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Environmental Infection Prevention and Control
Contaminated Laundry

Course Author(s): Géza T. Terézhalmy, DDS, MA; Michaell A. Huber, DDS

Contaminated Laundry

OSHA defines contaminated laundry as “laundry which has been soiled with blood or OPIM" and includes towels, personal clothing, uniforms, scrub suits, gowns, and drapes for surgical procedures. Although contaminated textiles and fabrics in healthcare facilities can be a source of substantial numbers of pathogenic organisms, reports of HAIs linked to contaminated fabrics are so few in number that the overall risk of disease transmission during the laundry process is negligible.1

OSHA regulations prohibit home laundering of items considered PPE; however, experts disagree whether this regulation extends to uniforms and scrub suits that are not contaminated with blood or OPIM. Such items presumably do not differ appreciably from street clothes in the degree of bioburden and home laundering would remove the level of soil adequately. However, in response to the recent SARS‑CoV‑2 virus pandemic, the ADA recommends office attire such as scrubs be changed between street clothes upon entry and exit and not be taken home.9 Clearly, employers must launder workers’ personal protective garments or uniforms contaminated with blood or OPIM (Table 4).1

Table 4. Recommendations for Contaminated Laundry.1
  1. Routine handling of contaminated laundry
    1. Handle contaminated textiles and fabrics with minimum agitation to avoid contamination of air, environmental surfaces, and persons.
    2. Bag or otherwise contain contaminated textiles or fabrics at point of use.
      1. Use leak-proof containment for textiles and fabrics contaminated with blood or OPIM.
      2. Identify bags or containers for contaminated textiles with labels, color coding, or other alternative means of hazard communication.
  2. Laundry facility and equipment
    1. The laundry facility in a healthcare setting should be designed for efficiency in providing hygienically clean textiles, fabrics, and apparel for patients and staff.
    2. Laundry area should have a handwashing facility readily available to workers
    3. Laundry workers should wear PPE
    4. Laundry equipment must be used and maintained according to manufacturers’ instructions
  3. Laundry process
    1. If hot-water laundry cycles are used, wash with detergent in water ≥160°F (≥71°C) for ≥25 minutes
    2. Choose chemicals suitable for low-temperature washing at proper use concentration if low-temperature (<160°F[<71°C]) laundry cycles are used
    3. Do not leave damp textiles or fabrics in machines overnight
    4. Package, transport, and store clean textiles and fabrics by methods that will ensure their cleanliness and protect them from dust and soil during inter-facility loading, transport, and unloading.
  4. Special laundry situations
    1. Some textiles, surgical drapes, and gowns must be sterilized before use
      1. Require steam autoclaving after laundering
    2. Dry cleaning should be reserved for those circumstances in which fabrics cannot be safely cleaned with water and detergent.
      1. Dry cleaning alone is relatively ineffective in reducing the number of bacteria and viruses on contaminated linen.
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