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Content about Staining

June 7, 2012

ROANOKE, Va. — Two words that laundry managers fear most: chlorhexidine gluconate

ROANOKE, Va. — Several times a year, I am asked about poor-quality wash or stains. About stains, my philosophy has always been that they represent a failure to properly handle or clean the fabric; I have frequently found that most stains are caused by improper wash formulas. I was convinced that I had not met a stain I could not beat until I arrived in Milwaukee, Wis.

While working at Aurora Health Care, I encountered a light yellow stain that resisted all attempts to remove it. We attempted to identify what the substance might look like before it was washed, but the source of the stain eluded us. We worked with our chemical vendor to identify the stain. We tried developing a reclaim formula but still the stain stumped the company experts.

We requested that our chemical vendor and linen vendor send samples of the stained linen to independent labs for analysis; the labs could not identify the stain or find a way to remove it. The stain showed up more frequently in early-morning loads than at other times of the day, we determined, but the source of the stain and its tool for removal remained a mystery.

When I accepted a job at Health Group of Alabama, the stain “followed.” The fact that the stain could be present in two different laundries 600 miles apart led me to look at other environmental factors. This time, we narrowed our search to various chemicals used in the hospital and quite accidentally discovered that the source of the pesky stain was a hand soap used at the largest facility.

The active ingredient was chlorhexidine gluconate, the most effective hand sanitizer on the market today. The soap is clear; it shows no color in liquid form or when dried on linen. But the cleaner will react with chlorine to form a light yellow to dark brown stain (its color depends on the amount of soap and chlorine present).

In Milwaukee and again in Alabama, there was enough chlorine in the local water system to cause the chlorhexidine gluconate to form a stain. In an effort to reduce the amount of staining, I worked with our chemical company to devise a formula that would limit the chances of setting the stain before we could rinse the soap from the fabric.

Our first step was to change from chlorine bleach to hydrogen peroxide bleach. This reduced the stain by 50% but apparently there was still enough chlorine in the incoming water to cause the problem.

Our next step was to add an antichlor or hydrogen peroxide to the first pocket of the tunnel washers. Both chemicals neutralize the chlorine and thus prevent the chlorhexidine gluconate from setting.

By taking these steps, we were able to reduce our stains from this chemical by 80%.

At the Roanoke, Va., laundry where I now work, chlorhexidine gluconate stains have reared their ugly head once again. This time, the hand cleaner is part of a bed-bath kit used to bathe bedridden patients. The Roanoke city water system contains chlorine levels sufficient to cause the chemical to set a light yellow stain.

To add to our frustration, the sodium vapor lights used in the laundry’s overhead lighting make it difficult for workers to see the stain. Under normal fluorescent light, the stain can be easily detected.

In all my years in the laundry business, I have seen the process I detailed above remedy a number of stain and odor problems. Oil stains on high-thread count polyester surgical gowns or Gortex gowns can be almost eliminated through the use of a solvenated detergent in conjunction with enzymes but with no softeners. A barrier retreatment product, if used properly, will prevent oil from adhering to the polyester fibers while maintaining the barrier quality of the fabrics at like-new levels.

Residual odor problems in freshly laundered reusable diapers and underpads can be addressed by switching to an enzyme detergent.

Numerous stains can be avoided by using a warm (not to exceed 120 F) fresh-water flush at the start of the wash formula. Many medicines and body fluids react unfavorably in the presence of heat or wash chemicals.

The key to overcoming a stain is the willingness to do the detective work required to identify the cause, then asking for help from the appropriate people to develop a system to avoid it.

May 15, 2012

CHICAGO — Input from chemicals supply, commercial laundry and textiles sectors

CHEMICALS SUPPLY: MARLENE WILLIAMS, ANDERSON CHEMICAL CO., LITCHFIELD, MINN.

marlene williamsWe have chosen to address three common stubborn stains that can best be managed with procedure, machine programs and chemistry. We will outline procedures important to all stain removal and then address specifics for each stain category.

In all cases, it is important to either pre-treat the stain, or begin the laundering process, as soon as possible after staining. The sooner that stains are removed from the fabric, the less aggressive the program required for removal and the greater the possibility for success.

With a few exceptions, it is important to treat stain removal with the warmest temperature appropriate for the fabric and color blends. Chemical activity increases with elevated temperature and stain removal is generally enhanced with higher temperatures. Exceptions to the “higher the better” are situations involving color fading/bleeding, fabric shrinking, protein or blood “setting,” or exceeding temperatures recommended for enzyme products.           

Medicinal Stains — There are a number of medicinal preparations that can be irreversibly set with chlorine bleach if not thoroughly removed prior to bleach process. Chlorhexidine gluconate and iodine preparations must be thoroughly rinsed prior to standard wash cycles. Education of healthcare staff regarding possibility of irreversible staining, vigilance by laundry staff for particular laundry categories, and possible replacements of non-staining materials can provide solutions. Salves and skin-protection preparations compounded with oils may need special attention and are best removed with selective surfactant products.

Food Stains — Food stains are common to healthcare and hospitality linens. Conventional chemistry with increased alkali and detergent usually provides satisfactory results for greasy soils. Protein stains can be removed with a bleach program step if fabric dyes are compatible. There are a number of enzyme detergents and enzyme presoak products that provide good removal of protein and/or greasy stains if soak time is available. Be sure to match specific enzyme product to type of food stain.

Athletic Uniforms — School and professional athletic colors have never been selected for laundry compatibility! Before beginning any aggressive stain-removal program, make sure that both uniform materials of construction and colors can withstand temperatures and chemistry chosen. Always consult manufacturer’s care tags. Temperature and chlorine bleach are two often-exceeded treatments that can do irreversible damage to fabric finish, fading/bleeding of incompatible colors, and overall irreversible color deposition. There are also a small number of hazardous chemistries that are used to strip dyes and field marking colors. These should be avoided by using an enzyme presoak program if team schedules allow.

It is important to identify impact-generated (helmet and plastic padding) stains that are a result of fabric and protective gear colors being physically transferred into the opposing team’s uniform fabric. Impact transfer is usually an irreversible situation.

COMMERCIAL LAUNDRY: TOM GILDRED, EMERALD TEXTILES, SAN DIEGO, CALIF.

From the perspective of an industrial healthcare linen services provider, the most stubborn stains regularly encountered include bodily fluids, metal and rust stains, tape residue and finally medicinal chemical stains.

tom gildredWe address these difficult stains through a multi-tiered approach, designed to address each particular type of stain. Time, temperature, chemical action and mechanical action are the keys to effective stain removal, and can be adjusted as each case requires. 

As a first step, we work closely with our chemical company to create the proper formulation, or “chemical cocktail,” to remove specific types of stains. Heavily stained linens are identified during soil sort and separated for special treatment.

After the appropriate treatment has been determined, we pre-wash the heavily stained items to remove the first level of soil in our heavy-duty single-batch washers. Hand inspection is employed throughout the process to determine what the next steps are, as well as to ensure quality control. A stringent quality-control program ensures that we effectively launder items until the stains are eradicated.

Because of the intense nature of healthcare laundry stains, there are instances in which items are destroyed in the process of stain removal and those pieces are placed in our linen recycling program. By continually evolving our processes, and working with our chemical vendor, we successfully remove a large number of stains.

TEXTILES: TOM LANGDON, ENCOMPASS GROUP, MCDONOUGH, GA.

Not having had much experience with this topic, I sought the advice of a few long-time laundry professionals. What I found was a little surprising. While most agreed about which substances were the most difficult to treat and remove, their approaches to accomplish this task were completely different.

tom langdonOne approach is stain avoidance. The process starts with sorting the soiled linen from least stained to most stained, or light, medium or heavy soil. By isolating the dirtiest linen, the launderer reduces the chance of contaminating the rest. They also sort by soil factor (whether the stains are protein- or oil-based), as this will determine what wash formula should be used to process the linen. Using this approach, most of the cleaner linen can run through the normal process and be cleaned satisfactorily. They then save the “blood load” to be processed at the end of the shift when the wash formula, along with temperature and process time, can be adjusted.

On the other end of the spectrum is the “one wash” method. Using this approach, the laundry does not segregate its linen because it has optimized its process and system to yield the best overall cleaning results. Of course, if an item that is obviously heavily soiled turns up, they would not process it, preferring instead to rag it out. As stains are the enemy of efficiency, this method works to minimize their disruption on the process.

Stains, after all, are a big problem. Some operators advise that they incur more loss due to stains than to wearing out product through processing. Up to three times more product is “ragged out” because of stains than from actually being worn out.

Regardless of the approach, most operators agree that, in the healthcare setting, Hibiclens, or chlorhexidine gluconate/isopropanol, is the toughest stain to get out. This antiseptic liquid is applied directly to a patient’s skin at the incision site prior to surgery. Its normal state is a clear pink liquid. After being transferred to a textile article and exposed to chlorine bleach during processing, it turns orange-brown and is a difficult stain to remove.

The products themselves play a part in the challenge of dealing with stains. Results from my research rank incontinence products, patient apparel and bath items as the products that experience the most stains. Fabric type is also a factor in stain resistance and stain removal.

Due to advances in finishing chemistry and applications, polyester-rich products actually fare better than cotton-rich items, even though in its natural state polyester has an affinity for oil. These predominantly synthetic-rich products also last longer, which is a plus when exposing them to additional mechanical action and stronger wash formulas that can accelerate the breakdown of cotton-rich fabrics.

Stain treatments are changing. Historically, stain-release treatments were based on C8 fluorocarbon chemistry that has been identified as being harmful to the environment and bio-accumulative. The Environmental Protection Agency (EPA) has requested a voluntary elimination of this chemistry by 2015; manufacturers of these products have been working toward alternatives since 2000. As with most developments, the alternative technologies are more expensive to produce. Some estimates predict as much as a double-digit increase in the cost of stain removal with the new technology as compared to current options.

Regardless of which method you use to process your tough stains, one thing is clear. Stains are here to stay and will become more challenging to treat as the demands for environmentally friendly chemistry becomes the norm.

Check back tomorrow for Part 2!

June 29, 2007

What measures can a laundry manager take to reduce the percentage of stain rewash found in their operation? How can they differentiate stains from soils? What do you consider an acceptable reject/rewash rate to be?