Why your doctor’s white coat may make you sick
A recent study of patients at 10 academic hospitals in the United States 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 realize, though, is that health care workers’ attire — including that seemingly “clean” white coat that many prefer — 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 per cent of white coats tested positive for methicillin-resistant Staphylococcus aureus, and up to 42 per cent for the bacterial class Gramnegative 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 problematic. The review also found that stethoscopes, phones and tablets can be contaminated with harmful bacteria. One study of orthopedic surgeons showed a 45 per cent match between the species of bacteria found on their ties and in the wounds of patients they had treated. 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 randomized study. Daily laundering of health care workers’ attire can help somewhat, though studies show that bacteria can contaminate them within hours.
Several studies of U.S. physicians found that a majority go more than a week before washing white coats. Seventeen per cent go more than a month. Several London-focused studies had similar findings pertaining both to coats and ties.
A randomized 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. It may be easier to keep hands and wrists clean when they’re not in contact with sleeves, which themselves can easily brush against other contaminated objects. For this reason, the Society for Healthcare Epidemiology of America suggests clinicians consider an approach of “bare below the elbows.”
With the use of alcohol-based hand sanitizer — often more effective and convenient than soap and water — it’s far easier to keep hands clean than clothing.