From Shortages to Security: How Reusable Health Care Textiles Can Transform Infection Prevention

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The Textile Rental Services Association (TRSA) plays a vital role in supporting the health care industry and critical infrastructure by providing hygienically clean health care contact textiles (HCTs) and personal protective equipment (PPE). Representing a $50 billion industry with over 200,000 employees across 2,500 facilities, TRSA ensures that essential supplies, including isolation gowns, scrubs, bed linens, flame-resistant clothing, and safety items, are available to hospitals, first responders, laboratories, and food processing facilities. However, the US health care system relies heavily on disposable HCTs, leading to dangerous supply shortages during public health crises like the COVID-19 pandemic.

Currently, over 90% of HCTs used in US health care settings are disposable, although reusable HCTs provide equivalent or even superior protection. The excessive use of disposable textiles threatens supply chain stability, making hospitals susceptible to disruptions due to global supply shortages, shipping delays, and manufacturing constraints. During the pandemic, the supply of disposable PPE, including isolation gowns, was significantly compromised, forcing hospitals to search for alternatives. TRSA members stepped in to fill the gap by supplying reusable, hygienically clean HCTs, ensuring that health care facilities could continue to operate safely.

“TRSA members process 90% of the HCTs (ie, isolation and barrier gowns, bed linens, scrubs, etc) used by health care facilities across the US,” TRSA’s press release read, “As evident during the COVID-19 pandemic, laundry processing interruptions threaten the safe operation of health care facilities as well as other critical infrastructure businesses.”

Reusable HCTs processed by TRSA’s Hygienically Clean-certified laundries offer multiple benefits, including:

• Enhanced Safety: Reusable textiles meet rigorous cleanliness and sterility standards, ensuring they are contaminant-free after each use.
• Supply Chain Security: Unlike disposables, which are often imported and subject to international supply chain disruptions, reusable HCTs are processed domestically, providing a more reliable solution.
• Cost Savings: Long-term cost analyses show that reusables reduce overall expenses compared to continuously purchasing disposables.
• Environmental Sustainability: Disposable PPE generates massive amounts of medical waste. Reusable alternatives significantly reduce waste and carbon emissions, aligning with green initiatives in health care.

Recognizing the need for supply chain resilience, a bipartisan congressional letter was sent in 2023 to then-Health and Human Services (HHS) Secretary Xavier Becerra, urging an investigation into the benefits of reusable HCTs. This led the National Institute of Occupational Safety and Health (NIOSH) to contract with the National Academies of Sciences, Engineering, and Medicine (NASEM) to study the potential benefits of increasing reusable PPE adoption in health care.

In a 2-day NASEM workshop, technical experts, policymakers, health care providers, and industrial laundry operators evaluated reusable textiles’ safety, cost-effectiveness, and sustainability. The conclusion was clear: increasing reusable PPE use would significantly improve supply chain security, reduce waste, and lower costs. However, legislative action is required to drive widespread adoption.

TRSA’s Call to Action

Maryann D’Alessandro, director of the National Personal Protective Technology Laboratory (NPPTL), acknowledged the importance of reusable PPE but emphasized that the transition "is unlikely without legislation." She called for strategic partnerships to push for regulatory and legislative changes that support the increased use of reusable HCTs.

While long-term policy shifts take time, TRSA urges NIOSH to issue a “Workplace Solutions” document, which would serve as an interim step to promote reusable HCT adoption. Although it would not mandate enforcement, the document would raise awareness among health care facilities and provide guidance on integrating reusable PPE into daily operations.

The health care industry cannot afford another PPE crisis like the one experienced during COVID-19. Increasing the use of reusable HCTs is a proven solution for ensuring supply chain stability, cost savings, and environmental sustainability. TRSA remains committed to advocating for policies prioritizing reusable health care textiles, protecting frontline workers, and patient safety.