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Healthcare facilities must pass strict standards to receive accreditation. Included on the inspection checklist are linen and laundry operations. At TRSA's 15th Annual Healthcare Seminar, a hospital accreditor provided rental operators with an inside look at scoring guidelines used to rate hospital linen and laundry operations.
The question of whether to use disposable or reusable laundry and linen products is one that hospital managers have had to answer with increasing frequency over the past few years. Although it may ultimately depend on individual user or patient preference, each type of product does have its own advantages and disadvantages. On these two pages, a comparison of disposables and reusables is presented from the point of view of a major linen supplier and the director of the Canadian institutional laundry managers association. They discuss the benefits, and downfalls, of each with regard to costs, storage, convenience, disposal and infection control.
A portal monitor was installed to detect radioactivity in trash and laundry leaving the hospital facility. Experiences with selection, installation, calibration and detection capabilities are reviewed. Also reviewed are the topics used in training hospital employees on proper use of the monitor and response detected activity in trash or laundry.
The use of IgG antibodies and fragments has been limited to specific sectors of the biotechnology industry due to the high cost of producing large batches of product necessary for alternative applications. A novel class of Camelid antibodies, known as V(HH) offer a more economical opportunity to meet a wider application in industry. In this study, we report the evaluation of four llama V(HH)-cellulose binding domain fusion proteins displaying varying formats of V(HH) and CBD domains. Proteins were characterized in a targeted particle delivery system as a method of delivering agents such as perfume to laundry in the wash cycle. Fusion proteins were shown to be stable at high pH and in the presence of a detergent base. They were also shown to bind effectively to both the designated antigen, the azo-dye reactive-red 6 (either conjugated to BSA or attached to coacervate microparticles), and cellulose. Binding strength differences were observed between the different fusion protein formats using surface plasmon resonance. The effect of key laundry ingredients was also studied. Combining the fusion proteins and particles into a delivery and deposition study generated clear microscopy evidence for bifunctionality. Confirmation of this was validated by GC-MS analysis of retained fragrance. This research, reporting the construction and characterization of a variety of fusion proteins, illustrates that the single multidomain fusion protein route offers a new technology for successful targeted delivery of encapsulated benefit agents. Furthermore, the potential to modify or select for proteins to recognize a wide range of surfaces is also possible.
A cross-sectional study was conducted to evaluate monoamine oxidase type B (MAO-B) activity in platelets as a biomarker of effect of styrene and perchloroethylene exposures. MAO-B is an enzyme system involved in dopamine catabolism, the impairment of which has been postulated as a mechanism of styrene-induced neurotoxicity. We previously observed an inverse association between blood styrene and MAO-B among reinforced plastics manufacturing workers. The present study included 59 male boat plant workers exposed to styrene (exposure range < 1-144 ppm, 8-h TWA). Two comparison groups comprised six male dry cleaning workers exposed to perchloroethylene (PCE; exposure range < 2-37 ppm) and 14 male laundry workers not exposed to either agent. Respiratory protection was not used by any of the styrene- or PCE-exposed workers; thus, air concentrations were regarded as valid exposure indicators. MAO-B activity (pmol/10(8) cells/h) was measured in peripheral blood platelets, using phenylethylamine as substrate. Only small overall mean differences in MAO-B were observed among the three groups; mean values were 4.21, 4.51, and 4.12 for the styrene-exposed, PCE-exposed, and laundry workers, respectively. Despite the absence of gross differences among the groups, styrene exposure was inversely related to MAO-B. Mean values for four increasing exposure group quartiles were: 5.60, 4.13, 3.69, and 3.44. The Spearman rank correlation coefficient for styrene with MAO-B was -0.41. Adjustment for age, medication use, smoking, and alcohol consumption had only a minimal effect on this trend.(ABSTRACT TRUNCATED AT 250 WORDS)
Biological detergents are now routinely used in domestic laundry because the enzymes they contain provide the added benefit of low temperature washes with improved cleaning performance. One of the key enzymes found in these detergents are proteases, which if exposed to natural protein fibres such as wool or silk can cause irreversible damage, leading to loss of fabric strength, shape and poor colour fastness. Transglutaminases (TGases) are protein cross-linking enzymes capable of adding tensile strength to wool proteins, and as a consequence are capable of remediating the damage caused by previous chemical treatments, and more importantly, by proteases. In this paper we treated dyed wool fabric with TGase and then washed the fabric with biological and non-biological detergents to investigate whether TGases would protect wool garments from damage by the undue use of biological detergents in domestic laundry. We demonstrate using different cycles of detergent washes containing biological and non-biological detergents and different TGase treatments, that wool fabric treated previously with TGase release less dye into the washing liquor and in addition maintain fabric strength at levels greater than the washed controls. As a consequence, wool garments previously treated with TGase are likely to have increased resistance to domestic washing and thus provide increased longevity.
Metal adsorption and surface charge determinations were performed previously on well-characterised Sphagnum and Carex peat samples. The aim of this investigation was to determine metal adsorption from complex wastewaters onto these peat samples and compare it to the adsorption onto peat granules, clinoptilolite, glauconite and a flue dust from steel production. A sulphide mine leachate, a landfill leachate and a laundry wastewater were chosen, giving a variation in pH, ionic strength, total organic carbon and concentrations of metals. Metal adsorption was determined in batch and column experiments. The wastewater composition was of great importance for metal removal efficiency, mainly due to the difference in dominating metal species. In the sulphide mine leachate, containing free metal ions, a high metal adsorption was observed onto both peat and inorganic adsorbents. In the landfill leachate the metals formed carbonate and organic complexes and a low metal removal was achieved. Contrary to the leachates, the laundry wastewater contained suspended particles. The high amount of metals removed, 80% of the Cu and 30-60% of the Zn concentration, was probably withdrawn bound to the particle fraction. The highest removal of metal ions was obtained in the sulphide mine leachate with Carex peat, removing 97-99% of the Zn and 85-100% of the Cu content. The Sphagnum peat sample removed 37-77% of the Zn and 80-100% of the Cu content. The differences found between Sphagnum and Carex peat were attributed to the original chemistry of the plant material and the habitat conditions at the time of peat formation. Generally, the combination of glauconite or clinoptilolite with the peat samples in column experiments gave a minor improvement in metal removal.
Adsorbable organically bound halogens (AOX) are mostly persistent in the environment, and accumulate in the food web. Some of them are toxic to humans and other organisms. AOX were measured in the effluents from six German hospitals of different size and departments like internal medicine and ear-nose and throat (ENT) as well as from laundry, kitchen and laboratory. The concentrations in the day time mixed samples of the total effluent were 0.13 mg l(-1)-0.94 mg l-1 (phi = 0.43 mg l-1). For the separately investigated departments the lowest concentrations were found in the effluent from laundry and kitchen (0.015 mg l-1), and the highest ones in the effluents from the medical departments (0.12-1.71 mg l-1, phi 0.95 mg l-1 during the week and 0.06-0.10 mg l-1 at the week-end) and the laboratories (0.05-14.2 mg l-1, phi 2.73 mg l-1). The AOX concentration in night time mixed samples were 0.07-0.41 mg l-1 (phi = 0.41 mg l-1) for the total effluents and 0.25-2.64 mg l-1 (phi = 1.11 mg l-1) for medical departments. Concentrations expected by computing the input of AOX attributable to pharmaceuticals were between 11% and 16% for two hospitals and 7.7% for an ENT department. One additional important source of AOX in hospital effluents may be x-ray contrast media containing a iodine carbon bond.
The Coprinus cinereus (CiP) heme peroxidase was subjected to multiple rounds of directed evolution in an effort to produce a mutant suitable for use as a dye-transfer inhibitor in laundry detergent. The wild-type peroxidase is rapidly inactivated under laundry conditions due to the high pH (10.5), high temperature (50 degrees C), and high peroxide concentration (5-10 mM). Peroxidase mutants were initially generated using two parallel approaches: site-directed mutagenesis based on structure-function considerations, and error-prone PCR to create random mutations. Mutants were expressed in Saccharomyces cerevisiae and screened for improved stability by measuring residual activity after incubation under conditions mimicking those in a washing machine. Manually combining mutations from the site-directed and random approaches led to a mutant with 110 times the thermal stability and 2.8 times the oxidative stability of wild-type CiP. In the final two rounds, mutants were randomly recombined by using the efficient yeast homologous recombination system to shuffle point mutations among a large number of parents. This in vivo shuffling led to the most dramatic improvements in oxidative stability, yielding a mutant with 174 times the thermal stability and 100 times the oxidative stability of wild-type CiP.
Public health programs are generally targeted to communitywide, population-based prevention strategies, with little attention focused on the home environment as one potential source of transmission of infectious diseases. The purpose of this correlational prevalence survey was to describe the relationship between home hygiene practices and prevalence of infectious disease symptoms among household members. Three hundred and ninety-eight households with 1,662 members in an inner-city population (96.4% Hispanic) were surveyed to examine hygiene practices and determine the presence of transmission of infection, defined as the presence of the same symptom(s) in two or more household members for which at least one individual sought medical attention and received treatment. At least one individual in 78.6% of households reported symptoms of infection in the previous 30 days, and 37.9% of households met the definition of disease transmission. In univariate analyses, five factors were significantly associated with risk of household transmission, but in the logistic regression model, only use of communal laundry (p = 0.009) and lack of bleach use (p = 0.04) were significantly predictive of increased risk of transmission. This is the first comprehensive survey of home hygiene practices and the first study to identify a potential link between laundry and risk of disease transmission in homes. This potential link warrants further study in clinical trials.
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) in 1995 developed a list of 75 clinical privileges (in laundry-list format) that are typical of physiatric practice. This list has been used by some hospitals as a template for physiatric staff privileging. The National Association of Medical Staff Services has advocated a short list of core privileges, supplemented by a list of highly specialized procedures. To assess current practices in physiatric privileging, we surveyed 35 rehabilitation facilities. Results showed that 66% (20/30) of the respondents were not aware of the AAPM&R recommendations. Furthermore, we found an almost even split between facilities using core (16/30) versus laundry list (14/30) privileges. We also found evidence that the Joint Commission on Accreditation of Healthcare Organizations has recommended both types of approaches to different facilities in the recent past.
To determine whether there is any biological basis for complaints that fabric softener emissions can cause acute adverse effects in certain individuals, screening tests were performed in which groups of mice were exposed to the emissions of 5 commercial fabric softener products (antistatic pads used in laundry dryers) for 90 min. Pneumotachographs and a computerized version of ASTM test method E-981 were used to measure acute changes in several respiratory cycle parameters, especially the pause after inspiration, the pause after expiration, and the midexpiratory airflow velocity. From these changes, sensory irritation (SI), pulmonary irritation (PI), and airflow limitation (AFL) of differing intensities were measured with each of the five brands tested. At the peak effect, SI ranged from 21 to 58% of the breaths, PI ranged from 4 to 23% of the breaths, and AFL ranged from 6 to 32% of the breaths. After three exposures, histopathology revealed mild inflammation of interalveolar septae of the lungs. Gas chromatography/ mass spectroscopy (GC/MS) analysis of the emissions of one pad identified several known irritants (isopropylbenzene, styrene, trimethylbenzene, phenol, and thymol). Laundry that had been dried with one the fabric softener pads emitted sufficient chemicals to elicit SI in 49% of breaths at the peak effect Placing one fabric softener pad in a small room overnight resulted in an atmosphere that caused marked SI (61% of breaths). These results demonstrate that some commercial fabric softeners emit mixtures of chemicals that can cause SI, PI, and reduce midexpiratory airflow velocity in normal mice. The results provide a toxicological basis to explain some of the human complaints of adverse reactions to fabric softener emissions.
To test the hypothesis that electric-cable splicers contaminate their homes with lead and tin, nine splicers were matched with nine of their neighbors. House dust samples were collected in two areas within each home: a laundry room/dirty clothes area, and a composite sample from other areas in the house. Samples were analyzed by energy dispersive X-ray fluorescence for lead and tin (tin is a tracer to the occupational source of lead). The difference in the geometric mean lead concentrations in the laundry areas between the splicers' and neighbors' homes (1021 ppm and 390 ppm) was statistically significant (p < 0.025). The difference in concentrations from the other areas of the house (585 ppm and 329 ppm) was also significant (p < 0.05). Tin concentrations in house dust were very different between the two groups (p < 0.0005), suggesting that electric-cable splicers were contaminating their homes with lead and tin from work. Recommendations are included to prevent paraoccupational lead exposures by eliminating the pathways into the home. Another recommendation suggests that blood-lead levels be screened in children under the age of seven who live with electric-cable splicers.
OBJECTIVE: to evaluate whether faecal incontinence can be improved by treatment of constipation in elderly patients with faecal incontinence associated with impairment of rectal emptying. DESIGN: a prospective randomized study with a 2-month follow-up. SETTING: five long-term care units. SUBJECTS: 206 patients with daily faecal incontinence associated with chronic rectal emptying impairments such as faecal impaction received either a single osmotic laxative (group I) or an osmotic agent along with a rectal stimulant and weekly enemas (group II). MEASUREMENTS: episodes of faecal incontinence and associated details of soiled laundry (used as indicators of the workload for caregivers). We performed periodic digital rectal examinations on group II patients to evaluate whether treatment resulted in complete and long-lasting rectal emptying. We compared data between groups and in group II between persistently constipated patients and patients with complete rectal emptying. RESULTS: the frequency of faecal incontinence did not significantly differ between the two groups. The 23 patients in group II who had complete rectal emptying had 35% fewer episodes of faecal incontinence and 42% fewer incidents of soiled laundry than the rest of the group. CONCLUSIONS: when long-lasting and complete rectal emptying is achieved by laxatives, the number of episodes of faecal incontinence as well as the workload for caregivers is reduced.
An empirical model describing the relationship between the partition coefficients (K) of perfume materials in the solid-phase microextraction (SPME) fiber stationary phase and the Linearly Temperature Programmed Retention Index (LTPRI) is obtained. This is established using a mixture of eleven selected fragrance materials spiked in mineral oil at different concentration levels to simulate liquid laundry detergent matrices. Headspace concentrations of the materials are measured using both static headspace and SPME-gas chromatography analysis. The empirical model is tested by measuring the K values for fourteen perfume materials experimentally. Three of the calculated K values are within 2-19% of the measured K value, and the other eleven calculated K values are within 22-59%. This range of deviation is understandable because a diverse mixture was used to cover most chemical functionalities in order to make the model generally applicable. Better prediction accuracy is expected when a model is established using a specific category of compounds, such as hydrocarbons or aromatics. The use of this method to estimate distribution constants of fragrance materials in liquid matrices is demonstrated. The headspace SPME using the established relationship between the gas-liquid partition coefficient and the LTPRI is applied to measure the headspace concentration of fragrances. It is demonstrated that this approach can be used to monitor the headspace perfume profiles over consumer laundry and cleaning products. This method can provide high sample throughput, reproducibility, simplicity, and accuracy for many applications for screening major fragrance materials over consumer products. The approach demonstrated here can be used to translate headspace SPME results into true static headspace concentration profiles. This translation is critical for obtaining the gas-phase composition by correcting for the inherent differential partitioning of analytes into the fiber stationary phase.
Protein protease inhibitors could potentially be used to stabilize proteases in commercial products such as liquid laundry detergents. However, many protein protease inhibitors are susceptible to hydrolysis inflicted by the protease. We have engineered Streptomyces subtilisin inhibitor (SSI) to resist proteolysis by adding an interchain disulfide bond and removing a subtilisin cleavage site at leucine 63. When these stabilizing changes were combined with changes to optimize the affinity for subtilisin, the resulting inhibitor provided complete protease stability for at least 5 months at 31 degrees C in a subtilisin-containing liquid laundry detergent and allowed full recovery of the subtilisin activity upon the dilution that occurs in a North American washing machine.
Indoor 222Rn concentrations were measured in 37 houses with alpha track detectors placed in water-use rooms near water sources (bathrooms, laundry rooms, and kitchens) and in non-water-use living rooms, dining rooms, and bedrooms away from water sources. Results show that relative contributions of 222Rn to indoor air from water use are insignificant when soil-gas concentrations are high but become increasingly important as the ratio of 222Rn-in-water: 222Rn-in-soil gas increases. High soil-gas 222Rn concentrations may mask 222Rn contributions from water even when waterborne 222Rn concentrations are as high as 750 kBq m-3. Ground water in Precambrian Pikes Peak granite averages 340 kBq m-3 222Rn, vs. 170 kBq m-3 in Precambrian migmatite, but average 222Rn concentrations in soil gas are also lower in migmatite. Because the ratio of 222Rn-in-water: 222Rn-in-soil gas may be consistently higher for houses in migmatite than in Pikes Peak granite, indoor air in houses built on migmatite may have a greater relative contribution from water use even though average 222Rn concentrations in the water are lower. Continuous monitoring of 222Rn concentrations in air on 15-min intervals also indicates that additions to indoor concentrations from water use are significant and measurable only when soil-gas concentrations are low and concentrations in water are high. When soil-gas concentrations were mitigated to less than 150 Bq m-3 in one house, water contributes 20-40% of the annual indoor 222Rn concentration in the laundry room (222Rn concentration in water of 670 kBq m-3). Conversely, when the mitigation system is inactive, diurnal fluctuations and other variations in the soil-gas 222Rn contribution swamp the variability due to water use in the house. Measurable variations in indoor concentrations from water use were not detected in one house despite a low soil-gas contribution of approximately 150 Bq m-3 because waterborne 222Rn concentrations also are low (80 kBq m-3). This result suggests that 222Rn concentrations in water near the recommended EPA limit in drinking water of 11 kBq m-3 may not contribute measurable amounts of 222Rn to indoor air in most houses.
A simple model was used to calculate the contribution of urinary incontinence (UI) to the costs of nursing home care. First-order costs are defined as the costs of managing UI: supplies, laundry, and labor. Second-order costs are defined as the costs of managing the complications of UI. Data were gathered from nursing homes, medical supply companies, and a large laundry company. First-order costs of four common methods of managing UI range between $ 3.00 and $ 11.00 per incontinent patient per day. Based on these estimates, UI accounts for between $ 0.5 and $ 1.5 billion (3-8%) of the costs of nursing home care. Management of UI with indwelling catheters results in the lowest first-order costs, but the second-order costs (as well as the potential increased morbidity and mortality risks) probably outweigh any cost savings. More active evaluation and treatment of UI in nursing homes could result in considerable cost savings and improved well-being for both patients and caregivers.