No Bacterial Advantage Found in Short-Sleeved Uniforms

After an eight-hour shift, there is no difference in contamination among physicians wearing long- and short-sleeved shirts, or on the skin at the physicians' wrists, according to a new study published today in the Journal of Hospital Medicine.

Researchers from the University of Colorado assessed the claim that longer sleeves lead to more contamination by testing the uniforms of 100 physicians at Denver Health who were randomly assigned to wearing a freshly washed, short-sleeved uniform or their usual long-sleeved white coat.

"We were surprised to find no statistical difference in contamination between the short- and long-sleeved workwear," said lead researcher Marisha Burden, MD, a hospitalist at Denver Health, and assistant professor of medicine at the University of Colorado Health Sciences Center. "We also found bacterial contamination of newly laundered uniforms occurs within hours of putting them on."

In the study, 50 physicians were asked to start the day of the trial in a standard, freshly washed, short-sleeved uniform. The 50 physicians wearing their usual long-sleeved white coats were not made aware of the trial date until shortly before the cultures were obtained, to ensure that they did not change or wash their coats. Cultures were taken from the physicians' wrists, cuffs and pockets. No significant differences were found in bacteria colony counts between each style.

The researchers also found that although the newly laundered uniforms were nearly sterile before putting them on, three hours into a shift nearly 50% of the bacteria counted at eight hours were already present.

"By the end of an eight-hour work day, we found no data supporting the contention that long-sleeved white coats were more heavily contaminated than short-sleeved uniforms," Burden said. "Our data do not support discarding white coats for uniforms that are changed on a daily basis, or for requiring healthcare workers to avoid long-sleeved garments."

Burden's study notes that some British government agencies have instituted guidelines banning physicians' white coats and the wearing of long-sleeved garments to decrease the transmission of bacteria in hospitals in the belief that cuffs of long-sleeved shirts carry more bacteria.