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At least 19 recordsLinked to original sources

Bacterial survival in laundered fabrics.

Bacterial survival was determined in linens (i) inoculated with Staphylococcus auerus (ii), taken from hospital isolation patients' beds, and (iii) used by students in their homes. Two different washers using temperatures of 38, 49, 54 and 60 C, respectively, for different times were empolyed along with a commercial tumbler dryer. Findings, after macerating the linens in Waring blender and enumerating on nonselective media, indicate that acceptable levels of survivors can be acheived in motel and hotel linens by an 8- to 10-min wash cycle at 54 C followed by adequate drying. However, it is recommended that a wash cycle with 60 C for 10 to 13 min be employed for linens in health care factilities. The microbial significance of various laundering practices is discussed.

Bedding and Linens

Radiographic artifacts caused by the laundering of flame-retardant materials.

Federal law now mandates the use of flame retardants in children's sleepwear, and regulations are pending in several areas to require their use in all hospital fabrics. These flame retardants produce radiographic artifacts due to their alteration of fabric surface properties. Knowledge of the cause of these problems and their solution should be of help in radiographic interpretation and should save patient expense and radiographic exposure.

Diagnostic Errors

Sanitation in self-service automatic washers.

The potential for microbial transfer in self-service laundry washing machines was investigated by obtaining swab samples from the interior surfaces of commercial machines and wash water samples before and after disinfectant treatment. Three disinfectants (chlorine, a quaternary ammonium product, and a phenolic disinfectant) were used. Four self-service laundry facilities were sampled, with 10 replications of the procedure for each treatment at each location. Although washers were set on a warmwater setting, the wash water temperatures ranged from 24 to 51 degrees C. The quaternary ammonium product seemed most effective, averaging a 97% microbial kill; chlorine was the second most effective, with a 58% kill, and the phenolic disinfectant was least effective, with only a 25% kill. The efficacies of the chlorine and phenolic disinfectants were reduced at low water temperatures commonly experienced in self-service laundries. Interfamily cross-contamination in self-service facilities is a potential public health problem, which is aggravated by environmental conditions, such as water temperature and the practices of the previous users of the equipment. Procedural changes in laundering are recommended, including the use of a disinfectant to maintain adequate levels of sanitation.

Chlorine

Toxic skin reactions caused by tributyltin oxide (tbto) in socks.

During some hot summer-days in 1973 about 70 cases of acute feet dermatitis were reported among soldiers from one regiment. They had used newly laundered socks from the same batch. The socks were disinfected with a solution containing TBTO and a quarternary ammonium compound, but by mistake a roughly 7 times too high concentration of the solution had been used. Patch tests with TBTO, quarternary ammonium compound and standard substances were negative. There was no suspicion of phototoxicity in these cases, but according to the literature TBTO may be photodynamic and several case reports relate specifically to sunny summerdays. We consider our cases to be due to the primary irritant properties of TBTO. As the span between optimal concentration for disinfection and the primary irritant concentration is narrow, we consider it inappropriate to use this substance for disinfection of textiles which are to be in direct contact with the skin until it has been established whether, for example, sweat may extract TBTO from treated fibres.

Adult

Toxicity to fish of flame retardant fabrics immersed in their water. Part I.

A number of commercial and candidate flame retardants were studied with regard to their toxicity to fish when released from fabrics immersed in their water. Immersion of laundered or unlaundered flame retardant 100% polyester or polyester blend fabrics used in children's sleepwear in water containing goldfish resulted in release of the anticholin-esterase flame retardant TDBPP (tris (2, 3-dibromopropyl) phosphate) and death of all fish within 24 hours. TDBPP undergoes loss of HBr in water and production of a metabolite.

Animals

An appraisal of Impregon as a deterrent of domestic fungus growth.

Impregon brand of tetrachlorsalicylanilide (TCSA) has been profferred widely as a household fungistatic agent, although its value remains unproved. To assess its effects, this agent was used as a laundry and paint additive and as a treatment for burlap rug backing; after recommended applications of Impregon, coded replicate materials were inoculated with mixed suspensions of fungus particles. No difference was evident in fungus growth points on fabric swatches washed in tap water with and without Impregon. However, growth on both of these was significantly greater than on samples laundered in tap water using only a commercial soap or liquid detergent. Fungus soiling of burlap was not clearly diminished by prescribed applications of Impregon solution 3 mo previously. Similarly, the addition of this agent to paint did not suppress fungus growth on Masonite plaques to which it had been applied. However, comparable levels of Impregon incorporated into agar media substantially inhibited spore germination. These findings suggest that the bioavailability of TCSA is insufficient to provide desired household antifungal effects when Impregon is used in accord with current recommendations.

Air Microbiology

Anti-mite measurements in mite-sensitive adult asthma. A controlled trial.

A cross-over controlled trial has been conducted among 32 adult patients with mite-sensitive asthma. The bedclothes and pillows of each subject were laundered and vacuum-cleaned and a plastic cover applied to the mattress for six weeks in an attempt to reduce exposure to mites. No improvement in daily peak-flow reading or drug usage was found in comparison with a control period.

Adult

The relationship between rainfall and well water pollution in a West African (Gambian) village.

Water pollution was monitored in six Gambian village wells over a period of 8 months spanning the 5-month monomodal rains and the pre- and post-rains dry periods. Faecal coliform (FC) and faecal streptococci (FS) counts were high throughout and there was a massive increase associated with the onset of the rains, maximum counts exceeding 5 x 10(5)/100 ml. This pattern was largely sustained throughout the rainy season. Some individual variations in patterns of pollution could be ascribed to well design, in particular lining of the shaft, but no well was protected from the seasonal increase in faecal pollution. The source of the increased pollution appeared to be a flushing in of faecal material of indeterminate or mixed human and animal origin, probably over considerable distances. Peaks of pollution not associated with rainfall episodes could have resulted from the practice of communal laundering in the near vicinity of the wells. Specific pathogens including Salmonella spp. were isolated only intermittently. Attention has been drawn to a problem complicating the standard method for assessing FC counts.

Animals

An instrument for measuring bacterial penetration through fabrics used for barrier clothing.

A new instrument has been designed to measure the penetration by rubbing of bacteria from cloth contaminated in the nursing of burn patients through fabrics designed for barrier garments. Most fabrics tested dry reduced the transfer of bacteria from the source cloth to about 10%, irrespective of the results of air filter tests, which agrees with mock nursing results. When the fabrics were tested against a wet surface, the transfer of bacteria rapidly reached 100% if the fabrics had a high wettability, but was slower for fabrics with a low wettability. Through closely woven waterproofed cotton, transfer was 5--25%, but increased three- to four-fold after ten launderings, in line with the water absorption. Transfer through plastic-laminated material was less than 1%. The results suggest that barrier garments should be made either of plastic or of recently waterproofed closely woven cotton at points of contact between nurse and patient where the clothes may be wetted by bacteria-containing wound secretions.

Asepsis

Dose response relationships in allergic contact dermatitis: glutaraldehyde-containing liquid fabric softener.

Glutaraldehyde (GTA) is an effective preservative in some consumer products. Because it is a weak cutaneous allergen at certain concentrations, studies were conducted to assess any potential hazard of adding a low level (550 ppm) of GTA to an experimental liquid fabric softener. Allergic contact dermatitis (delayed hypersensitivity) was not elicited in challenge tests of 16 GTA-sensitive subjects or in repeated insult patch tests of 706 normal human male and female subjects. The subjects were exposed (1) to the experiment formulation, (2) to the formulation with 10 times the normal level of GTA, and (3) to fabrics laundered with the normal use level or with 10 times the normal use level of these experimental formulations.

Aldehydes

Intraoperative bacterial transmission.

A clinical evaluation of bacterial penetration through operating room gowns was made during 100 general surgical procedures. A comparison of the degree of penetration through the standard cloth and a commercially available disposible gown was carried out. Cloth gowns, even in the dry state, were shown to be ineffective bacterial barriers. In addition, routine laundering of scrub suits failed to eliminate pathogenic bacteria.

Alkenes

Wood fiber contamination of reusable cotton laparotomy pads.

If the thesis that disposable fabrics are responsible for granulomatous peritonitis is correct, surgeons who operate within the abdominal cavity and use these products would be reporting instances of granulomatous peritonitis in epidemic proportions. Such is not so. Consequently, there can be valid concern expressed as to implied medicolegal problems. While the observations and conclusions were made in obvious good faith, nevertheless, there appears to be sufficient grounds for questioning this apparent cause and effect conclusion and for focusing interest on a more important consideration, the indiscriminate collection, sorting and laundering of the reusable cotton laparotomy pad. Certainly, attention should be directed to the more rigidly controlled use and disposition of these pads by the individual hospital.

Equipment and Supplies, Hospital

The effect of normalization of plasma amino acids on hepatic encephalopathy in man.

Previous work from this laboratory has suggested that the plasma amino acid pattern, known to be deranged in hepatic encephalopathy, may be related causally. In order to test this hypothesis, 23% dextrose and a special amino acid solution whose components were calculated to normalize the plasma amino acid pattern were infused in 11 patients, eight with chronic cirrhosis and acute exacerbation (Group 1) and three patients with fulminant hepatitis (Group 2), in amounts of up to 120 Gm. of protein equivalent per 24 hours. Plasma amino acids were abnormal but different in both groups. In Group 1 (cirrhosis) changes in plasma amino acid pattern including elevated phenylalanine, tyrosine, glutamate, aspartate, and methionine and decreased valine, leucine, and isoleucine. In Group 2 all amino acids were elevated, with the exception of the branched chains which were normal. Hepatic encephalopathy improved in all patients in Group 1 and in one of three patients in Group 2 following the infusion. The ratio (see article) showed an excellent correlation with a grade of encephalopathy. When this ratio, previously 1.0 in the presence of encephalopathy, returned to the normal value near 3.0 to 3.5, encephalopathy improved. An excellent correlation was obtained between the ratio and the grade of encephalopathy and was dose related as well. The results suggest that different amino acid patterns in hepatic encephalopathy of differing etiologies require treatment modalities which may differ for the two types of encephalopathy. Whereas amino acid infusion appears to be a valuable, efficacious way of providing nutrition in treating hepatic encephalopathy in patients with cirrhosis and acute deterioration and coma, other means of therapy such as plasms "laundering" appear to be necessary in patients with fulminant hepatitis.

Adult