COVID-19 is changing significantly the way we behave, the way we interact and the way we protect ourselves, especially at work. Occupational risk prevention measures are right now in the spotlight, even more if we talk about hospital, nursing homes and other health institutions where COVID-19 is highly present or where its consequences can be devastating.
Many infectious diseases have the capacity to spread within care establishments, where large numbers of people, many of whom may be susceptible to infection, share eating and living accommodation. More than 19.000 elderly people have died in nursing homes only in Spain due to COVID-19. The provision of clean linen is a fundamental requirement of care. Incorrect handling, laundering and storage of linen can pose an infection hazard. All reasonable steps should be taken to protect residents and staff from acquiring infections in care homes. Infected linen from patients with or suspected of suffering from infections specified by the infection control officer as hazardous to staff should be treated according to guidelines of Disease Control and Prevention. Several guidelines were already published and some more are being published with specific focus on COVID-19.
According to these guidelines, linen should be separated into categories ready for decontamination, negating the need for additional handling within the laundry. Linen should be divided into different categories ready for decontamination; many care homes currently use water-soluble/alginate bag liners within cotton sacks in a wheeled trolley to aid this separation, keeping linen off the floor before taking the bags to the laundry[1].
Three categories should be used, these can be colour coded[1].
- Used linen and clothing – white cotton sack. Soiled linen should be placed into a clear, water-soluble/alginate bag, clothing into a separate water-soluble bag, within a white cotton sack.
- Heavily soiled/infected linen – red cotton sack. Heavily soiled items should have any solids removed prior to being placed into a red, water-soluble/alginate bag within a red cotton sack. Infected linen includes linen with blood or other body fluids present that could contain pathogenic organisms.
- Clothing and heat-labile linen – off white cotton sack. This should be placed into a clear, water-soluble/alginate bag within a cotton sack. Heavily soiled clothing should be placed into a red, water-soluble/alginate bag. Manual soaking/sluicing must never be carried out. The pre-wash/sluice cycle in the washing machine should be used after removing any solids.
According to NHS Executive guidelines, HSG (95) 18 – Hospital Laundry Arrangements for Used and Infected Linen, it is recommended that infected linen should be washed in designated washer extractors. It is most important that linen likely to infect staff should be put immediately into a water-soluble bag or bag with a water-soluble stitched seam or membrane which will release its load in the wash process and which is sealed with an appropriate soluble tie and labelled as to its origin[2].
The washing process should have a disinfection cycle in which the temperature in the load is maintained at 65°C (150°F) for not less than 10 minutes or preferably at 71°C (160°F) for not less than 3 minutes. With both options, “mixing time” must be added to ensure heat penetration and assured disinfection. There must be a physical barrier between clean and used or infected linen, when carried on a vehicle at the same time. No bag of linen that is not securely fastened should be placed in a vehicle[2].
According to the Health Technical Memorandum 01-04: Decontamination of linen for health and social care, infectious linen should be sealed in a water-soluble bag, which should then be placed in an impermeable bag immediately on removal from the bed or before leaving a clinical department[3].
- Water-soluble bags are also recommended for heavily fouled linen if capable of being processed by the washer and if agreed with the linen processor.
- Water-soluble bags should be transferred to the designated washer without opening, followed by any washable, reusable laundry outer bag, which should be washed in a similar fashion.
- In future, easy-emptying bags or automatic bag opening equipment may offer an alternative to water-soluble bags. If easy-emptying bags or an automated procedure is adopted, a bag handling procedure should be used that :
- Minimises manipulation of the bag and prevents exposure of staff to the infectious linen prior to decontamination ;
- Is fully automated for washer loading ;
- Incorporates equipment that is capable of being adequately disinfected ; and
- Requires any outer bag to be decontaminated before disposal or reuse.
- It is not acceptable for staff to manually open bags containing infectious linen.
- All linen identified as infectious should be placed in a red water-soluble bag.
March 27th AFNOR published the “Masques barrières. Guide d’exigences minimales, de méthodes d’essais, de confection et d’usage” in this guideline, recommendations for the use of masks, including usage and washing are published[4]:
- It is recommended before washing the masks to clean your washing machine, by carrying out a cold rinse with bleach or to run it empty at 60° C or 95° C without spinning.
- The complete washing cycle (wetting, washing, rinsing) must be at least 30 minutes with a washing temperature of 60° C.
- It is recommended that the barrier mask is completely dried within less than two hours after leaving the wash. Masks must not dry in the open air.
- The masks should be discarded in a bin with a plastic bag (preferably with cover and not manually operated). Double packaging is recommended to preserve the contents of the first bag in case of tearing of the outer bag, during collection.
- A water-soluble bag can be used in order to limit the contact of people with dirty masks during the washing phase if the mask allows it.
In this sense, water soluble bags or soluble liners that allow the bag to release the laundry without manipulating it, can be indeed an efficient solution to minimize risks in laundry operations. Lactips’ material offers the solution to stop pandemic and adopt the unique anti-infectious laundry bags adapted to the sanitary needs of users.
Validated by hospitals, Lactips designed a preventive bag to secure the handling of infected linens and limit the risk of contamination in the laundry processing channel. Push by authorities and stakeholders of the sector, Lactips sells today the unique laundry bags with soluble opening available in Europe. Put directly in the machine, the soluble opening disappears totally on contact with cold and hot water releasing the linen from the bag during the washing cycle and without leaving any sticky residues. Based on 100% natural ingredients, Lactips material addresses sanitary and ecological challenges reducing the use of single use linen and prefering biobased and fully biodegradable solution to protect humans and save environment.
Video “Good practice guide for hospital laundries to prevent contamination risks”
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[1] Infection control guidance for care homes
[2] NHS Executive guidelines, HSG (95) 18 – Hospital Laundry Arrangements for Used and Infected Linen
[3] Health Technical Memorandum 01-04: Decontamination of linen for health and social care
[4] AFNOR SPEC S76 001
