The Impact of Routine Laundering on Ultraviolet Protection Factor (UPF) Values for Commercially Available Sun-Protective Clothing

Background Ultraviolet (UV) radiation has potentially harmful effects on the skin. Sunscreen products have historically focused on blocking UV-B radiation to prevent sunburns while efforts to block UV-A radiation have been lacking. UV protective clothing, rated by ultraviolet protection factor (UPF) values, has gained popularity as an alternative form of UV protection, offering a physical barrier against UV rays. However, concerns arise regarding the disclosure and sustainability of UV-protective textiles, as companies often do not disclose the methods used to achieve UV protection. The addition of chemical sunscreen additives to textiles raises questions about their potential release during laundering and their impact on sustained UV protection and environmental health. Further research is needed to understand the risks and benefits of these practices. Methods Seven garments from commercially available sun-protective brand names claiming UV protection were tested for UPF values. The garments were washed separately using cold water in commercially available detergent in cold water followed by drying on a low setting. UPF measurements were obtained at baseline and at intervals of 10 wash cycles until 50 wash cycles were completed. Results Two brands (Brands A and D) experienced a significant decrease in UPF value (70% to 78%) by the completion of 50 washes. Brand A disclosed the use of a nano-zinc additive in their garments while Brand D did not disclose the means of achieving UV protection. In comparison, five brands (Brands B, C, E, F, G) maintained relatively stable UPF values throughout the 50 washes. The comparison between Brand A and Brand G, who disclosed their UV protection methods, showed that Brand A gradually decreased in UPF value throughout the washes while Brand G remained stable. Conclusion The findings suggest that textile compositions with UV finishes may lose their UPF effectiveness during laundering by loss of the finish used over time or the textile integrity could be affected. This raises questions about the necessity of adding these UV finishes if there are fabrics that can maintain their UPF values without them.

Bench-Scale and Full-Scale Level Evaluation of the Effect of Parameters on Cleaning Efficacy of the Firefighters' PPE

The National Fire Protection Association (NFPA) 1851 document provides guidelines for firefighters on the care and maintenance of their PPE, including decontamination practices. Firefighters are exposed to various toxic chemicals during fire suppression activities, making effective decontamination crucial for their safety. This study evaluated the efficacy of different washing parameters, including temperature, time, and surfactants, on cleaning outer-shell material contaminated with nine targeted compounds from three different functional groups: phenols, polycyclic aromatic hydrocarbons (PAHs), and phthalates. The study was conducted on both bench-scale and full-scale levels, with contaminated swatches washed in a water shaker bath in the bench-scale evaluation and full-sized washer extractors used in the full-scale evaluation. The results showed that bench-scale washing demonstrated similar trends in contaminant removal to full-scale washing. Importantly, the study highlighted the complexity of removing fireground contaminants from the personal protective ensemble (PPE). The findings of this study have practical implications for the firefighting industry as they provide insight into the effectiveness of different washing parameters for PPE decontamination. Future studies could explore the impact of repeated washing on PPE and investigate the potential for developing more efficient decontamination strategies. Ultimately, the study underscores the importance of ongoing efforts to ensure the safety of firefighters, who face significant occupational hazards.

Effect of Household Laundering, Heat Drying, and Freezing on the Survival of Dermatophyte Conidia

Dermatomycoses are one of the most common dermatological infectious diseases. Dermatophytoses, such as tinea pedis (athlete’s foot) in adults and tinea capitis in children, are the most prevalent fungal diseases caused by dermatophytes. The transmission of anthropophilic dermatophytoses occurs almost exclusively through indirect contact with patient-contaminated belongings or environments and, subsequently, facilitates the spread of the infection to others. Hygienic measures were demonstrated to have an important role in removing or reducing the fungal burden. Herein, we evaluated the effectiveness of physical-based methods of laundering, heat drying, and freezing in the elimination of Trichophyton tonsurans, T. rubrum, and T. interdigitale conidia in diverse temperatures and time spectra. Based on our findings, laundering at 60 °C was effective for removing the dermatophyte conidia from contaminated linens. On the contrary, heat drying using domestic or laundromat machines; freezing at −20 °C for 24 h, 48 h, or one week; and direct heat exposure at 60 °C for 10, 30, or 90 min were unable to kill the dermatophytes. These results can be helpful for clinicians, staff of children’s communities, and hygiene practitioners for implementing control management strategies against dermatophytoses caused by mentioned dermatophyte species.

The effect of washing and wearing on sports bra function

Sports bras provide support by restricting breast motion during exercise, which may prevent damage to breast structures. Laundering affects the mechanical properties of some sports bra materials. Bra function on the wearer after washing is unreported, meaning sports bra durability is unknown. This intervention study compared subjective and objective performance of sports bras that were washed, and worn/washed, to a control. Twenty-two females were assigned three identical sports bras; control, washed and worn/washed (washed after 60-min wear). Pre-intervention: breast position was recorded while standing and running in each bra. Comfort, fit and aesthetics were rated. Intervention: participants undertook their normal exercise in their worn/washed bra. Post-intervention: after 25 washes (n = 19), pre-intervention testing was repeated. Breast volume and control bra motion were consistent pre/post-intervention; however, post-intervention breast motion increased (20% mediolaterally, 16% superioinferiorly) in washed bras and (32% mediolaterally, 25% superioinferiorly) worn/washed bras. Post-intervention washed, and worn/washed bras were perceived as less supportive and washed bras less comfortable than worn/washed bras. Sports bra support reduced after 25 washes; this was compounded by wear. Participants detected reduced support, but comfort was sustained, suggesting replacement may not be considered. Guidelines on sports bra durability are recommended for breast health.

Textile Washing Conveys SVOCs from Indoors to Outdoors: Application and Evaluation of a Residential Multimedia Model

Indoor environments have elevated concentrations of numerous semivolatile organic compounds (SVOCs). Textiles provide a large surface area for accumulating SVOCs, which can be transported to outdoors through washing. A multimedia model was developed to estimate advective transport rates (fluxes) of 14 SVOCs from indoors to outdoors by textile washing, ventilation, and dust removal/disposal. Most predicted concentrations were within 1 order of magnitude of measurements from a study of 26 Canadian homes. Median fluxes to outdoors [μg·(year·home)^-1] spanned approximately 4 orders of magnitude across compounds, according to the variability in estimated aggregate emissions to indoor air. These fluxes ranged from 2 (2,4,4'-tribromodiphenyl ether, BDE-28) to 30 200 (diethyl phthalate, DEP) for textile washing, 12 (BDE-28) to 123 200 (DEP) for ventilation, and 0.1 (BDE-28) to 4200 (bis(2-ethylhexyl) phthalate, DEHP) for dust removal. Relative contributions of these pathways to the total flux to outdoors strongly depended on physical-chemical properties. Textile washing contributed 20% tris-(2-chloroisopropyl)phosphate (TCPP) to 62% tris(2-butoxyethyl)phosphate (TBOEP) on average. These results suggest that residential textile washing can be an important transport pathway to outdoors for SVOCs emitted to indoor air, with implications for human and ecological exposure. Interventions should try to balance the complex tradeoff of textile washing by minimizing exposures for both human occupants and aquatic ecosystems.

Laundry Hygiene and Odor Control: State of the Science

Laundering of textiles—clothing, linens, and cleaning cloths—functionally removes dirt and bodily fluids, which prevents the transmission of and reexposure to pathogens as well as providing odor control. Thus, proper laundering is key to controlling microbes that cause illness and produce odors. The practice of laundering varies from region to region and is influenced by culture and resources. This review aims to define laundering as a series of steps that influence the exposure of the person processing the laundry to pathogens, with respect to the removal and control of pathogens and odor-causing bacteria, while taking into consideration the types of textiles. Defining laundering in this manner will help better educate the consumer and highlight areas where more research is needed and how to maximize products and resources. The control of microorganisms during laundering involves mechanical (agitation and soaking), chemical (detergent and bleach), and physical (detergent and temperature) processes. Temperature plays the most important role in terms of pathogen control, requiring temperatures exceeding 40°C to 60°C for proper inactivation, while detergents play a role in reducing the microbial load of laundering through the release of microbes attached to fabrics and the inactivation of microbes sensitive to detergents (e.g., enveloped viruses). The use of additives (enzymes) and bleach (chlorine and activated oxygen) becomes essential in washes with temperatures below 20°C, especially for certain enteric viruses and bacteria. A structured approach is needed that identifies all the steps in the laundering process and attempts to identify each step relative to its importance to infection risk and odor production.

Effects of outdoor weathering and laundering on the detection and classification of fluorinated oil-and-water-repellent fabric coatings

Fluorinated polymer coatings are used to impart durable oil-and-water-repellent properties on fabrics, potentially offering a persistent fiber characteristic for forensic fiber comparisons. To evaluate the persistence of these coatings, we investigate effects of outdoor weathering and laundering on detection and classification of the fluorinated oil-and-water-repellent coatings on 9 garments and 2 spray-coated fabric samples. Single fibers from the samples are pyrolyzed and subjected to gas chromatography coupled to a fluorine-selective detector. The positive detection of coatings is indicated by a signal-to-noise ratio (S/N) >50 for the tallest peak in the pyrograms. Moreover, a multinomial logistic regression model trained using fibers prior to weathering and laundering is utilized to determine the class of the weathered and laundered fibers, providing a metric to evaluate the effect of these processes on fiber classification. Notably, fluorinated coatings are detected on all of the fibers exposed to outdoor elements in Arlington, VA, up to 12 weeks from August to October 2020, while a detection rate of 95.5% is achieved for samples laundered up to 10 wash cycles. The detection rate prior to weathering and laundering was 98%, indicating negligible effect of these processes on detection of coatings. The classification accuracy is determined to be 99% and 100% for weathered and laundered samples, respectively, illustrating that these processes do not significantly affect the major pyrolysis products of the coatings responsible for classification. These results highlight the persistence of the fluorinated oil-and-water-repellent fabric coatings and their potential for forensic fiber discrimination at single-fiber level.

Presence of Methicillin-Resistant Staphylococcus aureus (MRSA) on Healthcare Workers' Attire: A Systematic Review

Contaminated healthcare workers' (HCW) clothing risk transferring methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. We performed a systematic review in Pubmed and Scopus for 2000-2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to analyze evidence of MRSA on HCW attire. The primary study outcome was MRSA isolation rates on HCW clothing in healthcare settings. Out of 4425 articles, 23 studies were included: 18 with 1760 HCWs, four with 9755 HCW-patient interactions and one with 512 samples. There was a notable variation in HCWs surveyed, HCW attires, sampling techniques, culture methods and laundering practices. HCW attire was frequently colonized with MRSA with the highest rates in long-sleeved white coats (up to 79%) and ties (up to 32%). Eight studies reported additional multidrug-resistant bacteria on the sampled attire. HCW attire, particularly long-sleeved white coats and ties, is frequently contaminated with MRSA. Banning certain types and giving preference to in-house laundering in combination with contact precautions can effectively decrease MRSA contamination and spread.

Impact of Repeated Exposure and Cleaning on Protective Properties of Structural Firefighting Turnout Gear

The US fire service has become acutely aware of the need to clean PPE after fires. However, there is concern that damage from repeated cleaning may impact critical protection from fireground risk. Using a protocol that included repeated simulated fireground exposures (between 0 and 40 cycles) and/or repeated cleaning with techniques common in the fire service, we found that several important protective properties of NFPA 1971 compliant turnout gear are significantly changed. Outer shell and thermal liner tear strength showed a statistically significant reduction when laundered as compared to wet or dry decontamination. Larger changes in outer shell tear strength resulted when the coat closure incorporated hook & dee clasps as compared with garments using zippered closures. Total Heat Loss (THL) was reduced for all samples that underwent any form of cleaning while Thermal Protective Performance (TPP) was only increased in the gear that was laundered. These results suggest that some important protective properties of bunker gear can be decreased after repeated exposure/cleaning cycles relative to their levels when tested in a new condition. For the specific materials tested, outer shell trap tear strength in the fill direction and seam strength dropped below NFPA 1971 requirements after 40 laundering cycles. The findings for this study may have utility for setting preconditions for the measurement of certain performance properties in future editions of NFPA 1971.

Guidelines in Practice: Surgical Attire

Surgical attire provides a barrier to microorganisms shed from health care workers' skin and hair to help protect patients and promote a clean environment. The AORN "Guideline for surgical attire" includes recommendations for selecting, wearing, and cleaning surgical attire that are based on the highest-quality evidence available. Recommendations are rated as Regulatory Requirement, Recommendation, Conditional Recommendation, or No Recommendation according to the level of evidence, an assessment of the benefits versus harms of implementing specific interventions, and consideration of resources required to implement the interventions. This article discusses guideline recommendations related to laundering surgical attire, wearing long-sleeved attire, and wearing head coverings. A scenario provides an example in which an interdisciplinary facility team uses a gap analysis and a risk assessment to prioritize process changes for implementing the guideline. Perioperative personnel should review the entire guideline for additional information and for guidance when creating and updating policies and procedures.

Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs

Firefighters are occupationally exposed to products of combustion containing polycyclic aromatic hydrocarbons (PAHs) and flame retardants (FRs), potentially contributing to their increased risk for certain cancers. Personal protective equipment (PPE), including firefighter hoods, helps to reduce firefighters' exposure to toxic substances during fire responses by providing a layer of material on which contaminants deposit prior to reaching the firefighters skin. However, over time hoods that retain some contamination may actually contribute to firefighters' systemic dose. We investigated the effectiveness of laundering to reduce or remove contamination on the hoods, specifically PAHs and three classes of FRs: polybrominated diphenyl ethers (PBDEs), non-PBDE flame retardants (NPBFRs), and organophosphate flame retardants (OPFRs). Participants in the study were grouped into crews of 12 firefighters who worked in pairs by job assignment while responding to controlled fires in a single-family residential structure. For each pair of firefighters, one hood was laundered after every scenario and one was not. Bulk samples of the routinely laundered and unlaundered hoods from five pairs of firefighters were collected and analyzed. Residual levels of OPFRs, NPBFRs, and PAHs were lower in the routinely laundered hoods, with total levels of each class of chemicals being 56-81% lower, on average, than the unlaundered hoods. PBDEs, on average, were 43% higher in the laundered hoods, most likely from cross contamination. After this initial testing, four of the five unlaundered exposed hoods were subsequently laundered with other heavily exposed (unlaundered) and unexposed (new) hoods. Post-laundering evaluation of these hoods revealed increased levels of PBDEs, NPBFRs, and OPFRs in both previously exposed and unexposed hoods, indicating cross contamination. For PAHs, there was little evidence of cross contamination and the exposed hoods were significantly less contaminated after laundering (76% reduction; p = 0.011). Further research is needed to understand how residual contamination on hoods could contribute to firefighters' systemic exposures.

Biological parameters used in setting captive-breeding quotas for Indonesia's breeding facilities

The commercial captive breeding of wildlife is often seen as a potential conservation tool to relieve pressure on wild populations, but laundering of wild-sourced specimens as captive bred can seriously undermine conservation efforts and provide a false sense of sustainability. Indonesia is at the center of such controversy; therefore, we examined Indonesia's captive-breeding production plan (CBPP) for 2016. We compared the biological parameters used in the CBPP with parameters in the literature and with parameters suggested by experts on each species and identified shortcomings of the CBPP. Production quotas for 99 out of 129 species were based on inaccurate or unrealistic biological parameters and production quotas deviated more than 10% from what parameters in the literature allow for. For 38 species, the quota exceeded the number of animals that can be bred based on the biological parameters (range 100-540%) calculated with equations in the CBPP. We calculated a lower reproductive output for 88 species based on published biological parameters compared with the parameters used in the CBPP. The equations used in the production plan did not appear to account for other factors (e.g., different survival rate for juveniles compared to adult animals) involved in breeding the proposed large numbers of specimens. We recommend the CBPP be adjusted so that realistic published biological parameters are applied and captive-breeding quotas are not allocated to species if their captive breeding is unlikely to be successful or no breeding stock is available. The shortcomings in the current CBPP create loopholes that mean mammals, reptiles, and amphibians from Indonesia declared captive bred may have been sourced from the wild.

Examination of Hospital Policies Regarding Certified Registered Nurse Anesthetist Attire in the Operating Room

The purpose of this study was to examine operating room (OR) policies related to infection control and attire worn by Certified Registered Nurse Anesthetists (CRNA) and the attitudes of CRNAs toward these policies. A 20-question survey was distributed to a random sample of 3,000 members of the American Association of Nurse Anesthetists. The response rate was 26% (N = 790). Data collected were demographics, characteristics of OR attire protocols in surgical facilities, CRNA beliefs regarding infection control, and compliance with attire policies. Same-day/ambulatory surgery centers were less likely to have formal protocols on OR attire than were inpatient hospital ORs. More than half (53.2%) of CRNAs reported being "always" compliant with attire protocols, but only 39.1% strongly agreed that their coworkers are compliant. CRNAs working in inpatient hospital ORs were more likely to report their coworkers as noncompliant with attire protocols, although there was no significant difference in reported personal compliance among groups. Experienced CRNAs tend to be more compliant with attire protocols. Implications for practice include evidence-based standardization of attire policies and encouragement of CRNAs' participation in development of and compliance with policies to reduce surgical site infection rates.