Issue link: https://www.massageandbodyworkdigital.com/i/72093
depends on a number of variables, from species, to inborn immunity, to variable resistance. Finally, the mode of transport can be direct (like blood-to-blood exchange), indirect through the air with respiratory secretions, or by way of an intermediate object like a doorknob or a light switch. These disease-relaying objects are sometimes called fomites. Massage therapists carry a responsibility to create an environment in which the potential for a pathogen to pass from one person to another is as close to zero as possible. Most massage equipment cannot be sterilized, but much of it can be effectively cleaned or disinfected (for the technical definitions of those terms, see Definition of Terms, page 37). The benefits of good hygienic practice go beyond conveying a sense of professionalism. Massage therapists work with skin-to-skin contact, and the risk of picking up an inadvertent infection, or of spreading one to another client, is a career- shortening (and possibly life-shortening) occupational hazard. While many pathogens don't last long outside a human host, a few can be sturdy in a warm, moist setting. Hepatitis B, herpes simplex, and tuberculosis are examples of pathogens that have been seen to last for hours, weeks, or longer if the circumstances are conducive. For instance, warm, humid environments that are not frequently cleaned provide multiple potential sites for the transfer of infectious material. Resources Centers for Disease Control and Prevention. "Guideline for Hand Hygiene in Health-Care Settings." Accessed March 2012. www.cdc.gov/mmwr/PDF/ rr/rr5116.pdf. Occupational Safety & Health Administration. "Healthcare Wide Hazards." Accessed March 2012. www.osha.gov/SLTC/etools/hospital/hazards/ univprec/univ.html. University of Massachusetts Amherst. "Policy: Human Body Fluids Precautions." Accessed March 2012. www.umass.edu/research/human- body-fluids-precautions-policy. Centers for Disease Control and Prevention. "Guideline for Disinfection and Sterilization in Healthcare Facilities." Accessed March 2012. www.cdc.gov/ hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf. Centers for Disease Control and Prevention. "Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings." Accessed March 2012. www.cdc.gov/hicpac/pdf/isolation/ isolation2007.pdf. Centers for Disease Control and Prevention. "Management of Multidrug- Resistant Organisms in Healthcare Settings." Accessed March 2012. www.cdc.gov/hicpac/pdf/guidelines/MDROGuideline2006.pdf. If Myrtle had the following information, she could improve her hygienic practices, and reduce the risk for harm to herself and her clients. LAUNDRY 1. Standard laundering has good antimicrobial effect with water temperatures between 71°F –77°F (21.6°C–25°C), if the detergent is used according to the manufacturer's directions. This is adequate for most situations. 2. Chlorine bleach will wear out fabrics, and, of course, it is not appropriate for colors. However, nonchlorine bleach is only a color booster: it does NOT have antimicrobial action. 3. If chlorine bleach is added to the wash, it becomes most active at temperatures above 135°F (62.7°C). Most home hot water heaters heat water to 120°F–140°F (48.4°C–60°C), so bleach in a home washing machine may not reach its full antimicrobial potential. 4. The recommended amount of bleach is a ratio of 50 to 150 parts per million (ppm); 150 ppm of bleach in a standard top-loading washing machine with a 40-gallon tub is 8 ounces of bleach per load. In a front-loading washing machine with a 24-gallon tub, it is 4.8 ounces. 5. Bleached laundry must be thoroughly rinsed (professional laundry services do this at least twice) to minimize irritation to users. 6. Laundry must not be left damp: mildew can begin growing within 24 hours. 7. All laundry should be dried on high heat (160°F, 71.1°C). Ironing adds extra antimicrobial action, but this is probably not a practical suggestion for most massage therapists. 38 massage & bodywork may/june 2012