Though the use of disposable cleaning wipes continues to grow in healthcare facilities, cotton and microfiber cloths are still popular, making added precautions during laundering necessary. 

“Hot water makes a big difference in the removal of bacteria during laundering,” says Dr. Charles Gerba, a microbiologist at the University of Arizona. “But it appears some contractors are either not using hot enough water or adding bleach when laundering these towels. Every state has some guidance on how these things are laundered, but apparently there is some variability.” 

Steve Attman, co-owner of Acme Paper & Supply Co., in Richmond, Va., agrees. “A lot of times, commercial cleaners and even hospital-based laundering facilities clean at temperatures around 140 degrees Fahrenheit, and don’t wash long enough to kill the microorganisms,” Attman says.

Water needs to be at least 180 degrees Fahrenheit to clean the fabric, and the wash cycle needs to be longer (European washing machines have 140-minute cycles versus 12-minute cycles in the United States). In addition, a sanitizing rinse needs to be part of the process, according to Gerba. 

“Things will come out almost sterile when you get them,” he says. “Of course, they’ll be about two-thirds the size because they shrink and color comes out after the first wash, but boy are they clean.”

There needs to be a different laundering process for microfiber because there is a breakdown of the microfiber over time, Attman says. He notes that some newer washing machines have built-in cycles for washing microfiber.

“Some cleaning processes use a softener and that’s going to close up the microfibers so that it won’t be as effective as it could be, because you’ve closed up its ability to grip and grab dirt,” says Attman. “However, you need to remember that you have got to do more than clean to get the dirt out of them, you need to clean to kill the microorganisms as well.”

Attman recommends fully evaluating laundry facilities before washing cloth, or microfiber towels. Besides looking at the temperatures and the length of wash cycles, he recommends making sure the process incorporates a high-speed spin to release as much soil and dirt from the microfiber as possible. 

The process might go as follows: A regular wash cycle, then a 15-minute cycle at high heat, followed by a high-speed spin cycle. 

“Some machines can even pre-spray with disinfectant,” he says.

Gerba adds that bleach must be used in the process — even if it degrades microfiber over time. 

“You need to check to make sure that it’s being done and procedures are being followed, because our feeling is that it wasn’t being done in some laundering facilities,” he says.

How these cloths are handled after cleaning should also be considered, adds Gerba.

“If they’re folding these towels, they need to make sure they disinfect the tables first,” he says. “And they could be taking their dirty laundry down and piling it on the table before putting it in the machine,” which is also a big no-no.

Pay attention to workers’ hand hygiene as well, he adds. Gerba explains that hands get heavily contaminated when they put dirty laundry into a washer, then remove wet laundry to put it in the dryer. Hands need to be washed between these tasks, he says.

“Improper hand hygiene is the greatest cause of HAIs,” says Attman, who adds that it’s beneficial to set up a compliance monitoring system for hand washing to make sure that people wash their hands properly and as often as required.