Linens can become contaminated with HDs from sweat, excreta (urine, stool, emesis), and leaking connections (see spills). Therefore, handling of linens requires the use of PPE. Unfortunately, current OSHA standards defer to protecting against bodily fluids rather than the HD, and therefore recommend standard precautions (Bloodborne Pathogens). However, since the recommendation for nurses is to wear chemotherapy gowns and double-gloves for handling excreta, best practice would to use that same level of PPE for linens containing said excreta.
Compounding the confusion further, hospitals (and their laundry service) may require contaminated linen to be handled and bagged the same as all other linen. Nurses must be aware of their organization's policies for handling linen and make every effort to prevent spreading HD contamination throughout the hospital or clinic environment. Best practice is to double-bag all soiled linen to ensure traces of HD do not come in contact with floors or equipment.
For some excreta issues, preventing linen contamination is a practical goal. ONS recommends that bedpans and urinals be discouraged whenever possible in order to prevent inadvertent contamination of linens. However, this is not always an option and we must therefore remain vigilant.
If we think of handling excreta as if it were highly contaminated with MRSA, the use of products and systems to reduce contamination makes sense.