nurses should have access to a professional laundry service. Hospitals already outsource commercial laundry for bed and patient linen, so why can’t the same be done for our key workers.”
The full research paper can be found here.
• Read more about De Montfort and TSA research on this subject in LCNi, below.
