Sterilization

Perhaps the most critical concern for healthcare linen facilities is preventing the spread of drug resistant strains of highly infectious bacteria, including Staphylococcus Aureus, or “Staph” and fecal-borne spores and cysts including Clostridium difficile, or “C. diff” spores, Giardia Cysts and Cryptosporidium Oocysts. Incomplete sterilization of linens can facilitate the spread of bacteria and provide a means of infection in both healthy people and patients with compromised immune systems. Staph and other Drug Resistant Bacteria can cause devastating infections and possibly death. For this reason, the utmost care must be taken when processing linen in healthcare facilities. 

Hospitals, nursing homes, acute care facilities and other healthcare operations produce a variety of dirty linens with a wide range of soil loading. Sheets with blood, urine, feces and other bodily fluids are routinely washed with other, less contaminated, linens. Although incontinent pads are generally washed apart from other types of linens, they too pose a great risk for infection as each pad will inevitably end up on a new patient after each cleaning.

To ensure a consistently clean and sanitized finished product, stringent procedures must be in place. Ozone is your complete safety net. Cold water with dissolved ozone concentrations of 1.5 to 3.5ppm will kill all biological activity within only a few seconds after contact; much more rapidly than hot water with Chlorine. The high levels of dissolved ozone that our systems deliver will completely sanitize the linen in just a few seconds after the wash cycle starts.

Ozone is also far superior at eliminating all types of contaminants and persistent pathogens from linens. Many studies have shown how much more effective ozone is at eradicating all types of hard-to-kill pathogens like fecal cysts and drug resistant Staph.

Oxidizing Agent vs. Oxidizing Potential
Oxidizing Agent Oxidizing Potential
Fluorine 3.06
Hydroxyl Free Radicals 2.80
Atomic Oxygen 2.42
Ozone 2.07
Permanagenate 1.67
Hypochlorous Acid 1.59
Chlorine 1.36
Molecular Oxygen 1.23
Bromine 1.09
Hypochlorite 0.94

Towels used in a health club or exercise area are also very prone to spreading drug-resistant Staph. That’s why you absolutely need to employ an ozone standard in your laundry to ensure each processed towel is completely sterile and free of any persistent pathogens left by the last user of the towel.
Sheets and towels can harbor cysts found in fecal material that can spread to the next guests and cause diarrhea and other serious intestinal problems. These can be especially dangerous to younger guests and guests with reduced immune capabilities.

Giardia Cyst and Cryptosporidium Oocyst are the two most prevalent contaminants that are hard to kill even with Chlorine. Ozone is extremely effective in eliminating these parasites. This is because of the higher oxidative capacity of ozone over Chlorine and other disinfecting methods. Pathogens such as these can remain on towels and sheets and can then be transmitted to unsuspecting guests sleeping on what they thought were ‘clean’ sheets. 

The United States Environmental Protection Agency (EPA) recognizes ozone as the safest disinfectant that provides highly effective disinfection to achieve high log inactivation not achievable by chlorine, UV or chlorine dioxide. The EPA also recognizes Ozone as being able to achieve high levels of Cryptosporidium and Giardia inactivation. For more information please read the EPA’s Alternative Disinfectants Guide.

Ozone Level Contact Time Bacteria Species Percent Removal
0.009 ppm < 1 min E. coli 99.99%
0.099 ppm < 1 min Staphylococcus sp. 99.99%
0.099 ppm < 1 min Pseudomonas Fluorescens 99.99%
0.21 ppm 5 min Legionella pneumophila 99%
Ozone Level Contact Time Virus Species Percent Removal

Reference
< 0.8 ppm 5 min Poliovirus 2 99.9%
1.7 ppm 5 min Coxsackie Virus B3 99.999%

Water Energy Ozone Laundry Systems are designed to consistently deliver water to your washers with dissolved ozone concentrations in a range between 1.5 and 3ppm. This assures virtually complete inactivation of all potentially harmful pathogens from all of your linens.

Guidelines and policies published by the CDC and JCAHO state that a hospital can wash their linen utilizing virtually any method they want as bacteria and viruses are inactivated in the heat and dry environment found within the dryer. That’s great for linens exposed to the dryer cycle, but what about sheets going through the ironers? They are only in contact with a hot roller for just a moment before they are folded and stacked for use again within the hospital. Wouldn’t you rather know for sure that your linens are thoroughly sanitized while still within the washer? When you use ozone laundry equipment that reliably and consistently delivers a high dose of dissolved ozone to the washers, all of your linens will be sanitized within a few seconds after being submerged.

Most hospitals have Infection Control departments that dictate how their linens are washed in their laundries. They rely upon high levels of Chlorine bleach and lots of energy intensive hot water. This procedure is effective, but not 100% effective. Additionally, the processed linens often contain residual Chlorine and alkali after the washing process which contributes to numerous skin irritations including bed sores and other chronic hospital-acquired ailments.

From JAMA, October 2007:

Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known hospital pathogen. More than 10% of bloodstream infections in hospitals are due to MRSA, and patients with MRSA have worse outcomes than those with methicillin-sensitive S aureus.1-2 In recent years, identification of MRSA in otherwise healthy individuals in the community (community-associated MRSA) has become increasingly common. 

Health care–associated and community-associated MRSA have different clinical and molecular epidemiology. Health care–associated MRSA is associated with invasive disease, health care exposure, and multi-drug resistance. Community-associated MRSA has been primarily reported in young, healthy individuals with no recent health care exposure.

This fact sheet is a summary of the data presented in the Journal of the American Medical Association 2007;298(15):1763-1771.

The estimated number of people developing a serious MRSA infection (i.e., invasive) in 2005 was about 94,360; this is higher than estimates using other methods.

Approximately 18,650 persons died during a hospital stay related to these serious MRSA infections.
Serious MRSA disease is still predominantly related to exposures to healthcare delivery:

  • About 85% of all invasive MRSA infections were associated with healthcare, and of those, about two-thirds occurred outside of the hospital, while about one third occurred during hospitalization. 
  • About 14% of all the infections occurred in persons without obvious exposures to healthcare.
    Although the rates of disease varied between the geographically diverse sites participating in the surveillance, overall rates of disease were consistently highest among older persons (age >65), Blacks, and males.

Evaluation of the pathogens causing these infections confirmed that most of the strains associated with these serious MRSA infections were caused by strains traditionally associated with healthcare. However, the strains traditionally associated with transmission in the community are now being identified in healthcare.

CDC recommendations for prevention of spread of MRSA, October 10, 2007:

Methicillin-resistant Staphylococcus aureus (MRSA) has become a prevalent nosocomial pathogen in the United States. In hospitals, the most important reservoirs of MRSA are infected or colonized patients. Although hospital personnel can serve as reservoirs for MRSA and may harbor the organism for many months, they have been more commonly identified as a link for transmission between colonized or infected patients. The main mode of transmission of MRSA is via hands (especially health care workers’ hands) which may become contaminated by contact with a) colonized or infected patients, b) colonized or infected body sites of the personnel themselves, or c) devices, items, or environmental surfaces contaminated with body fluids containing MRSA. Standard Precautions, as described in the Guideline for Isolation Precautions: Preventing Transmissionof Infectious Agents in Healthcare Settings 2007 , should control the spread of MRSA in most instances. Additional measures for prevent the spread of MRSA are described in Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006.

For more information on the prevelance and prevention of Healthcare-Associated and Community-Associated MRSA and other Drug Resistant Organisms, please read the Center for Disease Control’s Guide on Antimicrobial Resistance in Healthcare Settings.

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