Proper laundry protocol

At a glance…

Laundry workers at long-term care facilities can help stem the outbreak of the H1N1 virus by washing hands before and after being in a resident’s room and before and after handling laundry, clean or soiled. Wearing a mask is also advised.

The headlines concerning infections caused by the 2009 H1N1 flu virus (also referred to as the swine flu) are rampant. Since June 11, 2009, when the World Health Organization (WHO) signaled that a pandemic of the 2009 H1N1 flu was under way, there has been an outpouring of information about how to prevent and deal with this outbreak.

Prevention is key

The H1N1 virus can cause a wide range of symptoms including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. What has made this H1N1 virus different from previous variations is the ability for it to infect the young adult population ages 25 years and below. However, individuals age 65 years and older and people with chronic conditions are still at high risk of complications if infected by H1N1 or the seasonal flu.1 This makes preventing the spread of the flu, seasonal and H1N1, extremely important to long-term care facilities because their residents are primarily people over the age of 65 who have chronic medical conditions.

By now everyone should understand how important the roles of hand washing and thorough cleaning of high-touch surfaces play in controlling the spread of the flu, whether the seasonal or H1N1 variety. What hasn’t been discussed very much is what kind of a role the laundry room and its attendants play during a pandemic like this. What can long-term care workers do to help prevent the spread of the flu when collecting, sorting, and using linen? How does a well-run laundry room help to prevent the spread of the flu?

How it’s spread

We know that the H1N1 virus is spread in the same manner as the seasonal flu, primarily by person-to-person via coughing and/or sneezing by those infected with the influenza virus. All housekeeping staff and laundry room attendants should wash their hands before and after being in a resident’s room. These employees should also wash their hands before and after handling a resident’s linen, whether clean or soiled, to prevent cross contamination. It is advisable to have housekeeping staff and laundry room attendants wear masks over their nose and mouth as well as gloves to help minimize transmission of the flu. The Centers for Disease Control and Prevention (CDC) recommends that anyone who may be sick with the flu stay home to not infect anyone else.2

People can also become infected by touching a surface with flu viruses on it and then touching their own mouth or nose. This includes linen surfaces such as towels, sheets, bed pads, clothing, and tablecloths. All soiled linen should be collected in a manner that minimizes agitation of the soiled linen, yet also minimizes contact with the person collecting the soiled linen. The CDC recommends that laundry room attendants avoid “hugging” laundry prior to washing it to prevent contaminating themselves.3 Wearing a mask and gloves can also help prevent transmission of the flu from the linen to the attendant, or vice versa.

Contaminated linen in a long-term care facility can contain high numbers of microorganisms (such as the H1N1 flu virus) from body substances including blood, skin, stool, urine, vomitus, and other body tissues and fluids. According to the CDC, contaminated laundry is disinfected during the laundering process and generally rendered free of vegetative pathogens (i.e., hygienically clean).4 The antimicrobial action of the laundering process results from a combination of mechanical, thermal, and chemical factors.5 Following proper laundry room procedures, along with the proper mix of laundry chemicals, will result in hygienically clean laundry coming out of the dryer. Once this linen is clean, keep it that way by washing your hands before touching the clean linen, and if possible wear a mask and gloves.

Nathan s. gaubert
Nathan S. Gaubert

Stay motivated, educated

In a long-term care facility, getting through the flu season can be hard enough on elderly residents, but by keeping your staff motivated and educated you can help to prevent the unnecessary transmission of the flu virus. By staying on top of handwashing protocols your staff will minimize cross contamination and transmission of the virus. Remember to keep clean linen clean by always washing your hands before handling and whenever possible wear a mask and gloves. During the flu season, a little extra effort goes a long way, especially in a long-term care facility.

Nathan S. Gaubert, MS, is a chemist and laundry specialist for Spartan Chemical Company, Inc. He holds a bachelor of science degree in chemistry from Texas A&M and a master’s degree in analytical chemistry from The Ohio State University. A native of Texas, currently living in Toledo, Ohio, Mr. Gaubert has been with Spartan Chemical for three years.

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  1. (“Swine Flu”) and You. Centers for Disease Control, November 5, 2009. Available at
  2. Interim Guidance for 2009 H1N1: Taking care of a sick person in your home. Centers for Disease Control, October 23, 2009.
  3. Walter WG, Schillinger JE. Bacterial Survival in Laundered Fabrics. Applied Microbiology 1975; 29:368-73.
  4. 2003 Guidelines for Environmental Infection Control. Centers for Disease Control: 203.
  5. Nicholes PS. Bacteria in Laundered Fabrics. American Journal of Public Health 1970; 60:2175-80.

Long-Term Living 2010 January;59(1):32-33

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