Women's Health Research Institute

Scrubs, white coats, and lab coats: The garb of healthcare professionals sets them apart from the layperson and may often (misleadingly) bring to mind the seemingly sterile and clean environment in which these professionals work. But more recently, folks are speaking up on the dangers of taking scrubs and the like outside the office or operating room. Many nurses, doctors, and medical techs remain in their garments for trips to the store, to restaurants, and to their own homes, introducing multiple opportunities for bacteria to hitch a ride along the way, and remain on clothing until the next workday and beyond. Often unbeknownst to them, patients are exposed to filthy scrubs and coats, and are met with additional risk for contracting various types of bacteria that could lead to illness or even death.

Betsy McCaughly of the Wall Street Journal writes,

“Dirty scrubs spread bacteria to patients in the hospital and allow hospital superbugs to escape into public places such as restaurants. Some hospitals now prohibit wearing scrubs outside the building, partly in response to the rapid increase in an infection called “C. diff.” A national hospital survey released last November [sic] warns that Clostridium difficile (C. diff) infections are sickening nearly half a million people a year in the U.S., more than six times previous estimates.

The problem is that some medical personnel wear the same unlaundered uniforms to work day after day. They start their shift already carrying germs such as C.diff, drug-resistant enterococcus or staphylococcus. Doctors’ lab coats are probably the dirtiest. At the University of Maryland, 65% of medical personnel confess they change their lab coat less than once a week, though they know it’s contaminated. Fifteen percent admit they change it less than once a month. Superbugs such as staph can live on these polyester coats for up to 56 days.”

For a sick patient, 56 days is a long time to have potential exposure to bacteria that could further threaten immune health or introduce new disease. Day-to-day, we touch innumerable surfaces, including our faces. Each time we touch something and fail to thoroughly wash our hands, we risk introducing bacteria into our own bodies or transferring it to someone else. For healthcare professionals, this risk could lead to danger for patients.

McCaughly continues,

“Health-care workers habitually touch their own uniforms. Studies confirm that the more bacteria found on surfaces touched often by doctors and nurses, the higher the risk that these bacteria will be carried to the patient and cause infection. Until about 20 years ago, nearly all hospitals laundered scrubs for their staff. A few hospitals are returning to that policy. St. Mary’s Health Center in St. Louis, Mo., reduced infections after cesarean births by more than 50% by giving all caregivers hospital-laundered scrubs, as well as requiring them to wear two layers of gloves. Monroe Hospital in Bloomington, Ind., which has a near-zero rate of hospital-acquired infections, provides laundered scrubs for all staff and prohibits them from wearing scrubs outside the building. Stamford Hospital in Connecticut recently banned wearing scrubs outside the hospital.”

Fortunately, institutions are responding by creating policies to minimize risk and exposure. The British National Health Service is providing nurses with hospital-laundered “smart scrubs,” which include short sleeves, since long sleeves are more likely to transfer bacteria between patients. The University of Maryland and Virginia Commonwealth University found that lab coat sleeves can be a source of MRSA exposure, so scrubs and uniforms with short sleeves could minimize such exposure.

Charles P. Gerba, Ph.D., professor of environmental microbiology in the Department of Microbiology and Immunology at the University of Arizona states, “When doctors or nurses lean over the beds of patients who are carrying organisms, their clothing can become contaminated. Hours later, that bacteria can still be alive and passed on through incidental contact with other patients.”

Dr. Charles Kinder, director of the Heart Rhythm Program at Heart Care Centers of Illinois, adds, “The goal in our profession is to help cure you, not introduce you to another deadly infection.”

As this conversation continues, we can hope that individuals in the medical field and healthcare institutions will aggressively tackle this issue on behalf of patients and providers alike. In the meantime, whether clothed in white coat or scrub, let us at the very least wash our hands, and be conscious of the environments through which we pass on our way back to the bedside.