Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England)

J. A. Wilson*, H. P. Loveday, Peter Hoffman, R. J. Pratt

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

91 Citations (Scopus)

Abstract

A systematic search and quality assessment of published literature was conducted to establish current knowledge on the role of healthcare workers uniforms' as vehicles for the transfer of healthcare-associated infections. This review comprised a systematic search of national and international guidance, published literature and data on recent advances in laundry technology and processes. We found only a small number of relevant studies that provided limited evidence directly related to the decontamination of uniforms. Studies concerning domestic laundry processes are small scale and largely observational. Current practice and guidance for laundering uniforms is extrapolated from studies of industrial hospital linen processing. Healthcare workers' uniforms, including white coats, become progressively contaminated in use with bacteria of low pathogenicity from the wearer and of mixed pathogenicity from the clinical environment and patients. The hypothesis that uniforms/clothing could be a vehicle for the transmission of infections is not supported by existing evidence. All components of the laundering process contribute to the removal or killing of micro-organisms on fabric. There is no robust evidence of a difference in efficacy of decontamination of uniforms/clothing between industrial and domestic laundry processes, or that the home laundering of uniforms provides inadequate decontamination.

Original languageEnglish
Pages (from-to)301-307
Number of pages7
JournalJournal of Hospital Infection
Volume66
Issue number4
DOIs
Publication statusPublished - Aug 2007

Keywords

  • Decontamination
  • Domestic laundry of uniforms
  • Healthcare clothing
  • Healthcare-associated infections
  • Hospital laundry
  • Nurses' uniforms

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