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Maintaining a high standard of hygiene in therapy and allied health settings is crucial for ensuring the health and safety of clients. With multiple people using the same equipment throughout the day, the chances of cross-contamination increase significantly if proper hygiene protocols are not followed.
Towels, which are used often in these environments, can become hidden sources of infection. Even with regular washing, towels can still hold on to harmful bacteria, creating potential risks for clients and therapists.
This guide aims to help you understand these risks, avoid common mistakes and implement the best hygiene practices, all while considering the importance of environmental sustainability.
Towels are typically made from cotton due to its softness, high absorbency and quick-drying properties. However, there is limited research on the effectiveness of cotton in filtering out bacteria.
What researchers do know is that cotton towels, especially those with terry loops, can retain and embed microorganisms — like bacteria and viruses — within their fibres. In fact, bacteria was found in higher concentrations on 100% cotton terry towels compared to 100% plain-woven cotton sheets. Studies have also demonstrated that bacteria like S. aureus, E. coli and E. faecium can survive on cotton towels for up to 21 days. This confirms the risks associated with the repetitive use of towels.
Many cotton towels have a pile-looped texture that can trap microorganisms deep within the fabric, making them tough to get rid of, even with regular washing. Over time, these microorganisms can form biofilms — layers of bacteria and other microorganisms that stick to surfaces, including towels. When this happens, the towel’s effectiveness in maintaining hygiene diminishes, and its texture and appearance may alter.
Towels, especially when damp, create the perfect environment for bacteria and other microorganisms to thrive. These microbes are transferred to towels from anything your hands have touched, including surfaces that may carry harmful organisms like coliform bacteria — which can lead to symptoms like an upset stomach, vomiting, diarrhea and fever.
A 2017 study found that nearly 90% of towels are contaminated with coliform bacteria. The study also found that 14% of towels carry E. coli, a bacterium that can lead to severe gastrointestinal issues.
How easily a microorganism can travel through fabric depends on several factors. These include the microbe’s size and shape, the properties of the fabric, and the fabric’s physical and chemical characteristics. Researchers believe that while microorganisms can penetrate materials, they cannot pass through them entirely due to their larger size compared to gas and vapour molecules.
Read: The Running Cost of Towels
Reusing unwashed towels increases the risk of transferring bacteria and other harmful microorganisms. Therefore, it is essential to ensure that towels are laundered before another client uses them. Adopting a single-use-per-client approach is the most effective method to prevent cross-contamination between clients.
Many clinics and salons wash their towels in cold water to prevent colour fading. However, to kill germs effectively, towels should be washed at a high temperature. The World Health Organization states that while bacteria can be killed at 100°C, effective cleaning and significant reduction of bacterial load can still be achieved at a lower temperature of 65°C. This means that you don’t always need to reach 100°C to clean the towels effectively. Maintaining a temperature of 65°C and using detergents containing bleach is sufficient to reduce bacteria to safe levels. Studies have shown that bleach can reduce virus transmission by 99.99%.
Other studies show that linen should be washed in water at 70°C for at least 25 minutes.
Read: The Trouble With Treating Towels
Viruses with a lipid (fatty) envelope, such as influenza, COVID-19 and respiratory syncytial virus, are usually easier to remove with the right detergents and higher temperatures. However, this can make your fabrics wear out faster, meaning you might need to replace them more often.
Only remove towels from the dryer or washing line when completely dry. If towels are still damp, they can become a breeding ground for bacteria, leading to unpleasant odours and potential health issues. Ensuring towels are thoroughly dry helps prevent bacterial growth and keeps them fresh and safe for use.
Towels left on the floor can pick up dirt, bacteria and other contaminants. These contaminants can then be transferred to anyone who uses the towel next, potentially causing hygiene issues. To avoid this, it’s important to always store towels in a clean, dry place where they won’t come into contact with additional germs.
It’s important to note that washing may not remove everything the towel has absorbed, so it's important to use a separate basket for soiled linen.
A 2023 study found biofilm can start forming on towels after just four months of use. The biofilm that develops over this period cannot be removed through laundering and poses an infection risk. To prevent this buildup and keep your towels clean and fresh, it’s recommended that you replace them every four to six months.
Named after German chemical engineer Herbert Sinner, the 'Sinner’s Circle' helps us understand how four key factors — temperature, time, chemistry and mechanical action — work together during washing. If you adjust one of these factors, you’ll need to tweak the others to keep everything balanced.
For instance, if you decide to wash your towels at a lower temperature to save energy, you’ll need to either wash them for a longer time or use more cleaning agents to ensure they stay clean and hygienic.
When it comes to towel use and laundering, it’s not just about keeping things clean — thinking about the environment is important too. The Life Cycle Assessment is a tool used to understand the environmental impact of different processes, including washing. Laundry, especially in places like healthcare settings, uses a lot of electricity, water and detergents, which can affect the environment.
Many clinics and salons are working to address these issues by washing at lower temperatures to save energy and cutting back on harsh chemicals. However, it’s a balancing act, as effective cleaning often requires higher temperatures and stronger cleaners. There's also the extra task of ensuring wastewater is treated properly before it goes into public drains.
Unlike traditional towels, which can grow and spread bacteria, the FaceShield provides complete coverage for the face, creating a protective barrier between the client and the therapy bed.
In 2018, the FaceShield underwent extensive testing for bacterial filtration efficiency (BFE), which yielded impressive results. When tested with S. aureus under normal conditions, the FaceShield achieved an 86.3% bacterial filtration rate.
Further evaluations using ASTM-F2101 standards, which measure the BFE of medical surgical mask materials, showed that the FaceShield can filter 40% of bacteria in real-world applications. It also demonstrated a 43% filtration rate against the PhiX174 virus in viral filtration efficiency (VFE) tests.
Designed for single use, the FaceShield significantly reduces the risk of cross-contamination. Plus, it’s 100% recyclable. By choosing the Purifas FaceShield, therapists can ensure a higher standard of hygiene while providing their clients with a safer and more comfortable experience.
The BodyShield is engineered to provide superior protection against bacteria and other contaminants, ensuring a level of safety that surpasses that of traditional towels.
An independent international lab tested the BodyShield fabric for BFE using the ASTM F2101 standard. The results were impressive, showing an 81% bacteria filtration rate. This represents a significant improvement over an unbranded, single-use fitted bed cover, which only filtered 21% of bacteria. With the BodyShield, you can be confident that both your clients and therapy bed are well protected from cross-contamination.
Unlike towels, which need frequent washing and can lose their effectiveness over time, the BodyShield provides consistent, reliable protection with every use.
The BodyShield is designed to guard against bacteria and other contaminants, providing comprehensive protection that surpasses traditional towels.
Therapists often layer their treatment beds with towels to offer clients extra comfort, a sense of luxury, or to enhance the bed's appearance. However, Purifas' Dream Topper eliminates the need for towels while providing a higher level of comfort and hygiene. This innovative mattress topper features a soft memory foam layer covered in medical-grade TPU fabric, designed to cushion and support your clients.
Market research shows a significant disconnect between what therapists believe clients expect and what clients actually value. A survey revealed that 65% of clients are willing to pay 50 cents or more for a product that helps reduce the spread of germs, and more than half of long-term patients (those with a practitioner for over two years) are willing to switch providers for one who uses more hygienic solutions.
Additionally, over 90% of participants preferred a single-use barrier, especially compared to towels or no barrier (lying directly on the therapy bed), citing peace of mind as the primary reason. The Dream Topper, coupled with our BodyShield, not only meets these expectations but exceeds hygiene requirements, offering a solution that benefits practitioners and clients alike.
Learn more about our cost-effective, single-use solutions.
Maintaining clean and hygienic towels in therapy settings is key to preventing infections and ensuring the safety of both clients and staff. To create a safer and more eco-friendly environment, it’s important to understand the risks, avoid common pitfalls and follow best practices. For expert tips on towel hygiene and to discover products that boost cleanliness and sustainability, reach out to Purifas. We’d be delighted to demonstrate how our innovative products can make a difference in your practice.