2026 articles

Antimicrobial Textiles are Here, but are They Ready for the Laundry?

By Gregory Gicewicz

This article originally appeared in the Sept-Oct 2026 issue of Healthcare Hygiene magazine.

Few objects in a hospital make the case for antimicrobial textiles as well as the privacy curtain. Curtains are handled constantly, by patients, visitors, and staff who rarely glove up to pull one closed. They pick up pathogenic organisms within days of hanging. And depending on institutional policy, they may not come down again for weeks or months.

That gap between contamination and cleaning is precisely the gap a residual antimicrobial is meant to close. It is why curtains are the most defensible application for this technology. It is also why they are the hardest test of it.

Picture a hospital piloting a copper infused curtain marketed as self-sterilizing. On paper it is ideal. Continuous inhibition between cleanings, fewer touchpoint risks, a smoother workflow for an environmental services team that is already stretched thin. Then the curtains enter real rotation, and the laundry team notices something the brochure never mentioned. Repeated high temperature reprocessing is quietly degrading the finish. After a few dozen cycles the curtain still looks clean. Nobody can say how much antimicrobial effect is left.
Clinically the idea was sound. Operationally the story got complicated. Evaluating these products means asking a different question than the sales sheet answers. Not what the textile can do once, but what it can still do after 200 wash cycles and 4,000 patient touches.

Three Mechanisms, Three Failure Modes
Vendors sort these products by material. It is more useful to sort them by how they kill, because that determines how they fail.
Leaching ion systems. Silver and copper work by releasing ions. That reservoir is finite by definition, so the relevant question is not whether efficacy declines but how quickly, under your wash formula and your temperatures.

Bonded quaternary silanes. These bind covalently to the fiber and disrupt cell membranes mechanically, a field of microscopic spikes rather than a released agent. They do not wash out the way ions do. They fail through abrasion and soil loading instead, which makes physical condition matter more than cycle count alone.

Catalytic coatings. Titanium dioxide and cerium oxide systems generate reactive species in place rather than carrying a supply of active agent. In principle they do not deplete, which makes this the most interesting category and the least mature. Photocatalytic versions carry a catch: performance depends on light exposure that patient care areas do not reliably provide.

What the Evidence Shows
The useful research puts fabrics through the wash instead of testing them once at installation. Researchers at the Hong Kong Polytechnic University laundered treated fabrics through 26, 52, and 104 cycles. Samples held a full bactericidal effect through 52 washings, with activity beginning to decline at 104 (Wang et al., Coatings, 2020). The encouraging read is that this chemistry can be made genuinely durable. The sober read is that it does fade, which makes validated cycle count a specification rather than a footnote.

Barrier fabrics tell a harder story. Easter and Dabbain evaluated six commercially available reusable Level 2 isolation gowns at 0, 5, 10, 25, 50, and 75 launderings. One product line failed the 20 cm H2O hydrostatic requirement after 50 cycles, and five of the six fell below the minimum tear strength, all within the service life their manufacturers promoted (AATCC Journal of Research, 2023).
That finding is the whole argument in miniature. These were not experimental materials. They were products hospitals buy today, and they stopped performing before their stated lifespan ended. If that happens with a barrier property you can measure on a hydrostatic head tester, assume it can happen with an antimicrobial claim you cannot verify at the bedside.

What the Label Can and Cannot Claim
Most treated textiles reach the US market under the EPA treated articles exemption, which permits claims that the antimicrobial protects the article itself from odor, staining, or deterioration. It does not cover public health claims. EPA states that it “does not regard this exemption as including articles or substances bearing implied or explicit public health claims against human pathogens” (PRN 2000-1).
A product presented to your infection prevention committee as protecting patients is making a claim that requires registration. Ask which category it falls into, and for the registration number if it is the second.

Four Questions Before You Buy
How many industrial wash cycles, at what temperature and chemistry? If the vendor cannot answer, you do not yet have enough to evaluate the product.

Will it survive our actual process? Tunnel washers and healthcare grade chemistry are harder on textiles than any laboratory protocol. Bring your laundry provider into the evaluation before purchase rather than after.

What happens to the rest of the program? Some advanced textiles need gentler processing, which can mean separate sort streams, different formulas, or added water and chemical use.

Can we pilot it? One or two units with a defined measurement period beats a system wide rollout every time.

The Laundry Is Also a Technology
One point gets lost when the conversation turns to engineered fabrics. Validated wash chemistry and in process disinfection, including ultraviolet treatment of rinse water, deliver measurable pathogen reduction today. They are proven, they are auditable, and unlike a coating, they do not degrade over 75 cycles. An accredited laundry running a validated process is not the old approach these textiles will replace. It is the foundation any of them would be built on.

These materials are legitimate and improving, and some will end up in routine use. But there is no silver bullet here. Infection prevention is multipronged, and a textile that performs beautifully in a petri dish and poorly in a tunnel washer has not solved a problem. It has moved one.

Gregory Gicewicz is a past president of the Healthcare Laundry Accreditation Council and has spent his career in healthcare laundry operations and textile compliance.

Sources
Wang, W.-Y.; Chiou, J.-C.; Yip, J.; Yung, K.-F.; Kan, C.-W. Development of Durable Antibacterial Textile Fabrics for Potential Application in Healthcare Environment. Coatings 2020, 10(6), 520. https://doi.org/10.3390/coatings10060520
Easter, E.; Dabbain, S. An Evaluation of the Barrier and Durability Performance of Reusable Level 2 Isolation Gowns Over Their Promoted Service Life. AATCC Journal of Research 2023. https://doi.org/10.1177/24723444231212950
U.S. Environmental Protection Agency. PR Notice 2000-1: Applicability of the Treated Articles Exemption to Antimicrobial Pesticides. epa.gov/pesticide-registration/prn-2000-1

When the World Shakes, Healthcare Textiles Feel It First

Why the Iran conflict is a stress test for your linen program — and what reusable strategy has to do with resilience

By Gregory Gicewicz

This article originally appeared in the May-June 2026 issue of Healthcare Hygiene magazine.

For most of the last two years, healthcare leaders have been talking about supply chain resilience the way patients talk about flossing — agreeing it matters, intending to do better, and quietly hoping it will not be tested anytime soon.

The unfolding war involving Iran has ended that grace period.

Crude oil has spiked above $110 a barrel at points during the conflict. Trade through the Strait of Hormuz has been disrupted. Petrochemical and plastic feedstocks — the raw materials that flow through nearly every corner of healthcare manufacturing — have tightened. The World Health Organization has been forced to reroute emergency medical shipments out of its Dubai hub, and global chemical companies have begun passing higher costs through to their customers.

For hospitals, the question is no longer whether this geopolitical shock will affect textile programs. It already is. The more useful question is where it will hit first, and whether your facility is positioned to absorb it.

The First Pressure Point: Plastic
The clearest near-term risk is in disposable medical textiles and the plastic-heavy clinical supplies that surround them. Reuters recently reported that war-driven disruptions have pushed plastics and polymer prices to record highs. MedTech Dive noted polypropylene up roughly 24 percent in a single month, with crude oil up nearly 47 percent over the same period. In India, manufacturers have already begun raising prices on surgical gowns, syringes, catheters, IV components, and dialysis kits as polypropylene and freight costs climb.

This matters more than most healthcare leaders realize, because so many “textiles” in the modern hospital are not woven cotton. They are nonwoven, barrier, and synthetic products built from polypropylene and other petrochemical derivatives. When resin prices spike, hospitals feel it through disposable gown pricing, drape availability, and packaging cost.
But the polypropylene exposure does not stop at the disposable shelf. It runs through the entire delivery system that supports clean linen: cart covers, soiled linen bags, transport liners, stretch wrap, and the woven polypropylene bags whose resin content can represent up to 80 percent of their cost. Volatility in petrochemical markets does not just raise the price of an isolation gown. It raises the price of getting a hygienically clean sheet from the laundry to the patient bed.

Freight is the second pressure point. Even when product is technically available, longer shipping routes, tighter insurance markets, and fuel inflation make every mile more expensive and less predictable. The WHO’s experience rerouting medical shipments out of Dubai is not an exotic logistics problem. It is a preview of what hospital supply chain leaders are going to be navigating over the coming year.

What It Means for Your Program
Stable supply and stable cost are not the same thing. A hospital may still be able to get the gowns, drapes, and barrier products it needs — but at higher prices, on shorter notice, with less confidence that next week’s quote will resemble this week’s. That uncertainty makes budgeting harder for infection prevention teams, perioperative leaders, and supply chain decision-makers all at once.

This is exactly the moment when reusable textile programs prove their value as something more than a sustainability story. They are a resilience story.
The UCLA Health reusable isolation gown program, which I detail in my book Linen Saves Lives, remains one of the clearest examples in the literature: more than 3.3 million reusable gown uses, over $1.1 million in purchase savings, and 297 tons of landfill diverted. UCLA built that program before the current conflict. The lesson is that the system already in place during a shock is the system that protects you. The hospital that has invested in reusables is less dependent on flooding the market for new disposables when the market is least cooperative.

Reusables are not immune to disruption. Laundries face their own exposures to energy, labor, transportation, and processing chemistry. But a well-run reusable program reduces how much imported, petroleum-linked product a hospital has to buy at peak pricing — and that is the definition of resilience in a volatile market.

Questions Worth Asking Now
Before the next quote cycle, healthcare leaders should pressure-test a few assumptions:
If disposable isolation gowns or barrier products climb sharply over the next month, how quickly does that show up in your operating budget?
If suppliers shorten quote validity or change allocations, do you have a documented plan, or will you be improvising?
If freight delays extend, do you know which products in your textile and PPE mix are most exposed?
If this disruption persists through the year, where could reusable options absorb risk that disposables cannot?

A Final Thought
Every war is, first and foremost, a human tragedy. From an operational standpoint, it is also a reminder — as the pandemic was only a few years ago — that healthcare supply chains are vulnerable to events far outside any hospital’s walls. Reliable healthcare must keep functioning even when external conditions change quickly.

When oil spikes, shipping routes tighten, and petrochemical resources get squeezed, healthcare textiles feel it fast. Resilience is not built during the disruption. It is built before it arrives.

Gregory Gicewicz is president and CEO of Compliance Shark, COO of Fillmore Linen Service, a past president of HLAC, and the author of Linen Saves Lives.

The Man No Algorithm Would Have Hired

By Gregory Gicewicz

This article originally appeared in the March-April 2026 issue of Healthcare Hygiene magazine.

I want to tell you about Maurice.

Maurice grew up in North Lawndale, one of Chicago’s most underserved neighborhoods. He had a good job once — at O’Hare. Then one legal mistake cost him that career. After that, door after door closed. He applied everywhere. Nobody would take a chance on him.

Fillmore did.

We put him in the soil sort room — the hardest job in a healthcare laundry. You’re handling incoming bags of soiled hospital linen. It is hot, heavy, and most people don’t last. Maurice showed up every single day. Within months, he was promoted to lead. Then to production supervisor. Today he runs the production floor before most people’s alarm clocks go off.

He said something to me once that I have never forgotten: “I want to be the kind of leader I needed.”

I run a healthcare laundry operation in Chicago. We process soiled linen from hospitals. It is physical, unglamorous, essential work. And I am less afraid of artificial intelligence than most people I know who work in knowledge industries. Maurice is part of the reason.

Because no algorithm would have hired him. No model trained on hiring data would have seen what we saw. And no AI, however sophisticated, is capable of sitting across from a man rebuilding his life and recognizing — in the way one human being recognizes another — that there is something worth betting on.

What the Floor Teaches

The panic around AI comes, I think, from a category mistake. We are confusing mechanism with mission. Mechanisms change. Missions endure.

We’ve integrated AI into planning, scheduling, compliance documentation, and operational modeling at Fillmore. The productivity gains are real. Tasks that once took days now take hours. But we are also learning what AI actually requires in practice. Every output demands human review — not as a formality, but because the technology cannot yet be trusted without it. That will improve. It will not become judgment. It will not become wisdom. And it will not become human.

Here’s a concrete example. We recently built a distribution model for a major hospital curtain program — processing tens of thousands of curtains across dozens of Chicago-area hospitals. AI was instrumental. We used it to run scenarios, stress-test assumptions, calculate routing logistics, and project costs across a complex variable set. It accelerated work that would have taken weeks.

But every critical decision required human judgment. Which hospitals needed premium pricing due to distance and complexity? How do you build a startup schedule that doesn’t overwhelm the plant or the client? How do you structure spare curtain inventory so hospitals aren’t left exposed? AI gave us raw material. Experience, relationships, and judgment shaped it into something real.

There are things AI cannot touch at all. It does not walk the floor and sense when morale is slipping. It does not invest in a person society has written off and help them discover their own capacity for leadership. It does not comprehend the moral weight of delivering hygienically clean linen to the sickest people in our community.

And it does not bear responsibility. Responsibility means someone can be summoned. Someone who stands behind the work, absorbs the consequences, owes something to the patient at the other end of the supply chain. That is not a limitation of current AI that future versions will overcome. It is a categorical distinction. Responsibility requires a moral agent. Tools, however sophisticated, are not moral agents.

The Gown

A few months into his time at Fillmore, Maurice took a tour of one of the hospitals we serve. He had been folding gowns for months — the same blue-and-green cotton-poly blend, size large, eight hours a day. Fold. Stack. Repeat. He was good at it. But if he was being honest, the work felt invisible. He had no idea where the gowns went or who wore them.

Then the hospital manager asked if the group wanted to see the ICU. A nurse had specifically requested that the laundry team come by. She wanted them to see what they do for her patients. Maurice walked into that unit and saw, for the first time, a patient in one of his gowns. Elderly. Fragile. Connected to monitors. Wearing something that Maurice’s hands had folded hours earlier.

He didn’t say much on the way back. But something had changed. He understood, in a way that no orientation video or mission statement could have conveyed, that his work was not invisible. It was intimate. It was the difference between a patient lying in clean, safe linen — or not.

That is the moral weight I am talking about. That is what AI does not comprehend. And that is why the mission of our operation is not reducible to any mechanism, however powerful.

Mission Over Mechanism

What makes AI distinctive is not that it replaces certain tasks — many technologies have done that. What makes AI distinctive is that it lowers the cost of intelligence itself: design, modeling, analysis, coordination, iteration. When that cost drops, the feasibility frontier expands and ambitious projects become viable.

But the short-term pain is real. Behind every compressed role is a person — someone who built a career on a skill that took years to develop, with a mortgage, a family, and a professional identity tied to work that may not exist in five years. That deserves to be named, not to paralyze us, but so we take the human cost seriously as we navigate what comes next.

The deeper principle: if the organizing mission of a firm becomes “maximize short-term margin by replacing labor wherever possible,” AI can hollow out communities. But if the mission remains broader — expanding opportunity, building resilient healthcare infrastructure, improving patient outcomes — then AI becomes an amplifier of those goals rather than a substitute for human purpose.

Maurice runs our production floor now. He mentors every new hire who walks through the door. He is, by any measure, a leader — not because an algorithm identified his potential, but because human beings did. Because someone was willing to see past the record and into the person. That is not something we are automating. That is the mission itself.

The floor at Fillmore is alive — the machines, the cultures, the music, the steam, people doing hard work that matters. AI has made us more productive. It has not made us more responsible. It has not made us more accountable to the patient in the ICU. It has not made us more human.

The defining question of this era will not be whether AI replaces certain jobs. It will be whether we remember what we are trying to build in the first place. Maurice already knows the answer. He said it best himself: he wants to be the kind of leader he needed.

So do we. And that is the work.

Gregory Gicewicz is chief operating officer of Fillmore Linen Service, an accredited healthcare laundry company in Chicago’s North Lawndale neighborhood that combines hospital-grade textile services with second-chance employment. He is the founder and CEO of Compliance Shark, a healthcare laundry compliance consulting platform, and previously served as president of the Healthcare Laundry Accreditation Council. He is the author of Linen Saves Lives.

Early Warning Signs Your Hospital Linen Program Is About to Fail—And How to Fix Them

By Gregory Gicewicz

This article originally appeared in the Jan-Feb 2026 issue of Healthcare Hygiene magazine.

Most hospital linen programs don’t collapse overnight. They erode slowly, sending quiet signals months before shortages trigger urgent complaints. By the time nursing is rationing washcloths or EVS is hoarding towels, you’re already in crisis mode. The key is catching the drift before it becomes a disaster—and implementing targeted remedies before small problems become expensive crises.

Here are the earliest indicators that your linen program is headed for failure, what they reveal about deeper operational breakdowns, and practical steps to reverse course.

Loss of Visibility and Measurement

Warning Sign: No one can tell you basic metrics—clean pounds delivered per unit per day, pounds per adjusted patient day, or week-over-week trends. If linen data only surfaces during problems, you’ve lost operational control. Reports may exist, but if they’re not reviewed or acted upon, the measurement system has become theater rather than management.

The Remedy: Establish a monthly linen dashboard reviewed by a cross-functional team (EVS, nursing leadership, supply chain, laundry). Track three core metrics: pounds per adjusted patient day, replacement cost per APD, and delivery fill rates. Set thresholds that trigger investigation—don’t wait for crisis. If the data doesn’t drive decisions, you’re just creating paperwork.

Par Levels Divorced from Reality

Warning Sign: Par levels based on “what we’ve always had,” wildly different levels between similar units with no documented rationale, or units self-adjusting inventory without approval. If your last formal par review was over six months ago, those levels are almost certainly wrong.

The Remedy: Conduct quarterly par reviews tied to census and acuity data. Document the logic behind every par level—census range, procedure volume, specialty needs. Require approval for any par changes and track the business case. Adjust pars seasonally if your hospital experiences predictable census fluctuations. Make par management a proactive discipline, not a reactive scramble.

Silent Hoarding and Behavioral Drift

Warning Sign: Clean carts sitting untouched for 48+ hours, visibly overfilled closets, linen stored in med rooms or hallways. When staff say “We like to keep extra just in case,” they’re compensating for a system they don’t trust.

The Remedy: Implement daily cart rotation protocols—first in, first out. Conduct weekly “linen walks” where leadership physically inspects storage areas for overfill and non-rotation. Most importantly, address the trust issue: if units hoard because deliveries are unreliable, fix delivery consistency first. You can’t audit away hoarding if the underlying system is broken.

The Accountability Vacuum

Warning Sign: Laundry thinks EVS manages it, EVS thinks nursing controls it, nursing thinks supply chain orders it. This diffusion of responsibility guarantees failure.

The Remedy: Assign a single linen program owner with authority across departments—someone who owns the entire flow from dock to patient and back. Create a RACI matrix (Responsible, Accountable, Consulted, Informed) that defines exactly who does what for ordering, delivery, quality, par management, and soil pickup. Make unit nurse managers accountable for their unit’s linen utilization metrics. Clear ownership eliminates the finger-pointing.

Replacement Costs Hiding in Plain Sight

Warning Sign: Replacement expenses buried in general supply budgets with no per-APD tracking. If increases are explained away by inflation without volume correlation, no one’s actually investigating.

The Remedy: Break out replacement costs as a separate line item tracked monthly per APD. Set a threshold (e.g., 10% increase over baseline) that automatically triggers root cause analysis. Correlate replacement spikes with specific units or time periods to identify patterns. Make someone own the number—if replacement costs rise, they need to explain why with data, not assumptions.

Clinical Misuse as Adaptation

Warning Sign: Linen used as wipes, padding, or disposable barriers. Gowns used for warmth rather than infection control. Specialty items appearing in general units. These signal that linen has become a substitute for missing supplies or inadequate processes.

The Remedy: Conduct a clinical use audit to understand why misuse is happening. Are towels being used as wipes because wipes aren’t stocked? Are gowns for warmth because blanket pars are too low? Fix the root cause—supply the right products or adjust pars—rather than just policing behavior. Also, provide education on proper use and the cost implications of misuse. Staff often don’t realize a bath blanket costs $40 to replace.

Cultural Indicators

Warning Sign: Linen only discussed during crises. “Laundry issues” treated as nuisance problems. Staff view shortages as inevitable. Leadership only engages after nursing complaints escalate.

The Remedy: Elevate linen to infrastructure status in leadership discussions. Include linen metrics in operational scorecards alongside length of stay and patient satisfaction. Celebrate wins—units that reduce waste, improve rotation, or maintain stable utilization. Make linen management visible and valued, not invisible until it breaks.

The Bottom Line

These quiet signals share a common theme: loss of intentional management. Linen programs fail when they transition from actively managed systems to passively accepted background operations. The erosion happens gradually, but the warning signs are clear—and the remedies are actionable—for those paying attention.

The question isn’t whether your program will send these signals. It’s whether you’re watching for them and ready to act before crisis forces your hand.

Gregory Gicewicz is chief operating officer of Fillmore Linen Service, an accredited healthcare laundry company in Chicago’s North Lawndale neighborhood that combines hospital-grade textile services with second-chance employment. He is the founder and CEO of Compliance Shark, a healthcare laundry compliance consulting platform, and previously served as president of the Healthcare Laundry Accreditation Council. He is the author of Linen Saves Lives.