Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Box: 357234, 1959 NE Pacific St, Seattle, WA 98195-7234, USA.
Ann Work Expo Health. 2017 Nov 10;61(9):1087-1096. doi: 10.1093/annweh/wxx082.
Little is known about exposure to pathogenic bacteria among industrial laundry workers who work with soiled clinical linen. To study worker exposures, an assessment of surface contamination was performed at an industrial laundry facility serving hospitals in Seattle, WA, USA. Surface swab samples (n = 240) from the environment were collected during four site visits at 3-month intervals. These samples were cultured for Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Voluntary participation of 23 employees consisted of nasal swabs for detection of MRSA, observations during work, and questionnaires. Contamination with all three pathogens was observed in both dirty (laundry handling prior to washing) and clean areas (subsequent to washing). The dirty area had higher odds of overall contamination (≥1 pathogen) than the clean area (odds ratio, OR = 18.0, 95% confidence interval 8.9-36.5, P < 0.001). The odds of contamination were high for each individual pathogen: C. difficile, OR = 15.5; MRSA, OR = 14.8; and VRE, OR = 12.6 (each, P < 0.001). The highest odds of finding surface contamination occurred in the primary and secondary sort areas where soiled linens were manually sorted by employees (OR = 63.0, P < 0.001). The study substantiates that the laundry facility environment can become contaminated by soiled linens. Workers who handle soiled linen may have a higher risk of exposure to C. difficile, MRSA, and VRE than those who handle clean linens. Improved protocols for prevention and reduction of environmental contamination were implemented because of this study.
工业洗衣房工人在处理受污染的临床织物时，对其接触致病菌的情况知之甚少。为了研究工人的暴露情况，在美国华盛顿州西雅图的一家为医院提供服务的工业洗衣房进行了环境表面污染评估。在四个间隔 3 个月的现场访问期间，从环境中采集了 240 个表面拭子样本。对这些样本进行了艰难梭菌、耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素耐药肠球菌（VRE）的培养。对 23 名员工进行了自愿鼻腔拭子检测以发现 MRSA，观察其工作期间的情况并进行问卷调查。在脏污区（洗涤前处理脏污衣物的区域）和清洁区（洗涤后）都观察到了这三种病原体的污染。与清洁区相比，脏污区的整体污染（≥1 种病原体）的可能性更高（比值比，OR = 18.0，95%置信区间 8.9-36.5，P < 0.001）。对于每个单独的病原体，污染的可能性都很高：艰难梭菌，OR = 15.5；MRSA，OR = 14.8；VRE，OR = 12.6（每个，P < 0.001）。在员工手动分拣脏污织物的主分拣和次分拣区，发现表面污染的可能性最高（OR = 63.0，P < 0.001）。这项研究证实，洗衣房环境可能会被脏污的织物污染。与处理清洁织物的工人相比，处理脏污织物的工人可能面临更高的接触艰难梭菌、MRSA 和 VRE 的风险。由于这项研究，实施了改进的预防和减少环境污染的方案。
