Annals of Work Exposures and Health, 2017, Vol. 61, No. 9, 1087–1096 doi: 10.1093/annweh/wxx082 Original Article © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society. Original Article Assessment of Environmental Contamination with Pathogenic Bacteria at a Hospital Laundry Facility Karen E. Michael, David No, William E. Daniell, Noah S. Seixas, and Marilyn C. Roberts* Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Box: 357234, 1959 NE Pacifc St, Seattle, WA 98195-7234, USA *Author to whom correspondence should be addressed. Tel: 206-543-8001; e-mail: marilynr@u.washington.edu Submitted 20 March 2017; revised 28 July 2017; editorial decision 21 August 2017; revised version accepted 25 October 2017. Abstract 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 inter- vals. These samples were cultured for Clostridium diffcile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Voluntary participation of 23 employ- ees consisted of nasal swabs for detection of MRSA, observations during work, and question- naires. 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% confdence interval 8.9–36.5, P < 0.001). The odds of contamination were high for each individual pathogen: C. diff- cile, OR = 15.5; MRSA, OR = 14.8; and VRE, OR = 12.6 (each, P < 0.001). The highest odds of fnding 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. diffcile, MRSA, and VRE than those who handle clean lin- ens. Improved protocols for prevention and reduction of environmental contamination were imple- mented because of this study. Keywords: Clostridium diffcile; environmental contamination; exposure assessment; laundry; linen; methicillin- resistant Staphylococcus aureus; MRSA; nasal colonization; occupational health; vancomycin-resistant enterococci; VRE Downloaded from https://academic.oup.com/annweh/article/61/9/1087/4616750 by guest on 15 September 2022