A Randomized Trial to Determine Whether Wearing Short-Sleeved White Coats Reduces the Risk for Pathogen Transmission

John, Amrita; Alhmidi, Heba; Gonzalez-Orta, Melany; Cadnum, Jennifer L.; Donskey, Curtis J.

doi:10.1017/ice.2017.264

Cited by 15 publications

(24 citation statements)

References 9 publications

(20 reference statements)

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“…This was likely the result of the sleeve cuffs touching the mannequin, which occurred during 44% of the observed interactions. Transmission of the cauliflower mosaic virus DNA to a second mannequin was limited and there was no significant difference between short and long-sleeved uniforms ( p > 0.05; 5% versus 0%) ( John et al, 2017 ). The rate of Micrococcus luteus transmission to mannequins during simulated physical examination was also statistically similar between short and long sleeve uniforms ( p > 0.05; zero versus one of five mannequins contaminated) ( Weber et al, 2012 ).…”

Section: Survey Methodologymentioning

confidence: 99%

“…The studies are limited by the risk of doctors behaving differently upon being observed and the results may not reflect their usual practice. The study by John et al (2017) is also limited by the use of viral DNA rather than a viable pathogen, which may have differing transfer efficiencies between textiles and the environment. There do not appear to be any similar investigations in the published literature on transmission from other healthcare textiles, such as bed linens, which are in more intimate contact with patients for longer periods of time.…”

Section: Sattar Et Al (2001)mentioning

confidence: 99%

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The role of textiles as fomites in the healthcare environment: a review of the infection control risk

Owen

Laird

2020

PeerJ

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Background Infectious diseases are a significant threat in both healthcare and community settings. Healthcare associated infections (HCAIs) in particular are a leading cause of complications during hospitalisation. Contamination of the healthcare environment is recognised as a source of infectious disease yet the significance of porous surfaces including healthcare textiles as fomites is not well understood. It is currently assumed there is little infection risk from textiles due to a lack of direct epidemiological evidence. Decontamination of healthcare textiles is achieved with heat and/or detergents by commercial or in-house laundering with the exception of healthcare worker uniforms which are laundered domestically in some countries. The emergence of the COVID-19 pandemic has increased the need for rigorous infection control including effective decontamination of potential fomites in the healthcare environment. This article aims to review the evidence for the role of textiles in the transmission of infection, outline current procedures for laundering healthcare textiles and review studies evaluating the decontamination efficacy of domestic and industrial laundering. Methodology Pubmed, Google Scholar and Web of Science were searched for publications pertaining to the survival and transmission of microorganisms on textiles with a particular focus on the healthcare environment. Results A number of studies indicate that microorganisms survive on textiles for extended periods of time and can transfer on to skin and other surfaces suggesting it is biologically plausible that HCAIs and other infectious diseases can be transmitted directly through contact with contaminated textiles. Accordingly, there are a number of case studies that link small outbreaks with inadequate laundering or infection control processes surrounding healthcare laundry. Studies have also demonstrated the survival of potential pathogens during laundering of healthcare textiles, which may increase the risk of infection supporting the data published on specific outbreak case studies. Conclusions There are no large-scale epidemiological studies demonstrating a direct link between HCAIs and contaminated textiles yet evidence of outbreaks from published case studies should not be disregarded. Adequate microbial decontamination of linen and infection control procedures during laundering are required to minimise the risk of infection from healthcare textiles. Domestic laundering of healthcare worker uniforms is a particular concern due to the lack of control and monitoring of decontamination, offering a route for potential pathogens to enter the clinical environment. Industrial laundering of healthcare worker uniforms provides greater assurances of adequate decontamination compared to domestic laundering, due to the ability to monitor laundering parameters; this is of particular importance during the COVID-19 pandemic to minimise any risk of SARS-CoV-2 transmission.

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Section: Survey Methodologymentioning

confidence: 99%

Section: Sattar Et Al (2001)mentioning

confidence: 99%

The role of textiles as fomites in the healthcare environment: a review of the infection control risk

Owen

Laird

2020

PeerJ

View full text Add to dashboard Cite

show abstract

“…25 Recent studies show that the long-sleeves of the doctors' white coats have been shown to transfer bacteria from one patient to another, thereby serving as fomites that could transmit infectious diseases. 4,26 Again, in the systemic review conducted by Haun and colleagues found that white coats had a contamination rate of up to 16% with MRSA and up to 42% with GNR. 4 It is important to highlight, that whitecoats in some instances had higher GNR prevalence than stethoscopes that were being used to examine patients.…”

Section: Dirty White Coatsmentioning

confidence: 99%

“…4 It is important to highlight, that whitecoats in some instances had higher GNR prevalence than stethoscopes that were being used to examine patients. 4,26 John et al randomized practitioners to long and short sleeves while examining a mannequin contaminated with viral DNA followed by examination of uncontaminated mannequin. The cuffs of long sleeve white coats touched the contaminated mannequin 77% of simulations and contacted the uncontaminated mannequin 68% of the simulations Also they found significantly more transfer of viruses to clean sites when wearing long sleeve white coats (figure 2).…”

Section: Dirty White Coatsmentioning

confidence: 99%

“…The cuffs of long sleeve white coats touched the contaminated mannequin 77% of simulations and contacted the uncontaminated mannequin 68% of the simulations Also they found significantly more transfer of viruses to clean sites when wearing long sleeve white coats (figure 2). 26 Qaday et al conducted a cross-sectional study sampling for bacterial contamination of white coats. 73% of all sampled white coats were contaminated with pathogens.…”

Section: Dirty White Coatsmentioning

confidence: 99%

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