IStock Photo 5414912 © Logan Dance

You’re sitting on an examination table, nervously tugging at a johnny robe while waiting for a doctor’s visit, feeling your heart start to pound and your palms get sweaty. The medical community recognizes this doctor-induced hypertension as a legitimate physiological reaction referred to as “white coat syndrome.” But what if it’s the white coat itself—not the anticipation of talking to the doctor wearing it—that should make you uneasy?

This new threat comes in response to increasing awareness of hospital-acquired infections (HAIs), those acquired while a patient is in the hospital for treatment of other conditions. The odds a hospital patient will be diagnosed with an HAI are 1 in 22.06, which represents an estimated 1.7 million cases each year. While about one-fifth of these are surgical site infections, the majority are unassociated with the primary medical condition and yet can be as much of a health risk, if not more, to the patient. The infections can be quite serious, complicating the primary medical condition and leading to 99,000 deaths from HAIs per year.

While hand-washing and rigorous surgical protocols have long been key to reducing infection rates, recent studies have focused on other methods of transmission. Drug-resistant superbugs like MRSA (methicillin-resistant Staphylococcus aureus) and “C. diff” (Clostridium difficile) are easily transferred from patient to patient through intermediary contact with healthcare workers’ clothing or shared medical equipment like stethoscopes and blood pressure cuffs. Once present in a hospital room, bacteria like MRSA can survive up to 90 days on fabric surfaces, is extremely hard to eliminate, and continues to spread. Recognizing the potential for clothing to carry and transmit harmful bacteria, the UK Department of Health established a new dress code for health care workers in 2008 that advises against lab coats, ties, long-sleeved shirts, and jewelry. Other countries may not be far behind. A New York study in 2004 showed that nearly half the ties worn by doctors at one hospital tested positive for potentially dangerous bacteria, compared with only ten percent in a control group of security personnel.

So will getting rid of the white coats help ease the risk of acquiring HAIs? More research is needed, but combined with even more thorough hand-washing and advances in anti-bacterial medical equipment, hospitals have begun to see some success in lowering infection rates. With the cost of treating HAIs totaling thousands of dollars per case, often borne by the facility itself rather than the patient’s insurance company, hospitals have strong motivation to keep battling the germs. And who knows? Losing those white coats might help ease the anxiety of the doctor’s visit along the way.