A recent study of patients at 10 academic hospitals in the US found that just over half care about what their doctors wear, most of them preferring the traditional white coat. Some doctors prefer the white coat, too, viewing it as a defining symbol of the profession.
What many might not realise, though, is that health care workers’ attire — including that seemingly “clean” white coat — can harbour dangerous bacteria and pathogens.
A systematic review of studies found that white coats are frequently contaminated with strains of harmful and sometimes drug-resistant bacteria associated with hospital acquired infections. As many as 16% of white coats tested positive for methicillin-resistant Staphylococcus aureus, and up to 42% for the bacterial class Gram-negative rods. Both types of bacteria can cause serious problems, including skin and bloodstream infections, sepsis and pneumonia.
It isn’t just white coats that can be a problem. The review also found stethoscopes, phones and tablets can be contaminated with harmful bacteria. Nurses’ uniforms have also been found to be contaminated.
Among possible remedies, antimicrobial textiles can help reduce the presence of certain kinds of bacteria, according to a randomised study. Daily laundering of health care workers’ attire can help somewhat, though studies show that bacteria can contaminate them within hours.
Several studies of American physicians found that a majority go more than a week before washing white coats — 17% go more than a month. Several London-focused studies had similar findings pertaining both to coats and ties.
A randomised trial published last year tested whether wearing short- or- long-sleeved white coats made a difference in the transmission of pathogens. Consistent with previous work, the study found short sleeves led to lower rates of transmission of viral DNA.
With the use of alcohol-based hand sanitiser, it’s far easier to keep hands clean than clothing. But the placement of hand sanitiser for health workers isn’t as convenient as it could be, reducing its use. The reason? In the early 2000s, fire marshals began requiring hospitals to remove or relocate dispensers because hand sanitisers contain at least 60% alcohol, making them flammable.
An article in The New York Times 10 years ago said the American Medical Association was studying a proposal “that doctors hang up their lab coats — for good.” Maybe one reason the idea hasn’t taken hold in the past decade is reflected in a doctor’s comment in the article that “the coat is part of what defines me, and I couldn’t function without it.” It’s a powerful symbol. But maybe tradition doesn’t have to be abandoned, just modified. Source: Times of India