Protective clothing worn during dental procedures may be contaminated with blood and saliva. After use it must be transported and laundered safely.
Regulations
Protective clothing laundry for healthcare workers
There are three options for laundering uniforms/reusable PPE:
- specialist healthcare laundry service
- staff take uniforms home to wash
- install a specialist washing machine and launder uniforms on the premises.
Staff laundering their own uniforms at home
If staff need to take uniforms home, they must:
- wash hands after removing their uniform and placing it into a bag for transport
- take it home in either:
- a disposable plastic bag, disposed in the household waste or
- a reusable cloth bag they wash with the uniform
- wash uniforms:
- separate from any other household linen
- in a load of no more than half the machine capacity
- at the maximum temperature the fabric can tolerate, then iron or tumble-dry
Quality standards for processing healthcare linen
Health Technical Memorandum 01-05 - responsibilities of processors of healthcare linen are the essential quality requirements and equipment standards. You must meet these if you are laundering (‘processing’) linen as a healthcare providers.
This standard includes (among others):
- hazard and risk assessment
- staff training
- written procedures for operation of laundering equipment
- physical measures to make sure processing of linen is done away from public and clinical areas
- “Detailed action plan” on how the provision and processing of linen will move towards “best practice”
- adhering to technical standards to show an equal level to BS EN 14065. This is the internationally recognised standard for certifying biocontamination control systems for laundry processing of textiles.
BS EN 14065 standards include:
- temperature measurement
- water flow and pressure measurement
- testing of washers used in laundry. This includes engineer installation and scheduling operational tests.
- obtaining documented evidence that the washer meets standards.
Washing machines
Washing machines installed in dental practices must meet the Water Supply (Water Fittings) Regulations 1999. These categorise healthcare work wear as fluid category 5, the highest category. We expect providers to consider the manufacturer's instructions. They should also consider the regulations, particularly Regulations 3 and 4.
Notification of plumbing work (Regulation 5)
Before any proposed plumbing work in a dental practice is done the local water provider must be told. This includes installing a washing machine. It is a legal requirement. Consent must be granted. More importantly it provides an important safety check. A water fittings inspection can identify ways to reduce water usage. It can also identify water quality risks. Risks could affect staff, patients and neighbouring premises.
For example:
- unsuitable fittings
- cross connections
- inadequate backflow protection
- poor design and
- poor workmanship may also be identified.
Backflow protection
The regulations identify five fluid categories. Fluids categorised as fluid category 3, 4 or 5 pose a health hazard. The most serious health hazards being those categorised as fluid category 5. The possibility of water supply contamination because of backflow is a known risk. The regulations identify backflow protection arrangements and devices that can be used. They specify the type (protection against back siphonage or back pressure). They also specify the level (fluid category rating) of backflow protection each provides.
Washing machines in dental practices
When assessing risk posed by a washing machine in non-domestic premises, several factors will be considered. They include what it will launder. They also include whether the machine has any built-in backflow protection. If so, what level and type of backflow protection this provides.
If laundered on site this would is considered a high-risk activity. The washing machines used would need backflow protection to fluid category 5. This is higher than found in domestic washing machines. If a washing machine does not have backflow protection complying with regulations it will need to be supplied from an independent break cistern by a Type AA or AB air gap.
Other contamination risks
A washing machine can connect to the plumbing system if it has adequate backflow protection. This connection is often made by a flexible hose. Flexible hoses connecting appliances to the water supply are a frequent cause of customer taste and odour problems. To avoid this check to make sure the hose conforms to BS 6920 or equivalent.