The Future of Reusable PPE in Health Care: A Sustainable and Cost-Effective Solution

The conversation around reusable personal protective equipment (PPE) is gaining traction, especially in the wake of the pandemic-induced shortages. Infection Control Today’s interview with Joe Ricci, CEO of Textile Rental Services Association (TRSA), and Dyan Troxel, MSN, RN, the director of clinical education at Handcraft Linen Services, shed light on the benefits and challenges of shifting toward reusable health care textiles. The experts cover key findings from the National Academies of Sciences, Engineering, and Medicine workshop on reusable personal protective equipment (PPE), addressing misconceptions about reusable linens, and current state policy issues.

The Case for Reusable PPE
The National Academies of Sciences, Engineering, and Medicine hosted a workshop to examine the viability of reusable PPE. Findings revealed that reusable textiles offer significant advantages: lower costs, reduced environmental waste, and strengthened supply chain resilience. Unlike disposable PPE, which creates 15,000 tons of waste daily, reusable PPE can withstand up to 75 washes while maintaining its protective integrity.

“The reusable product, specifically reusable PPE in [a] health care environment, it reduced cost, it reduced waste, it improved supply chain resilience, and is a more environmentally sustainable product for the industry. Their ultimate outcome is to explore partnerships with organizations that can help increase the adoption of reusable healthcare PPE,” Ricci said.

Hospitals often hesitate to adopt reusable PPE due to concerns over cleanliness and storage logistics. However, commercial laundries follow rigorous hygienic standards, ensuring that reused PPE meets or exceeds safety requirements. TRSA’s Hygienically Clean Certification ensures that laundering processes eliminate bacteria and contaminants effectively, reinforcing confidence in reusable options.

Troxel said, “We have to convince the people [that the process is safe], and that's part of my job as the clinical educator. I go in and explain the process, invite them to our plant and tour, showcase that we are hygienically clean certified by TRSA, and explain that part of it to get them to understand.”

Barriers to Adoption
Despite the benefits, barriers to widespread implementation remain. Many healthcare facilities rely on disposable PPE due to habit, convenience, and purchasing structures tied to group purchasing organizations (GPOs). Decision-makers often view PPE as a disposable commodity rather than a service-based system, making the transition challenging.

Nurses and frontline workers must also feel comfortable using reusable PPE. Studies indicate that 60% of health care workers prefer cloth-based PPE over disposable alternatives due to comfort, durability, and perceived safety. Educating staff and administrators about the efficacy of reusable textiles is essential to shifting mindsets.

Legislation and Policy Initiatives
Ricci explained that several states, including New York and California, are considering mandates to require at least 50% reusable PPE usage in health care facilities. Europe’s health care sector has already embraced reusable textiles, experiencing fewer PPE shortages during the pandemic. The CDC and other federal agencies could play a pivotal role by recommending reusable PPE in health care guidelines.

“Europe had about 30% more reusable products than Canada, and they avoided shortages because they could rely on that rotating inventory. Since that inventory was available, production continued, allowing them to obtain that product and not [have the shortages we experienced.] They also consider the environment seriously. They are ahead of us on environmental issues, no doubt about it. Just look at their approach to the carbon tax and their efforts on extended producer responsibility and reducing single-use products. It makes a lot more sense to them than it does to us, but we're making progress. I think we're beginning to look at it more universally.”

Looking Ahead
The shift toward reusable PPE requires a cultural change, strategic investment, and industry-wide collaboration. As health care facilities prioritize sustainability and supply chain resilience, reusable PPE offers a proven, long-term solution.

Ricci said educating health care workers on the benefits of reusable linens is vital. “We're making an effort to sit down with the stakeholders in our industry, collaborate with them, communicate with them, educate them on the importance of the reusable product and what it does within our current healthcare environment and our changing health care environment.”

Troxel agreed and said, “It's about making sure that frontline staff have what they need for their best protection possible to keep patients safe.”

Join the TRSA 112^th Annual Conference from May 13 to 15 in Greater Palm Springs. Find information here.

Resources for the video:

• Here is a link to the National Academies’ proceedings: https://www.nationalacademies.org/our-work/reusable-health-care-textiles-for-personal-protective-equipment-a-workshop
• The NAS final report can be found here: https://nap.nationalacademies.org/catalog/27762/reusable-health-care-textiles-for-use-in-personal-protective-equipment
• Here is a link to the TRSA release, which includes a handy summary of the NAS findings: https://www.trsa.org/news/national-academies-workshop-validates-the-benefits-of-reusable-ppe/
• Here is a link to the congressional letter requesting the NAS study: https://www.trsa.org/wp-content/uploads/2024/06/Letter-to-HHS-Secretary-Becerra-Requst-Study-on-Reusable-Health-Care-Textiles.pdf
• Here is some information on the site tour Ricci mentioned with the New York state assemblyperson: https://www.trsa.org/news/ny-state-assembly-member-engages-with-trsa-members-tours-unitex/
• Here is a link to the New York state bill Ricci mentioned: https://www.nysenate.gov/legislation/bills/2023/S8169