Use of quantitative microbial risk assessment for evaluation of the benefits of laundry sanitation,☆☆

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Abstract

The goal of this study was to evaluate the risk assessment process for quantifying the contribution of contamination in the home to microbial infections. Whereas risks of enteric pathogens spread through food has been assessed, the spread of fecal-oral pathogens through surfaces likely at low rates would be difficult to address through epidemiologic studies. An alternative is quantitative risk assessment. The 4-step process of hazard identification, dose-response, exposure assessment, and risk characterization can be used; however, exposure assessment may follow a complicated pathway consisting of survival and transference. Microbial hazards in the home have focused primarily on enteric bacteria. Dose-response data are available; however, the transfer from the hands to the dose is uncertain. Through day care studies, Shigella has been shown to be transferred in this manner, and a dose-response model is available. By using these data and information on the transference of bacteria between clothing and hands, risk estimates were made for contaminated laundry. Risks were calculated as high as 10 per million population to much lower levels associated with lower excretion rates of the bacteria in the feces. Approximately a 90% and 99% reduction in the probability of disease through laundering and use of a sanitizing detergent, respectively, were suggested by the models. Better data are needed on incidence of disease in the population, excretion rates over the course of an infection, amount of feces spread in the home, distribution of bacteria, survival, and the transfer of the bacteria from surfaces to the hands and to the mouth. (AJIC Am J Infect Control 1999;27:S34-S39)

Section snippets

Hazard: Shigella, an example microorganism

Transmission of diseases via contaminated clothing is an old established risk.7 The earliest documented spread of disease through contaminated clothing is found in Leviticus 13 of the Bible,8 which states that “the garment that the plague of leprosy is in whether it be a woolen or a linen garment; whether it be in the warp or woof; of linen or of woolen; whether in a skin or anything made of skin;” shall be washed or burned according to the judgment of the priest. A well-known outbreak of

CONCLUSIONS

Recently, more attention has been focused on household sanitizing agents. As the technology develops to further reduce the possibility of illness resulting from exposure to microbial pathogens in the home, these products can be evaluated through a risk assessment process to determine the number of cases of disease they may prevent. In this example, approximately a 99.9% reduction in the probability of disease through exposure to contaminated laundry, given the presence of a family member

References (27)

  • CS Crockett et al.

    Prevalence of shigellosis in the US: consistency with dose-response information

    Int J Food Microbiol

    (1996)
  • RG Feacham et al.

    Sanitation and disease health aspects of excreta and wastewater management

    (1983)
  • CE Enriquez et al.

    Bacteriological Survey of used cellulose sponges and cotton dishcloths from domestic kitchens

    Dairy Food Environ Sanitation

    (1997)
  • P Rusin et al.

    Reduction of faecal coliform, coliform and heterotrophic plate count bacteria in the household kitchen and bathroom by disinfection with hypochlorite cleaners

    J Appl Microbiol

    (1998)
  • TJ Humphrey et al.

    Contamination of hands and work surfaces with Salmonella enteritidis PT4 during the preparation of egg dishes

    Epidemiol Infect

    (1994)
  • VT Covello et al.

    Risk assessment methods

    (1993)
  • E. McNeil

    Dissemination of microorganisms by fabrics and leather

    Developments in industrial microbiology

    (1964)
  • Bible. New International Version

    (1985)
  • BR Frisby

    Cleansing of hospital blankets

    Br Med J

    (1957)
  • R Kundsin et al.

    Ecology of staphylococcal disease. The coliform bacilli

    JAMA

    (1963)
  • R Kundsin

    Staphylococcal disease in the home

    Clin Med

    (March 1966)
  • E McNeil et al.

    Control of transmission of bacteria by textiles and clothing

    (1961)
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