I don't think I'll ever look at a doctor's necktie the same way after reading the study that said half of neckties worn by medical personnel harbor bacteria that can cause disease.
Researchers at the New York Hospital Medical Center of Queens sampled neckties worn by physicians, physician assistants and medical students at a teaching hospital in New York.
For comparison purposes, they also sampled neckties worn by security personnel at the hospital. The doctors' ties were much more likely to harbor potential disease-causing bacteria than the security workers', according to study author Steven Nurkin.
"This study brings into question whether wearing a necktie is in the best interest of our patients," said Nurkin. "Being well dressed adds to an aura of professionalism and has been correlated with higher patient confidence. Senior physicians and hospital administrators often encourage staff to wear neckties in order to help promote this valuable relationship, but in so doing, they may also be facilitating the spread of infectious organisms."
Nurkin had been studying medicine in Israel, where men wore their shirt collars open. When taking a course in a New York City hospital, he noticed neckties swing over bedding, touch patients and equipment and get coughed on. He presented his findings at a conference of the American Society of Microbiology in New Orleans in May 2004.
"There was a similar study that found germs on the stethoscopes of doctors -- and another on a blood pressure cuff -- but the point is the germs on the membrane (tube) of the stethoscope can't penetrate solid skin and the doctor wouldn't put the stethoscope on an open wound," Nathan Belkin, who is retired but still publishes research papers, told UPI's Caregiving.
However, clothing worn by both visitors and patients in hospitals are a leading source of transmission of spores of Aspergillus fungus, a common fungus long known to pose a potentially deadly threat of infection in hospital patients with damaged or impaired immune systems.
Kay Obendorf, professor of textiles and apparel at Cornell University in Ithaca, N.Y., said that by simply walking into a patient's room one can easily dislodge the spores from clothing.
"One of our researchers had a relative with leukemia -- and getting better -- but Aspergillus spores came in from the outside environment even though they say they have HEPA (High Efficiency Particulate Air) filtered air. Unless you can control exposure from the outside it can be fatal for someone with a seriously compromised immune system," Obendorf told Caregiving.
"Aspergillus can be carried from place to place off of textiles -- the textile acts as a medium to transport the spores from one place to another."
Hugging, kissing, sitting on a patient's bed or pulling up a chair creates air turbulence and friction within and around the fabric, releasing the potentially deadly spores, according to Obendorf. However, less than 7 percent of bone marrow units in a national survey conducted by other researchers restrict such activities, Obendorf pointed out.
Some studies have found Aspergillus spores are responsible for as many as 40 percent of deaths among leukemia patients, as well as many deaths among chemotherapy, organ and marrow transplant and AIDS patients, all of whom have weakened immune systems, according to Obendorf.
"For a normal patient this is not a big concern, but there's a different level of concern when dealing with someone with a bone marrow transplant," said Obendorf, who presented the findings at the American Society for Testing and Materials.
Since clothing and bedding harbor germs, should caregivers be concerned about how they launder them?
"If you're a healthy professional couple in their 50s who work in an office, you really have nothing to worry about," Obendorf said.
"But if you have an infant or care for someone incontinent you want to separate -- to avoid cross-contamination from person to person -- all personal care items such as underwear, towels and bedclothes and wash them separately in hot water with a little bleach."
Belkin is also concerned about hospital laundering of linens and other fabrics.
"There is nothing less expensive that chlorine bleach, but many hospitals fear the use of bleach will prematurely wear out linens and other textiles. But when it comes to disinfecting, hot water and bleach is what you want. Cooler water or oxygenating treatment may clean and get rid of stains, but they don't disinfect," Belkin said.
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Alex Cukan is an award-winning journalist, but she always has considered caregiving her primary job. UPI welcomes comments and questions about this column. E-mail: [email protected]
