By JUSTIN MCKAY

When I’m brought back into the diagnostic area, one of the first things I see is a lead apron, well-worn and folded into itself, about ready to slide off the table where it was absentmindedly placed. For many people, this sight would not be startling, but I know firsthand the life-threatening dangers associated with garments that are not cleaned, stored, and maintained properly.

It is time that patients and staff understand this danger, and regulators take action.

My co-founder and I contracted ringworm in two different hospital networks from wearing unclean garments just like these, handled by hardworking, decent individuals in the imaging and surgery departments we routinely visited.

Healthcare professionals should be more mindful of the cleanliness and the condition of these garments, but those efforts alone are not enough to prevent hospital acquired infections. What my experience and the experiences of so many others indicate is that what is not measured, is not managed. To protect patients and medical professionals alike, there needs to be a clear regulatory protocol for cleaning and maintaining high utilization equipment and garments.

Study after study shows the need for this structure. Research shows that when regimented cleaning and maintenance protocols don’t exist, bacteria grows. In fact, Association of periOperative Registered Nurses (AORN) 2025 guidelines spell out this danger pretty clearly: aprons, vests, skirts, and thyroid shields have contamination rates between 62.5% and 100%. This finding is especially worrisome since, as the National Institutes of Health has found, 80% of chronic infections and 65% of microbial infections are associated with biofilms (thin, sticky layers of microorganisms that form on surfaces).

The question I keep coming back to is: why don’t the standards reflect what we already know? And, trust me, on this issue we know a lot about the danger.

A 2014 study found 84% of tested interventional radiology aprons were colonized with S. aureus and Tinea, and 12% with MRSA while a 2019 report detected bacteria on 80% of operating room apron swabs, with an 80% recurrence rate within six hours of disinfectant wipe-down (wipes alone are ineffective). The dearth of effective cleaning practices are also well-documented. A study released in 2025 found 51.7% positivity across 120 swabs from 20 aprons, only dropping to 41.7% after cleaning while another report issued the same year documented 80.7% contamination across 88 garments. Despite these threats, only two-thirds of departments had any cleaning protocol, or internal compliance records, none had a defined frequency for cleaning.

Clearly these garments are pathogen reservoirs.