Toss the Tie and Perish the Pathogen

by Christine Peets

No one likes to think that being in a hospital, doctor’s office or clinic could actually make you sick instead of making you feel better.  But that may just happen, and it may be due to what our healthcare professionals are wearing.

What do lab coats, long-sleeved shirts, sweaters, scarfs and neckties have in common? Apart from being pieces of clothing, doctors and healthcare professionals often wear these every day while they are seeing patients.  That very clothing might be a hotbed of germs, including the dreaded MRSA, Methicillin-resistant S. aureus.  Complications from MRSA can include endocarditis, meningitis and even sepsis.

There have been many reports of this pathogen spreading, especially in hospitals. There is still perhaps a lack of awareness about what this little bug can do, and how long it can hang around, especially on fabrics. One study showed MRSA to have lived on polyester for up to three months.  Polyester material in frequently found in hospital privacy curtains, patient gowns and even operating room scrubs.   But it’s not just polyester that makes a good host.

As healthcare writer Diane Bracuk points out in her article, Clean Hands. Contaminated Clothing, “Bacteria are also fond of textiles of all varieties. To a pathogen, a doctor’s nice silk tie is a comfy home, with all sorts of rough, porous surfaces to burrow into.  Long sleeved white coats follow close behind ties for being notorious bug havens, not only because the sleeves come in contact with the patient, but because they may interfere with hand washing.”  Bracuk also notes that lab coats may not get washed all that frequently. Physicians and other healthcare professionals may not have adequate laundry standards or practices, leading to the spread of more infection.

And what about hand washing? Doctors, nurses, and other staff do seem to be getting better with that.  Strict adherence to hand washing guidelines posted in healthcare settings (and just about everywhere else) definitely can minimize the spread of germs and contribute to better infection control, but it may not be enough.  Different standards, especially with respect to acceptable attire and laundering, is also an issue.

 In England, wearing ties and long-sleeved lab coats has been banned since 2006. According to an article published in The Telegraph in December 2006, doctors were ordered to “ditch their ties over fears they are spreading the deadly superbug MRSA.” National Health Services trust (in Britain) has also told all its staff involved in direct patient care not to wear jewellery, wrist watches, scarves or any ‘superfluous clothing’.”  There was a bit of a backlash to this, with some people feeling that doctors looked “scruffy” when not smartly attired in their coats and ties.  In 2008, ties and the white lab coats were banned in Scotland ( The Scottish government introduced a new uniform, which included blue or green tunics, similar to what we call ‘scrubs’ in North America.

Could that be the solution here? Most healthcare professionals do wear some type of
”scrubs”, but if the uniforms are not thoroughly and regularly cleaned well, the germs may linger. The same goes for the ties, scarfs and lab coats.

In an article published in the journal, Infection Control and Hospital Epidemiology, Gonzalo Bearman, an infectious disease specialist from Virginia Commonwealth University, Richmond says, “We’ve not made the definitive link showing someone getting a hospital-acquired infection from the tip of someone’s neck tie, but there’s reason to suspect it could happen.” So while there is no recent research to show that banning ties and lab coats will, or will not, prevent the spread of MRSA or any other pathogen, it seems to be a prudent infection control precaution.

It seems that this common sense approach that includes all of the infection control measures mentioned will be the best way to fight the spread of MRSA and other bacteria. That will help hospitals, doctors’ offices, and clinics as they try keeping it clean, and will most certainly help patients.


Christine Peets is a freelance writer based in Ontario, Canada. Her work includes writing about various healthcare issues, and the connections between artistic and musical expression and health.

2Ascribe Inc. is a medical transcription services agency located in Toronto, Ontario Canada, providing medical transcription services to physicians, clinics and other healthcare providers across Canada and the US.  Having recently introduced WEBscribe, a client interface portal for document management, 2Ascribe continues to implement and develop technology to assist and improve the transcription process for physicians and other healthcare providers.  As a service to our clients and the healthcare industry, 2Ascribe offers articles of interest to physicians and other healthcare professionals, medical transcriptionists and office staff, as well as of general interest.  Additional articles may be found at  

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