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Background
Fomites are an important pathway for infectious disease spread in residential and
home healthcare settings (i.e., nursing, assisted living, and retirement communities).
Many healthcare professionals launder work clothes at home that may be contaminated
by contact with infected patients. Through quantitative microbial risk assessment
(QMRA), the study objectives were to (1) evaluate pathogen transmission risks for
those doing laundry, and (2) compare infection control interventions to reduce laundering
risks.
Methods
A simulation model was used to evaluate exposure events related to laundry process.
One baseline scenario (no handwashing) and three handwashing scenarios (scenario 1:
after moving dirty clothes to washing machine, scenario 2: after moving wet clothes
to dryer, scenario 3: after both of these previous steps) were evaluated. Each scenario
involved a single user, three contacts with contaminated laundry, and three contacts
with the face. Five representative microorganisms known to spread via intra-familial
transmission were modeled: SARS-CoV-2, rotavirus, norovirus, nontyphoidal Salmonella,
and Escherichia coli.
Results
The mean infection risks for the baseline scenario were all above a 1 in 1,000,000
risk threshold: 7.22 × 10^(-4) (SARS-CoV-2), 8.74 × 10^(-1) (rotavirus), 7.49 × 10^(-4)
(norovirus), 7.12 × 10^(-1) Salmonella), and 1.41 × 10^(-3) (E. coli). Regardless
of organism type, handwashing after loading dirty clothes into the washing machine
yielded a greater risk reduction (scenario 1: 39.95 – 99.86 %) than handwashing after
loading washed clothes into the drying machine (scenario 2: 1.35 – 55.25 %). Handwashing
two times (scenario 3) further reduced risk where SARS-CoV-2 achieved 1/1,000,000
risk threshold and norovirus and E. coli achieved 1/10,000 risk threshold.
Conclusions
More data is needed to more accurately evaluate real-world exposure potentials (i.e.,
the hand-to-face contact frequency during laundering and viability of organisms on
laundry), however, handling contaminated garments may pose considerable infection
risks for some pathogens. To prevent infection, it is important to reduce hand-to-face
contacts and to handwash directly after touching contaminated clothing.
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Copyright
© 2022 Published by Elsevier Inc.
