CDC Guidelines for Laundry in Healthcare Facilities

When it comes to protecting a hospital’s staff from the transmission of infectious diseases, nurses and doctors are often the people that one thinks of; however, the some of the most important parties in these defensive measures are control practitioners. One risky aspect that many Sanitation Managers within healthcare tend to overlook is the constant handling of laundry and linens. This often poses a great amount of risks to hospital workers and patients. The laundry personnel in hospitals and healthcare are often responsible for the proper laundering of hundreds of thousands of pounds of linens that are contaminated. The risk of injury, if precautions are not taken, is high.

The Centers for Disease Control and Prevention (CDC)’s Guidelines for Laundry in Healthcare Facilities says that “Although soiled linen has been identified as a source of large numbers of pathogenic microorganisms, the risk of actual disease transmission appears negligible. Rather than rigid rules and regulation, hygienic and common-sense storage and processing of clean and soiled linen are recommended.” To help combat infectious disease within healthcare facilities, the CDC offers the following control measures:

• Soiled linen can be transported in the hospital by cart or chute. Bagging linen is indicated if chutes are used since improperly designed chutes can be a means of spreading microorganisms throughout the hospital.
• Soiled linen may or may not be sorted in the laundry before being loaded into washer/extractor units. Sorting before washing protects both machinery and linen from the effects of objects in the linen and reduces the potential for recontamination of clean linen that sorting after washing requires. Sorting after washing minimizes the direct exposure of laundry personnel to infective material in the soiled linen and reduces airborne microbial contamination in the laundry. Protective apparel and appropriate ventilation can minimize these exposures.
• The microbicidal action of the normal laundering process is affected by several physical and chemical factors. Although dilution is not a microbicidal mechanism, it is responsible for the removal of significant quantities of microorganisms. Soaps or detergents loosen soil and also have some microbicidal properties. Hot water provides an effective means of destroying microorganisms, and a temperature of at least 71 C (160 F) for a minimum of 25 minutes is commonly recommended for hot-water washing. Chlorine bleach provides an extra margin of safety. A total available chlorine residual of 50-150ppm is usually achieved during the bleach cycle. The last action performed during the washing process is the addition of a mild acid to neutralize any alkalinity in the water supply, soap, or detergent. The rapid shift in Ph from approximately 12 to 5 also may tend to inactivate some microorganisms.
• Recent studies have shown that a satisfactory reduction of microbial contamination can be achieved at lower water temperatures of 22-50 C when the cycling of the washer, the wash formula, and the amount of chlorine bleach are carefully monitored and controlled. Instead of the microbicidal action of hot water, low-temperature laundry cycles rely heavily on the presence of bleach to reduce levels of microbial contamination.

Although the laundry in healthcare and hospitals facilities are often contaminated with infectious diseases, the risk of infection to patients and workers is able to be greatly reduced through proper, common-sense practices.