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Clean Hands. Contaminated Clothing.

Diane Bracuk
August 05, 2014

Bacteria on ClothesIn his white lab coat and favorite striped tie, the hospital physician looked like the epitome of the consummate, caring professional. Moreover, he had just meticulously scrubbed his hands with an alcohol-based sanitizer before approaching his bedridden patient. Bending over to examine her, his tie fell loose, and he deftly tucked it back into his coat. At that moment, his hands went from clean to contaminated.


The bacterial tie-in


Why do ties have such high bacteria counts? Well, unlike shirts, they are rarely, if ever cleaned. They also hang freely during examinations, and are regularly handled by the wearer by tucking them in.


Bacteria are also fond of textiles of all varieties. To a pathogen, a doctor’s nice silk tie is a comfy home, with all sorts of rough, porous surfaces to burrow into.  In fact, one study found that doctors’ ties are eight times more contaminated when compared with security personnel working in the same facility.


Long sleeved white coats follow close behind ties for being notorious bug havens—not only because the sleeves come in contact with the patient, but because they may interfere with hand washing.


Both ties and white coats have been found to be contaminated with various types of pathogens, most commonly S. aureus, a major wound pathogen that is resistant to many antibiotics. 


And once ensconced in their comfy quarters of a tie or sleeve, many bugs are in no hurry to leave. Some can survive for a very long time on fabrics—months in fact. That can add up to a lot of patient encounters for a pathogen.   


How it’s all coming out in the wash.


Obviously, proper cleaning can go a long way to reduce the risk of infection. But much depends on the physician’s personal laundering regimen. 


Petri Plate with BacteriaA recent Canadian study conducted at the University of Saskatchewan evaluated medical students and physicians’ compliance with infection control policies. The results, which were published in the fall issue of The Canadian Journal of Infection Control showed that 30% of participants still wore ties to work every day. Of those, 36% had not cleaned them within the last two years.  


Out of the 74% of participants who wore lab coats, 20% washed them weekly, while 60% only washed them once or twice a month. Of those, 90% washed their coats at home, with a meager 8% using hospital laundry services.


Even more concerning, 8% actually admitted that they hadn’t washed their lab coats in the last two years


Dressing for infection control.


Given that physician’s laundry habits are highly variable, what are the implications for hospital dress codes?


In Britain, ties have been banned—along with the white coat, watches and long sleeves.


While it may seem a simple decision to consign physicians to hospital-laundered scrubs, it’s also a controversial one. Old habits die hard, and studies have shown that patients often prefer their physicians to look the part in a white coat, with nice, professional looking clothing.


Based on a recent study that shows the tie-in between hospital-acquired infections and doctors’ uniforms.


Diane Bracuk

About the Author

Diane Bracuk is a healthcare writer who has written about various bugs and pathogens for over 20 years. She now regards all neckties with a certain amount of trepidation.






Sources cited:


  1. AlMusawi A, Al-Mousawi A. Are you are clean as you think? The Canadian Journal of Infection Control. Fall 2012.
  2. Sandrick K. Don’t retire that (dirty) white coat. Today’s Hospital. July 2011.
  3. Picard A. Why do physicians wear white coats? The Globe and Mail. Monday, July 02, 2012.


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