Can Work Clothes Spread Germs?

Essential cleaning professionals frequently ask whether they can carry germs home on their work clothes and pass them on to family members or even infect themselves later in the day. Let’s examine what the research shows.

Related studies on germ transport

Work clothes can transport germs. Germs can accumulate on your work clothes in high numbers. They can spread through contact with soft, porous materials and can be resuspended into the air. Yet, to my knowledge, this has not been studied in work environments and the work clothes of professionals in the cleaning industry.

However, it is well-established that germs can accumulate on hospital uniforms, as reviewed by Haun et al. (2016).¹ Another study showed the accumulation of bacteria on sterilized uniforms worn by nurses and that 70% were positive for antibiotic-resistant Staphylococcus aureus (Sanon and Watkins, 2012).² Also, high concentrations of germs were found on the work clothes of waste collection workers after they had finished their shifts (Park et al., 2011).³ But none of these studies investigated the movement of germs on work clothes to other environments. Nevertheless, these types of studies do highlight the importance of infection control, hygiene, and laundry in relation to work clothes.

“Take-home” exposure, by bringing home contaminated work clothes, has been reported for chemicals such as lead, pesticides, asbestos, and polychlorinated biphenyls (PCBs). Exposure to biological particles that cause allergies from clothes has been studied for cat allergens, dog allergens, and dust mites, where these allergens were shown to be transported on clothes between homes, schools, and workplaces. Pollen has been shown to accumulate and be transported on clothes. One study showed that fungi and fungal spores in farmers’ homes can be up to 1,000 times higher when compared to apartments where non-farming families live, indicating fungi transport on clothes to the home (Pasanen et al., 1989).⁴

Cleaning professionals work to clean dirty environments and can be exposed to a wide range of germs, pollutants, and contaminants. Several studies have been conducted on exposure to biological risks and how workers could transport fungi and bacteria to vehicles and other non-workplaces through contaminated work clothes, skin, or hair (Møller and Madsen et al., 2022).⁵ They identified 275 fungal species and 54 different species of bacteria on the work clothes of waste collection workers. A series of studies found that workers who work with waste:

• Are exposed to a wide range of fungal and bacterial species, including those that are known to cause hypersensitivity pneumonitis and gastrointestinal infections.
• Waste collection has been associated with health symptoms related to exposure to elevated concentrations of germs.
• Workers that handle and sort waste cardboard have high at-work exposure to germs.
• Work clothes can be contaminated by germs from surface-to-surface contact.
• Shoes can spread germs.
• Germs can be aerosolized from the floor.
• Emptying of trash and waste containers can spill germs on the ground or aerosolize them onto clothes.
• Germs generally exhibit lower survival on porous surfaces than on non-porous surfaces. However, they can survive on textiles for days to weeks.
• Staphylococcus aureus, Escherichia coli, and Escherichia faecium survive on cotton for 21 days.
• Staphylococcus aureus and Escherichia faecium survive on polyester for up to seven days.
• Fecal coliforms can survive for 120 days on cotton and blended textiles.
• Clostridium difficile spores have been reported to persist on dry surfaces for five months.
• Candida, Aspergillus spp., Fusarium sp., Mucor sp., and Paecilomyces sp. survived from one to more than 30 days on cotton, terry, blended textile, polyester, and spandex.
• SARS-CoV-2, the virus that causes COVID-19, persisted on cloth (unspecified material type) for two days, compared to four days on glass and banknotes, and up to seven days on surgical masks, stainless steel, and plastic.
• Poliovirus survives at room temperature for 84–140 days on wool and 42–84 days on cotton.

The verdict

Work clothes can transport germs to places outside the work environment, such as your home. The current assumption that there is a low risk of infection from soft, porous materials and textiles like work clothes, is due to a lack of studies and direct epidemiological evidence. Therefore, there is less emphasis on worker safety and the risk of infection from work clothes, textiles, and soft surfaces.

Germs do survive on textiles for hours, days, and weeks and can transfer onto skin and other surfaces. It is biologically plausible that infectious diseases can be transmitted directly through contact with contaminated textiles. There are a number of case studies that link infection with inadequate laundering of bed linen, towels, and work clothes in hospitals and hotels. I am very concerned due to the lack of control and monitoring of decontamination for those cleaning professionals that are required to wash and dry their work clothes at home.

What can be done?

Germs, just like allergens, pollutants, and contaminants, can accumulate on work clothes, including shoes, throughout a workday and can lead to exposure. These germs can lead to infections and make people sick.

For the cleaning industry, understanding that germs can be transported and resuspended from work clothes is important for everyone, not just those that are immunocompromised, have allergies, or have open wounds and cuts. This knowledge should change workers’ behavior and actions for washing hands with soap and water, donning and doffing and wearing appropriate personal protection equipment, changing out of work clothes at the end of their workday, taking a shower after work, and handling of laundry of work clothes.

Again, I am unaware of studies specifically related to cleaning professionals, but I recommend the cleaning industry not ignore but learn from studies from other professions.

References:

¹Haun, N., Hooper-Lane, C., Safdar, N. 2016. Healthcare personnel attire and devices as fomites: a systematic review. Infection Control Hospital Epidemiology, 37 (11), 1367-1373

²Sanon, M.A., Watkins, S. 2012. Nurses’ uniforms: How many bacteria do they carry after one shift? Journal of Public Health Epidemiology, 4, 311-315

³Park, D.U., Ryu, S.H., Kim, S.B., Yoon, C.S., 2011. An assessment of dust, endotoxin, and microorganism exposure during waste collection and sorting. Journal of Air Waste Management Association. 61 (4), 461-468

⁴Pasanen, A.L., Kalliokoski, P., Pasanen, P., Salmi, T., Tossavainen, A., 1989. Fungi carried from farmer’s work into farm homes. American Industrial Hygiene Association Journal, Volume 50, Issue 12, 631-633

⁵Møller, S.A, Rasmussen, P.U., Frederiksen, M.W., Madsen, A.M., 2022. Work clothes as a vector for microorganisms: Accumulation, transport, and resuspension of microorganisms as demonstrated for waste collection workers, Environment International, Volume 161, 107112.