Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: a randomized controlled trial

J Hosp Med. 2011 Apr;6(4):177-82. doi: 10.1002/jhm.864. Epub 2011 Feb 10.


Background: Governmental agencies in the United Kingdom and Scotland have recently instituted guidelines banning physicians' white coats and the wearing of long-sleeved garments to decrease nosocomial transmission of bacteria.

Objective: Our aim was to compare the degree of bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians' white coats with that of newly laundered, standardized short-sleeved uniforms after an 8-hour workday and to determine the rate at which bacterial contamination of the uniform ensued.

Design: The design was a prospective, randomized controlled trial.

Setting: The setting was a university-affiliated public safety-net hospital.

Participants: One hundred residents and hospitalists on an internal medicine service participated.

Intervention: Subjects wore either a physician's white coat or a newly laundered short-sleeved uniform.

Measurements: Bacterial colony count and the frequency with which methicillin-resistant Staphylococcus aureus was cultured from both garments over time were measured.

Results: No statistically significant differences were found in bacterial or methicillin-resistant Staphylococcus aureus contamination of physicians' white coats compared with newly laundered short-sleeved uniforms or in contamination of the skin at the wrists of physicians wearing either garment. Colony counts of newly laundered uniforms were essentially zero, but after 3 hours of wear they were nearly 50% of those counted at 8 hours.

Conclusions: Bacterial contamination occurs within hours after donning newly laundered short-sleeved uniforms. After 8 hours of wear, no difference was observed in the degree of contamination of uniforms versus infrequently laundered white coats. Our data do not support discarding long-sleeved white coats for short-sleeved uniforms that are changed on a daily basis.

Trial registration: NCT01192841.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Load / methods
  • Bacterial Load / standards*
  • Clothing / standards*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Detergents / standards*
  • Equipment Contamination / prevention & control
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Physicians / standards*
  • Prospective Studies
  • Scotland
  • Time Factors
  • United Kingdom


  • Detergents

Associated data