Expert scientists at De Montfort University Leicester (DMU) have warned that healthcare workers who wash their uniforms at home could be transmitting coronavirus not only to their families but also to their colleagues and patients.
Dr Katie Laird, Reader in Microbiology and Head of the Infectious Disease Research Group at DMU, has written to the UK Government to express concerns over Public Health England (PHE)’s latest guidance stating that industrial laundering should be used but if this is not possible, healthcare workers should take uniforms home in a disposable plastic bag.
The NHS uniform and workwear guidelines states it is safe to wash healthcare workers’ uniforms at home, provided the temperature is set to at least 60°C.
Dr Laird, who has conducted extensive research into the domestic and industrial wash processes of healthcare uniforms, has advised the Government that all healthcare uniforms should be laundered in hospitals to commercial standards or by an industrial laundry to minimise the risk of contamination and transmission of the virus.
“Healthcare worker uniforms are commonly laundered at home in the UK, unlike in the rest of Europe where uniforms are either washed within the hospital or at an industrial laundry,” explained Dr Laird.
“By taking their uniforms home, workers run the risk of contaminating their home environment, including the washing machine, because unlike in-house or industrial laundries, there is no segregation of laundry based on designated soiled and clean areas.
“This means that if the virus is on the uniform, it could transfer onto other surfaces or items of clothing in the wash.
“We also have to consider the fact that washing machines we use at home do not always get up to the temperature shown – so you might think you are washing at 60°C but actually you’re not, which means there is potential for coronavirus to be transmitted back into the hospital environment via the same uniform.”
The updated NHS uniform and workwear guidelines published on 2 April 2020 state:
- There is little effective difference between domestic and commercial laundering in terms of removing micro-organisms from uniforms and workwear
- Washing with detergents at 30°C will remove most micro-organisms, including methicillin-resistant Staphylococcus aureus (MRSA)
- A ten-minute wash at 60°C is sufficient to remove almost all micro-organisms.
However, Dr Laird has raised concerns that the evidence that supports the above statements is mainly based on two literature reviews published in 2007, despite more recent publications – including her own – which indicate that domestic washing is not a sufficient way of decontaminating healthcare laundry.
In a previous study, in which she surveyed 265 hospital staff anonymously at four unnamed hospitals in the East Midlands, Dr Laird found that 44% of nurses said they launder their uniforms at temperatures below 60°C and 40% said they wash them with other items of clothing.
“Adherence to laundering policies at home is low, which leads to inadequate decontamination,” continued Dr Laird. “During the coronavirus outbreak, I would seriously advise that all healthcare uniforms are laundered in house or by an industrial laundry to meet the recommended commercial standard.
“We also need to see further education of nurses and healthcare staff in the role of textiles as a transmission route and laundering guidance.”
As well as offering her expert recommendations to the UK Government, Dr Laird has also secured funding from DMU’s Higher Education Innovation Fund to conduct new research looking specifically at the survival of coronavirus on textiles.
She will be working with virologist expert Dr Maitreyi Shivkumar, Lecturer in Molecular Biology at DMU, to conduct a full evaluation of coronavirus on a range of textile types.
“Along with the effect of temperature and disinfectants in wash systems to decontaminate coronavirus, we need to assess the protective role of soiling on the decontamination of coronavirus from textiles,” added Dr Laird.