How clean is "clean"? Regulations and standards for workplace clothing and personal protective equipment.

OBJECTIVE To compile current regulations and advisory recommendations on cleanliness of worker clothing and personal protective equipment and to evaluate the adequacy of criteria for determining whether cleanliness has been achieved. METHODS Systematic review of information provided by federal agencies (eg, OSHA, MSHA, and NIOSH), nongovernmental advisory bodies (eg, ACGIH, AIHA, and ANSI), and manufacturers of protective clothing and equipment. RESULTS We identified an array of terms describing "cleanliness" and the processes for achieving "cleanliness" that were almost never defined in regulations and recommendations. We also found a general lack of criteria for determining whether cleanliness and/or sterility have been achieved. CONCLUSIONS There is need to harmonize cleanliness-related terminology, establish best practices for equipment cleaning and sterilization, implement a signage systems to provide equipment-specific cleaning instructions, and adopt objective criteria for determining what is "clean."