Bicomponent Split Microfiber Reusable Textile Products to Achieve a Hygienically Clean Healthcare Setting with a More Sustainable Environmental Footprint

Abstract

Background: Bicomponent split microfiber reusable wipers and flat mops are innovative textiles used to hygienically clean healthcare surfaces and, hence, reduce hospital-acquired infections. Sustainability improvements are reflected as reduced energy and mass requirements over a life cycle. Methods: The environmental impacts of reusables were compared to disposable equivalents using standard life cycle assessment procedures. Results: With information from 80 hospitals, disposable flat mops and wipers were used at a higher rate than reusable counterparts; the disposable/reusable ratio was 2.3:1 for wipers and 2.5:1 for flat mop pads. Bicomponent split microfiber reusable products had lower impacts (65–95%) in all categories considered: global warming potential, natural resource energy, blue water use, and solid waste production. Discussion: Results reinforce other studies that compare reusable and disposable textile options in healthcare. Laundry energy is an important driver of energy use for reusables. The energy associated with water consumption for disposables’ supply chains is significantly greater than net water consumption for reusables laundry. Conclusions: Selecting disposables versus bicomponent split microfiber reusable flat mops and wipers increases these specific environmental life cycle assessment (LCA) impacts by 320% to 2000%, which is clearly not an environmental sustainability improvement. Group Purchasing Organizations may be barriers to hospital adoption of these reusables.

1. Introduction

Mops and wipers are essential tools for cleaning nonporous hospital surfaces as a critical step to reduce hospital-acquired infections (HAI). Multiple agencies and organizations [1,2] established that the healthcare surface cleaning and textile laundry objective is “hygienically clean”. Cleaning can be performed with reusable or disposable products. Thus, cleaning of patient rooms and other hospital spaces is decontamination that renders the environmental surface safe to handle or use by removing organic matter, salts, and visible soils” [3,4]. This is referred to as hygienically clean. The CDC states “Extraordinary cleaning and decontamination of floors in health-care settings is unwarranted” [1]. A recently published paper has looked at the 50 year HAI safety record (1970–2020) of reusable healthcare textiles, concluding the risk of HAI causation from reusables is inconsequential [5]. The role of the technology of bicomponent split microfiber reusables in achieving superior hospital cleaning and HAI reduction is covered in a recent studies [6,7].

Reusable flat mops and wipers utilize a bicomponent split microfiber (often PET and nylon). These are typically made by extrusion that forms a cross-sectional pattern in the shape of polyester pie pieces separated by nylon spoke pieces. After forming a fabric, the fibers are split by an alkali solution into a large number of strands (e.g., 16) to give much smaller size fibers. The major advantage of using these split bicomponent microfibers in reusable products is the acknowledged excellence in cleaning or soil removal [6].

Disposables for cleaning are also described as microfiber, but these are typically single polymer fibers that do not split, are substantially larger diameter, and less effective in the removal of the small soil and bio contaminants [6,7].

Studies of environmental life cycle assessment (LCA) of healthcare cleaning wipers or flat mops were identified. Malony et al. [8] evaluated the LCA of wipers, in relation to chemicals (which proved to have the largest impacts). Separate data on the wiper were not presented. Jewell et al. [9] undertook an LCA study of reusable wipers for the TRSA, but this was for reusable cotton and was never published in a journal and, hence, had not been externally reviewed and, therefore, is not suitable as a referred study. UMF undertook an evaluation of the life cycle of wipers, but again, this was never published [10]. All of these prior studies concluded the reusables were better for the environmental metrics.

Life Cycle Assessment (LCA) is the standard tool for comparing the sustainability characteristics and environmental impacts of products and services [11]. The environmental LCA methodology provides transparent, science-based assessment of the manufacturing, supply chains, use, and the end of life. The LCA utilizes common boundaries and avoids shifts to non-transparent impacts. The transparent LCA allows comparison within equivalent boundary assumptions on function and science-based life cycle inventory data.

Goals: The goals of this study were to compare the direct environmental performance of reusable versus disposable options for both bicomponent split reusable microfiber flat mops and wipers selected as representative of these healthcare products. Due to the wide range of materials and products that meet these definitions, we focused this comparison on products marketed for hospital use. The reusable bicomponent split microfiber products are typically managed by commercial laundries and are heavier in weight, manufactured with higher-quality bicomponent microfibers, and designed to withstand over 100 commercial laundry operations. On the disposable side, the “hospital-grade” dry flat mops and wiper products were used in this study.

2. Materials and Methods

A critical component of LCAs is good life cycle inventory (LCI) data. We used data from the Environmental Clarity database [12].

Metrics: The indicators selected for sustainability comparison were energy use, global warming potential, blue water consumption, and solid waste generation reflecting the mass of these products. These indicators have been used in previous sustainability studies comparing reusable and disposable options in the health care sector [13]. Process energy is broken out by energy type as electricity, various forms of process heat, and potential energy recovery. These are scaled to calculate the higher heating value (HHV) of fossil natural resource energy (NREc) that is extracted from the ground and combusted to transport materials and generate thermal energy. Water consumption and solid waste generation are two impacts that have frequently been used to argue for or against the use of disposable products and are of unique interest to this comparison. However, blue water refers to net consumption of freshwater (difference between input and output including wastewater treatment that is treated to necessary water quality standards. It is a common metric in the water footprint community since the focus is assuming surface freshwater source needs are met [14,15]. In chemical supply chains, blue water is typically consumed by energy use, either directly lost in heating systems or used in fuel extraction from the earth, and in the laundry process blue water; that is, consumption is due to water evaporated in the dryer. Water that is used in the washer and returned to the wastewater treatment system is typically returned to the same water supply that it came from and, consequently, does not contribute to net blue water consumption. Solid waste is generated when the microfiber products and the polymeric packaging materials are sent to landfill or incineration.

3. Results

Product definition: The Environmental Services Optimization Playbook (EvSOP) [16] cataloged a variety of wiper and flat mop products available on the market. To keep the focus specifically on the performance of the wipers and flat mops, we included only those products that were sold dry. We assume similar cleaning and maintenance chemicals are used to achieve hygienically clean hospital surfaces whether single use or reusable and so these are excluded. A number of the products used in EvSOP were dismantled and examined to determine the representative architecture. This formed the basis of the LCA of materials used to manufacture each item. Statistical data from each type of product are compared in

Table 1. Average weights and ranges of weights for each product studies.

	Reusable Wipers	Disposable Wipers	Reusable Mop Pads	Disposable Mop Pads
Number of samples	10	9	18	8
Average weight, g	26.7	5.85	83.1	16.1
Standard deviation, g	7.4	2.2	17	2.95
Representative range, g	19.5 to 34.4	3.7 to 8.1	66 to 100	13.2 to 19.0
Range, min to max	17.7 to 41	3 to 8	52 to 112	14 to 23

.

The bicomponent split microfiber reusable wipers selected were 30.5 cm × 30.5 cm (12 × 12 inches). The disposable wipers were about the same size, although there was some variation. The disposable flat mop pads were typically about 12.7 cm × 15.2 cm (5 to 6 inches wide) by 43.2 cm × 48.3 cm (17 to 19 inches) long, and the reusable mop pads were also about 12.7 cm × 15.2 cm (5 to 6 inches) wide and were 45.7 cm × 53.3 cm (18 to 21 inches) long.

Reusable wipers were made from a knitted double sided terry cloth material, and the edges were serge stitched. Each wiper contained 1.7 g of PET yarn for serging and 25 g of bicomponent microfiber yarn. The bicomponent microfiber yarn was 80% PET and 20% nylon 6 by weight. The disposable wipers were a single layer of nonwoven PET.

The reusable flat mop pads were typically constructed of three layers. The top layer was 23.9 g and was the loop portion of hook and loop made of undyed PET. The middle absorbent layer was 9.7 g and made of undyed nonwoven PET. The bottom layer was 43.2 g and was a knitted material made of 50% PET monofilament and 50% bicomponent microfiber yarn. The bicomponent microfiber yarn was again 80% PET and 20% nylon. The reusable mop pad in total was about 5% Nylon and 95% PET.

Functional Unit: The functional units for this study are 1000 uses of reusable wipers and 1000 uses of reusable flat mop pads. By comparison, with isolation and surgical gowns, the same number of gowns will be used regardless of whether reusables or disposables are chosen (1:1 ratio). On the other hand, for incontinence pads or microfiber cleaning products, the disposable and reusable options are typically used at different rates. In the case of incontinence pads, 2.1 disposable pads are used per 1 reusable pad [13]. To determine this ratio for microfiber cleaning products, we used two data sources. As part of the EvSOP study, participants cleaned a hospital in Loma Linda, and the number of wipers and flat mops used was measured for both reusable and disposable versions. The other source was from a case study where three hospitals switched from disposable products to reusable products, and the number of the two product types used was recorded. These data, summarized in

Table 2. Relative use rate—number of disposables used for each reusable use.

	Loma Linda Experiments	Hospital Ratio (Loma Linda)	Hospital Ratio (Three Hospital)	This Study, Default	This Study Range
Wipers	6.6:1	2.3:1		2.3:1	2:1 to 6.6:1
Flat mops	2.15:1	1.9:1	3:1	2.5:1	2:1 to 3:1

, were provided in private communication with Aaron Jett [16].

In the Loma Linda experiments, for flat mop pads, the ratio of disposable to reusable uses was measured on two floors. One floor was undamaged and waxed regularly, and the other floor was less well maintained and had damaged tiles. The disposable to reusable ratios on these floors were very similar (2:1 and 2.3:1), indicating that surface quality does not strongly impact the result. In the three-hospitals case study, 3 disposable mop pads were used per patient suite (patient room plus bathroom). For reusables, either a single pad was used for the whole suite, or a smaller mop was used to clean bathrooms. These smaller pads had a size of about 60% of the area of the standard reusable mop. Thus, the ratio was either 3:1 (single pad) or 1.9:1 (separate bathroom pad). The default ratio used in this study was 2.5 disposable mop pads per reusable pad. However, we also investigated the scenarios using ratios of 2:1 and 3:1. For wipers, data from Loma Linda included the patient room only, and 26.5 disposable wipers were used in the room, and 4 reusables were used, yielding a ratio of 6.6:1. When hospitals switched from disposable to reusable wipers, the ratio was a more modest 2.3 disposables for each reusable wiper use. We used 2.3:1 in this study.

The numbers of disposable wipers and flat mops needed to achieve the same functionality as 1000 reusable uses in a hospital cleaning context were determined to be 2300 disposable wipers and 2500 disposable flat mop pads.

Boundaries: The life cycle analysis boundaries for disposable wipers and flat mop pads includes the cradle-to-gate manufacture of the items and packaging from extraction of raw material from the earth through the supply chain and final product manufacture, the transport of items with packaging from point of manufacture in Asia to hospitals in the US, and disposal at the end of life [13]. Also, in the hospital cleaning phase (manual use phase), we assume that the products and service are not using electricity and, hence, do not use any significant energy or related emissions. Notably, all cleaning solutions and surface maintenance used are excluded from the study, since these are assumed to be the same for both the reusable and disposable options. Thus, the dry disposable is compared to the dry reusable plus required laundry. Finally, at the end-of-life phase, we used the current U.S. solid waste system, which is currently 83% of the products being landfilled and 17% being incinerated [17]. This waste management split is based on the study of the end of life of plastics that are not recycled in the United States [10]. Thus, sustainability improvements of the bicomponent split microfiber reusables are captured in the reduction in the mass-based supply chain (cradle to gate) and the savings in energy use in the supply chain and in cleaning.

The boundaries for the reusable flat mops and wipers are similar, except that these are used multiple times. Thus, the hospital cleaning use phase includes each round trip transport between the hospital and laundry. Packaging for this transport was an environmental services (EVS) cart with high density polyethylene (HDPE) liner. Transport was estimated to be a 146 km round trip (Griffing & Overcash, 2023) [13].

Six laundries responded to our requests for data on wiper and mop serves or cycles per new item. For mop pads, the data covered a total of 81 hospitals and 9.4 million pads served. For wipers, it was 79 hospitals and 17.7 million served. These numbers of serves are below the manufacturer’s estimates, presumably because these devices become damaged, discolored, lost during cleaning service, or diverted. Each laundry provided the total number of wipers and flat mops served and the total number of replacement items purchased. For each reusable product, the total number of serves across all responses was divided by the total number of replacements, which is used in the weighted average number of uses per new reusable pads or wipers purchased.

From field data from 86 hospitals, each new mop pad was found to be reused 49 times, and the number of new mop pads manufactured for 1000 uses was 1000/49 = 20.4 new mop pads. From 79 hospitals, each new wiper was found to be reused 30 times, and the total new wipers needed for 1000 uses was, thus, 33.3. As with the disposable items, packaging and transport from the point of manufacture to the laundry is included (

Table 3. Determination of the number of bicomponent split reusable uses of each new wiper or flat mop pad from a sample of about 80 hospitals participating.

	Total	Weighted Average	Numerical Average	Min	Max
Wipers served	17,711,851		2,973,125	126,896	11,732,640
Wipers, N cycles		30.5	46	14	100
Replacement wipers purchased	580,851
Flat mop pads served	9,445,996		38,743	11,983	82,902
Mop pads, N cycles		48.8	49	17	113
Replacement pads purchased	193,714

).

Energy use in the laundry process itself is an important part of the overall sustainability comparison. Laundry energy data have been collected from nine firms, and these were compared with data from IAHTM and previous LCA articles and reports. These data were found to be compatible with CDC guidelines on laundry using 71 °C, assuming a water content after extraction of 0.45 kg/kg dry material (which is, thus, the blue water usage), and a dryer operating at 48% efficiency. The laundry energy use was about 0.75 MJ electricity/kg clean textile and 5.0 MJ HHV of natural gas/kg clean textile. The improvements in sustainability based on mass are reflected in the total solid waste impact metric,

Table 4. Mass of items throughout the life cycle stages to provide the functionality equivalent to 1000 reusable uses and resulting end-of-life phase.

	Reusable Wipers, per 1000 Uses	Disposable Wipers, per 1000 Reusable Uses	Reusable Mop Pads, 1000 Uses	Disposable Mop Pads, per 1000 Reusable Uses
Number new wipers/pads manufactured	33.3	2300	20.4	2500
Mass of new wipers/pads manufactured, kg	0.89	13.5	1.74	41.3
Mass of packaging for new items, kg	0.115	2.13	0.0956	12.6
Mass of packaging for laundry, kg	0.283	0	0.200	0
Mass laundered, kg	26.700	0	84.8	0
Incineration polymers, kg (U.S. current solid waste is 17%) [17]	0.200	2.33	0.331	7.11
Landfill polymers, kg (U.S. current solid waste is 83%) [17]	0.980	11.4	1.61	34.7
Recycling of boxboard from packaging, kg	0.108	1.90	0.088	12.0

.

The mass of each item used throughout the life cycle stages is shown in Table 4. The number of disposable wipers equivalent to 1000 uses of reusables is 2300. When evaluated as solid waste to be managed, the total mass of these disposable wipers is 13.5 kg. The total new bicomponent split microfiber reusable wipers manufactured is 33.3 with a mass of 0.89 kg. In addition, packaging for new items scales with the number delivered for use in the hospitals. The reusables require additional packaging during the reuse phase for transport to the laundry, and so the total new use polymeric packaging was 0.0067 kg per 1000 uses plus 0.283 kg polymeric packaging for the transport to laundry. This gives a total mass of polymeric materials for the 1000 reusable wipers uses of 1.18 kg. This will be the eventual solid waste amount. An additional 0.108 kg of boxboard was used in the packaging, and this was assumed to be recycled with no environmental burden based on the cut-off method of allocation.

The number of disposable wipers equivalent to 1000 uses of reusables is 2300. When evaluated as the total mass, this value is 13.5 kg for disposable wipers. For disposables, there is a 0.23 kg polymeric packaging equivalent to the basis of 1000 reusable uses. An additional 1.9 kg of boxboard was assumed to be recycled with no environmental burden. The total of new disposable wipers and packaging manufactured for disposable wipers was 15.6 kg per equivalent 1000 reusable uses. This is about 12 times the mass of wipers and packaging for the same amount of cleaning with reusable wipers. A large portion of the new item packaging is boxboard, which is assumed to all be recycled and so was not included herein. However, the total amount of material sent to landfill and incineration is still much higher for disposables.

For flat mop pads, the result is more dramatic. For bicomponent split microfiber reusable mop pads, the total mass of new items is 1.74 kg, plus new packaging at 0.096 kg, plus 0.20 kg packaging to the laundry, which was 2.04 kg total per 1000 uses. Of this, 0.09 kg was boxboard that was assumed to be recycled. Thus, the total polymeric materials sent to solid waste was 1.95. In comparison, the amount of mass manufactured for disposables was 41.3 kg plus 12.6 kg new packaging for a total of 53.9 kg total mass for the equivalent of 1000 reusable uses. Of this, 12 kg was boxboard that was assumed to be recycled, and 41.9 kg was polymeric material sent to the landfill, which is 21 times more solid waste generated than reusables.

The fossil energy combusted to generate process energy in supply chains and laundry (NREc) and global warming potential (GWP) is shown for each life cycle stage in

Table 5. Environmental impacts by life cycle stage of wipers and flat mops.

	NREc, MJ/1000 Reusable Uses		GWP, kg CO2eq/1000 Reusable Uses
	Reusable	Disposable	Reusable	Disposable
Wipers manufacture, ctg	133	1006	8.63	64.4
Packaging for new wipers, ctg	1.43	28.7	0.0943	1.88
Transport of new items to laundry or hospital	7.40	114	0.480	7.38
Packaging for laundry	8.90	0	0.557	0
Laundry	208	0	12.6	0
Transport laundry to hospital roundtrip	23.8	0	1.55	0
Incineration	−2.65	−24.7	0.343	3.88
Landfill	0.50	5.82	0.0324	0.376
Wipers, total	380	1130	24.3	77.9
Flat mop manufacture, ctg	255	3687	16.3	234
Packaging for new pads, ctg	1.24	154	0.0814	10.2
Transport of new items to laundry or hospital	12.8	381	0.829	24.7
Packaging for laundry	6.29	0	0.393	0
Laundry	660	0	40.0	0
Transport laundry to hospital roundtrip	66.1	0	4.29	0
Incineration	−3.83	−75.2	0.558	11.8
Landfill	0.825	17.8	0.0533	1.15
Flat mop, total	998	4165	62.6	282

. Similar results for blue water and solid waste are included in the Supplementary Materials Table S3. For reusable wipers, the laundry contributes 55% of the total NREc, and new wiper manufactures (cradle to gate) contribute 35%. Of the remaining 10%, transportation has the largest impact. This split is similar to that in other studies on reusable healthcare items [13]. The impacts of each life cycle stage on GWP are similar to that of energy. The biggest difference is that there is a slight net positive emission of CO₂eq on incineration of the wipers and polymeric packaging (Table 5). The reason that there is a positive GWP emission for incineration is that generation of electricity by incinerating polymers generates more direct CO₂ emissions than the average electric grid that it displaces. This is due to the relatively low generation efficiency for waste incineration and the high oxygen content and lower heat value of PET. For disposable wipers, 83% of the GWP is from the cradle-to-gate manufacture of new wipers, Table 5. The balance is mostly from transport and incineration. Manufacturing of packaging directly contributes only 2.4% of the total GWP.

The percent net savings [(disposables − reusables)/disposables] × 100 of switching from disposable to reusable items can be calculated from the results in Table 5 for NREc and GWP. The savings for NREc are 66% for wipers and 76% for flat mop pads. The savings for GWP are 69% for wipers and 78% for mop pads. The savings for blue water and solid waste, calculated in the same manner (Supplementary Materials Table S3), are a bit higher. For wipers, the savings are 75% for blue water and 91% for solid waste. For flat mop pads, the savings are 84% for blue water and 95% for solid waste.

The importance of the relative usage rate (number of disposables used for each reusable use) is tabulated in the Supplementary Materials. Even in the case that the disposables are used at the same rate as reusables (1:1), the savings delivered by bicomponent split microfiber reusables was over 40% for all categories for flat mops and over 23% for all impact categories for wipers. The range of GWP savings for wipers for a relative use rate of 2.3:1 to 6.6:1 was 69% to 89%. For mop pads, the relative use range was 2:1 to 3:1, and the GWP savings ranged from 72% to 82%.

Due to a wide range of return rates, there was a large range in the number of uses for each new reusable wiper or flat mop (Table 3). For wipers, this range was 20 uses to 100 uses, and for mop pads, the range was 17 to 113 uses. A 99% return rate by the hospital allows for up to 100 uses for each new item purchased. On the low side, a 95% return rate yields a maximum of 20 uses for each new item. The impact of return rate can be calculated using information in Table 5, as some of these activities scale with the number of new items purchased while others are independent of this. We investigated the sustainability improvement over a range from a low return rate (20 uses per new item) to a high return rate (100 uses per new item). The full results are shown in the Supplementary Materials. For wipers, the GWP savings ranged from 62% for the low return rate to as much as 77% for the high return rate. For mop pads, the range for GWP savings was 69% to 81%, important sustainability improvement metrics.

4. Future Research

In healthcare, the procurement of many medical-related products is managed by a Group Purchasing Organization (GPO). The cost for particular items includes the direct purchase cost plus the indirect or overhead costs. The GPO has been unable or unwilling to provide reusable products, whether textiles or non-invasive or invasive items (like laryngeal mask airways). Hence, the percent disposables remains very high (85–95%) despite the environmental and annual cost improvements by selecting reusables. Further, the health care sector is trying to implement change to reduce their carbon footprints. So, the factors of health care management incentive, metrics of reusables and science-based sustainability improvement, and reduced annual costs for reusables all point to the adoption of reusables. However, the GPO is not offering reusables, possibly since they do not sell or promote the reuse laundry activity. An informal poll of laundries and other reuse technology providers led to the conclusion that there is no lack of service availability to meet the move from low to high (80–99%) adoption of reusables. The in-depth research on this adoption barrier is critical.

5. Conclusions

Overall, the evidence from this detailed, science-based evaluation of the bicomponent split microfiber reusable devices used for controlling hospital-acquired infections by achieving hygienically clean conditions is that reusables are a significant improvement over disposables in all environmental impact metrics. This study required a substantial database that contains all the life cycle inventory and impact assessment information (Environmental Clarity, Inc. 2024, www.environmentalclarity.com) [12], as is typical of these sustainability evaluations. Reusable wipers and flat mops had better sustainability metrics than single-use products in each of the four impact categories studied. The primary reason is the reduction in the mass of bicomponent split microfiber reusable product and associated packaging for 1000 uses that is manufactured and transported to the customer. These are also reflected in the energy improvement for the bicomponent split microfiber reusable.

The impacts were generally proportional to the mass of each product. For disposables, this is because each phase (manufacturing, transport, and end of life) scales by mass. For reusables, this is also generally true, as laundry energy is generally also determined by the mass of the laundered cleaning textiles. However, the ability to hold cleaning solution for both reusables and disposables, the durability with washing (reusables), and behavior of EVS personnel are also important, and these are dependent on product mass. Therefore, it is not clear that recommending lighter-weight reusable products would lead to much better environmental outcomes, if the product performance suffers.

Net water use (blue water) in the laundry was due primarily to water evaporation in the dryer, and the amount depends on the water content after the extractor. Water use throughout the supply chain is mostly from energy use, e.g., water is lost from steam loops and cooling loops, and water is used in extraction of gas and oil and evaporation in hydroelectric systems in the electrical grid. About half of the blue water for reusables was from the laundry and half was from the supply chain. The disposables have much higher energy use throughout the supply chain due to the large flat mops and wipers needed compared to the bicomponent split microfiber reusables and, consequently, have significantly more blue water consumption over the life cycle. Consequently, selecting disposable flat mops for these cleaning means an increase in GWP of 780% for the hygienically clean objective in a hospital.

Switching from disposable to bicomponent split microfiber reusable wipers results in GWP savings of 62 to 89%, even at a variety of different return rates and relative usage of disposable to reusable wipers. For flat mops, switching to reusables results in GWP savings of 69% to 82% for these variables. Again, selecting disposable wipers increases the GWP health care impact by 690% for this aspect of hospital EVS results. Bicomponent split microfiber reusables (flat mops or wipers) achieved roughly the same sustainability benefits relative to single-use products for blue water (400–620%), energy use (NREc) (290–420%), and solid waste generation (1100–2000%). For reusable items, about 50–60% of the energy use and GWP impacts were from the laundry operations, and 1/3 was from product supply chain and manufacture, which was similar to other reusable hospital items studied. For disposables, 90% of energy and GWP relates to the product supply chain and manufacture, and the rest is for transport. The sustainability benefits for selecting reusable microfiber EVS products are consistent with other products such as isolation gowns, surgical gowns, and incontinence pads.