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What are the health risks to laundry workers handling contaminated linens in healthcare?

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About This Project

Infectious diseases like Ebola, Zika, HIV, hepatitis C, and MRSA are notable risks to healthcare workers with exposure to patients and environments that are contaminated with these pathogens. What is less known is the risk that the contaminated patient linen pose to workers responsible for handling, transporting, and laundering them. This research will quantify that risk, their perception about job hazards and assess exposures.

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What is the context of this research?

Those working in laundries in healthcare facilities around the world are typically overlooked with regard to their occupational exposure to infectious disease. They are required to process laundry that is often visibly contaminated with blood and body fluids. Workers are often not given access to personal protective equipment or engineering controls that allow them to do their jobs safely and effectively. With the pressures on healthcare facilities to see more patients in less time, if we don't address these hazards to this group now, we will continue to undermine the health and wellness of those working in healthcare in these critical support functions.

What is the significance of this project?

During public health threats, we spend a great deal of time focused on risks to nurses, doctors, and other bedside healthcare workers, but we do not spend a significant enough time focused on those providing vital services to healthcare, such as those handling, transporting, and processing (sorting, washing, drying) linens, bedding, gowns, and other textiles generated in healthcare settings. As hourly workers in healthcare make up the largest percent of under-served employees, we owe them a greater focus. This project will give laundry workers a voice. It is designed to capture not only their perspectives on the work and its risks, but also biological samples to determine if their microbiological colonization rates reflect those risks.

What are the goals of the project?

The goals of this project include the following: review published literature detailing risks to laundry workers and exposure to infectious disease and design an employee/staff survey to capture data on perception of risk, job duties, and their needs. We will then conduct employee surveys and interviews in 2-4 healthcare facilities and perform nasal swab samples to quantify colonization with drug resistant MRSA as a marker for risk. We will analyze survey, interview, and biological sample data results and develop a manuscript to submit to a peer-reviewed journal. To make the results immediately actionable, we will develop a flyer and infographics to be used in hospitals to increase awareness about laundry worker exposure to infectious microorganisms.

Budget

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The budget captures expenses associated with performing laundry worker survey including interviews in 2-4 healthcare facilities to identify personal / professional accounts of the work they perform and the risks they identify as important to them with regard to occupational exposure to bloodborne and infectious disease. Development of a scientifically sound survey depends on building its elements based on a review of the peer-reviewed literature. The survey will be designed and will be validated by experts. 2-4 healthcare facilities (funding pending) will be recruited to participate in the research study. Interview will be conducted with laundry workers in those facilities via telephone and/or email. A random sample of workers will be asked to have a nasal swab for Methicillin-Resistant Staph aureus (MRSA)/ Methicillin Susceptible Staph aureus (MSSA) to identify prevalence of colonization, as a marker for occupational exposure and infection risk.

Endorsed by

During my 34-years of experience leading housekeeping and laundry services in hospitals, I can attest to the importance of this project Dr. Amber Mitchell is undertaking. The workers who are sorting grossly soiled laundry from the hospital operating room, patient isolation rooms and incontinent patients are often poorly educated, non-English speaking and earning less than $15 an hour. They need a CHAMPION who will give them a voice. Amber Mitchell is that CHAMPION.
Dr. Mitchell's expertise in public health, and her passion to understand and prevent healthcare worker risk, provides the foundation for projects such as this one. This research is seriously needed to take a deep dive into another area of risk that is not understood. Existing research continues to show soft surfaces such as linens, scrubs and gowns, provide a substrate of moisture and soil that supports the growth of microbes. What is not understood is the risk healthcare workers of infection. I support and encourage funding of this project.
I have known Amber (Dr. Mitchell) for about 15 years when we were invited by the Texas Department of State Health Services (DSHS) to be on their DSHS Statewide Healthcare-Associated Infections (HAIs) committee. I have worked with her on numerous projects related to HAIs and healthcare safety since that time. Dr. Mitchell is internationally recognized in these areas and has an outstanding ability to make complex issues simple to understand while being persistent in her own questioning and understanding of topics. A true hero to these causes!

Meet the Team

Dr. Amber Mitchell
Dr. Amber Mitchell
Executive Director

Affiliates

International Safety Center, University of Texas School of Public Health, University of Maryland Medical School
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Dr. Amber Mitchell

I grew up as an only child to a mom who was an AIDS nurse in the 1980s and 90s. Back then outside of New York City where we lived, the majority of her patients died because they were infected with HIV before we understood what it was and how it was transmitted. Since then, I have had an innate passion to protect the public from infectious disease to ensure a better quality of life and health. Working in a career dedicated to public health - specifically occupational health in healthcare - protecting people like my mom, I have worked in as many different sectors as possible including the uniformed services, public, private, and academic sectors.

I received my Doctor of Public Health (DrPH) degree from the University of Texas School of Public Health and a Master’s in Public Health from The George Washington University. My Bachelor's degree is from Binghamton University in NY and I am Certified in Public Health as a member of the very first CPH cohort offered by the National Board of Public Health Examiners.

I now run the International Safety Center - a nonprofit research and advocacy organization - with a very small, but tirelessly dedicated team that surveys, measures, and prevents occupational exposures to infectious diseases like HIV in healthcare facilities around the world.

I carry on my mom’s legacy and do this in memory of her and others like her that sacrifice their own lives to care for others.

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