Clean Uniforms Just as Dirty as a Lab Coat

Recent studies in England found that lab coats often were contaminated with bacteria. Consequently, physicians there had to begin wearing short sleeves. Lab coats had been found to be contaminated mostly in the cuff area, which is the part of the lab coat that is most likely to come in contact with patients or patient care items. Interestingly, a study published online on February 10, 2011 in the Journal of Hospital Medicine found that after 8 hours of wear, there is no significant difference in the degree of bacterial contamination of newly washed, short-sleeved uniforms compared with long sleeved lab coats that are laundered less often.

The researchers randomized 100 residents and hospitalists to wear their white lab coats or to wear a newly washed, short-sleeved uniform. The researchers collected cultures 8 hours into physicians' work days, including cultures from the breast pocket and sleeve cuff. They also cultured the wrist of the physician's dominant hand. The lab coats and uniforms were cultured for contamination with bacteria and methicillin-resistant Staphylococcus aureus (MRSA).

The lab coats of 8 (16%) of 50 physicians had MRSA contamination as did 10 (20%) short-sleeved uniforms worn by the other 50 physicians. In the group of 10 physicians, the uniforms were nearly sterile when they were put on, but by 2.5 hours of wear time, almost half of the bacteria colonies that would be counted after 8 hours were already present.

The researchers concluded that avoiding long sleeved lab coats—or even wearing a clean lab coat or uniform each day—does not reduce bacterial colonization. I was not surprised by this because I believe it’s the hands of physicians (and other healthcare providers) that spread bacteria and especially MRSA throughout health care facilities. It’s interesting how researchers keep trying different things related to clothing and uniforms and how these strategies are ineffective.