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Healthcare workers’ (HCW) clothing has been shown to harbor multidrug-resistant bacteria (MDRB) and may contribute to transmission. The aim of this study was to evaluate presence of MDRB on HCW uniforms in Cyprus. A cross-sectional study was carried out in 9 hospital wards and 7 long-term care facilities (LTCFs) in Nicosia, Cyprus, from April–August 2019. Sampling of HCW uniform pockets was conducted at the end of the first shift. Personal hygiene and other habits were recorded during personal interviews. Among 140 sampled HCW (69 from hospitals, 71 from LTCFs), 37 MDRB were identified, including 16 vancomycin-resistant enterococci (VRE), 15 methicillin-resistant Staphylococcus aureus (MRSA), 5 extended spectrum b-lactamase (ESBL)-producing bacteria, and 1 carbapenem-resistant Acinetobacter baumannii. Presence of MDRB was higher in LTCFs compared to hospitals (p = 0.03). Higher MDRB rates in uniforms were noted in HCWs that worked

Summary Healthcare workers (HCWs) wear uniforms, such as scrubs and lab coats, for several reasons: (1) to identify themselves as hospital personnel to their patients and employers; (2) to display professionalism; and (3) to provide barrier protection for street clothes from unexpected exposures during the work shift. A growing body of evidence suggests that HCWs' apparel is often contaminated with micro-organisms or pathogens that can cause infections or illnesses. While the majority of scrubs and lab coats are still made of the same traditional textiles used to make street clothes, new evidence suggests that current innovative textiles function as an engineering control, minimizing the acquisition, retention and transmission of infectious pathogens by reducing the levels of bioburden and microbial sustainability. This paper summarizes recent literature on the role of apparel worn in healthcare settings in the acquisition and transmission of healthcare-associated pathogens. It proposes solutions or technological interventions that can reduce the risk of transmission of micro-organisms that are associated with the healthcare environment. Healthcare apparel is the emerging frontier in epidemiologically important environmental surfaces.

Objective.Most professionals in the healthcare environment wear uniforms. For the purpose of this study, we concentrated on nurses' uniforms. In the United Kingdom, many nurses are expected to launder their uniforms at home by using a domestic washing machine that frequently has low-temperature wash cycles. We have investigated whether the use of low-temperature wash cycles results in a microbiologically acceptable product to wear on the wards.Methods.We have assessed the bioburden on uniforms before and after laundry and the effectiveness of low-temperature wash cycles and ironing on removal of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. We did not assess the role of tumble drying.Results.We demonstrate contamination of uniforms by gram-negative bacteria after wash, the removal of MRSA at low-temperature wash cycles in the presence of detergent, and the eradication of gram-negative bacteria after ironing.Conclusions.Our conclusions are that laundry in a domestic situation at 60°C (140°F) for 10 minutes is sufficient to decontaminate hospital uniforms and reduces the bacterial load by more than 7-log reduction, that items left in the pockets are decontaminated to the same extent, that the addition of either a biological detergent or a nonbiological detergent is beneficial in removing MRSA from experimentally contaminated swatches, and that uniforms become recontaminated with low numbers of principally gram-negative bacteria after laundry but that these are effectively removed by ironing.

We studied the preventive effects of socks against dermatophyte infection. Wearing various socks (cotton socks, nylon stockings, wool socks and "tabi"), a healthy volunteer walked on a bath mat on which a patient with tinea pedis had stepped earlier. The volunteer pressed her right foot with socks onto large agar medium (Foot-press method), then, took off the socks and performed the Foot-press method again. The number of colonies of isolated dermatophytes on the medium was counted. The number of isolated colonies from the sole after taking off the nylon stockings was larger than that from the foot wearing the stockings. Dermatophytes were also isolated from the sole after taking off cotton socks. In contrast, few dermatophytes were isolated from the sole after taking off wool socks or "tabi". On microscopic observation, fibers of the nylon stockings and cotton socks were seen to be loose enough for dermatophytes to pass through. In contrast with those socks, fibers of wool socks and "tabi" were tight or fluffy. In conclusion, the nylon stockings and cotton socks are unsatisfactory in preventing the adhesion of dermatophytes.

Three major factors determine the tropical fitness of fabrics: (1) thermal insulation, (2) porosity, (3) reflecting power.

Clothing is considered one of the most important tools for sun protection. Contrary to popular opinion, however, some summer fabrics provide insufficient ultraviolet (UV) protection. The European Committee for Standardization (CEN), has developed a new standard on requirements for test methods and labelling of sun-protective garments. This document has now been completed and is published. Within CEN, a working group, CEN/TC 248 WG14 'UV protective clothing', was set up with the mission to produce standards on the UV-protective properties of textile materials. This working group started its activities in 1998 and included 30 experts (dermatologists, physicists, textile technologists, fabric manufacturers and retailers of apparel textiles) from 11 European member states. Within this working group, all medical, ethical, technical and economical aspects of standardization of UV-protective clothing were discussed on the basis of the expertise of each member and in consideration of the relevant literature in this field. Decisions were made in consensus. The first part of the standard (EN 13758-1) deals with all details of test methods (e.g. spectrophotometric measurements) for textile materials and part 2 (EN 13758-2) covers classification and marking of apparel textiles. UV-protective cloths for which compliance with this standard is claimed must fulfill all stringent instructions of testing, classification and marking, including a UV protection factor (UPF) larger than 40 (UPF 40+), average UVA transmission lower than 5%, and design requirements as specified in part 2 of the standard. A pictogram, which is marked with the number of the standard EN 13758-2 and the UPF of 40+, shall be attached to the garment if it is in compliance with the standard. The dermatology community should take cognizance of this new standard document. Garment manufacturers and retailers may now follow these official guidelines for testing and labelling of UV-protective summer clothes, and the sun-aware consumer can easily recognize garments that definitely provide sufficient UV protection.

Background The exact incidence of textile dermatitis is unknown because of the lack of controlled epidemiological studies. Nevertheless, the increasing frequency of contact dermatitis to clothing has been demonstrated, thus indicating the importance of further investigations in this field. Objective To analyse the results from a 4-year prospective study of the clinical and aetiological features of contact dermatitis to textiles in Israel. We also aimed to assess the frequency and relevance of sensitization to textile dyes and resins in these patients. Methods Six hundred and forty-four patients (441 female and 203 male), referred for the investigation of contact dermatitis, and suspected of having textile allergic contact dermatitis (ACD), were studied. All patients were patch tested with the standard series (TRUE Tests), textile colour and finish series (TCFS) clothing extracts and pieces of garment in some cases. Readings were performed on days 2, 3 and in many patients also on day 7. Results Eighty-three patients (12.9%) had an allergic reactions to a dye and/or resin allergen. Of them, 43 (51.8%) had positive patch tests to the textile dye allergens, 28 (33.7%) to the formaldehyde and textile finish resins and 12 (14.4%) to allergens from both groups. The highest incidence of sensitization from the dye group allergens was due to Disperse Blue (DB) 124 (30.6%), DB 106 (27.0%) and DB 85 (8.1%) and from the resin group to melamine formaldehyde and ethyleneurea melamine formaldehyde (20.7% each) and urea formaldehyde (18.3%). Present relevance of the patch tests was found in 81.4% of the cases. Concomitant sensitization with allergens from the standard series included nickel sulphate, potassium dichromate, formaldehyde, rubber additives and others. Although chronic dermatitis was the typical clinical presentation, less frequent forms such as purpuric, hyperpigmented and papulopustular lesions and atypical forms such as erythema multiforme-like, nummular-like lesions, lichenification and erythrodermia were observed in 24.4% of the cases. The atypical manifestations were provoked by sensitization to dye allergens and never to resins. Along with the typical distribution in areas of friction on the trunk and extremities, less frequent areas including the hands, face, genital area and the soles were affected too. Conclusions In view of the increasing frequency of contact dermatitis to clothing, the clinical assessment should include awareness of the classical as well as the unusual and atypical clinical forms and locations of ACD to textiles, for they are not infrequent. Although dyes and among them DB 106 and DB 124 are the most frequent allergens inducing textile dermatitis, concomitant testing with allergens from the textile dyes and resin groups is recommended when investigating patients with textile dermatitis.