Specifying Healthcare Grade Fabrics in the COVID Era

I am often approached by healthcare facilities regarding soiling or staining on their furniture, cracked upholstery, or peeling of their coated fabrics. Why do these issues occur, and how can we as healthcare designers overcome these failures? In 2018, the American Academy of Healthcare Interior Designers (AAHID) and the Durable Coated Fabrics Task Group (DCF) surveyed over 150 healthcare designers about their main issue in evaluating upholsteries; 38% cited performance and durability.

What makes the specification and selection of healthcare fabrics so difficult is that often the standard industry tests that designers use to evaluate products do not reflect the real-world cleaning and disinfecting procedures that healthcare systems follow. The current COVID-19 pandemic has led to elevated cleaning protocols with harsher cleaners, resulting in even more product failures. As these healthcare-grade cleaning protocols are becoming common in other public spaces like airports, restaurants, schools, hotels, and office spaces, there will likely be widespread material breakdowns in the near future.

While the quick fix to solve these breakdowns is replacement upholsteries, problems will continue to occur if fabrics are not cleaned according to manufacturers’ recommendations. Unfortunately, lack of a consistent cleaning method between differing fabric types means environmental services (EVS) teams are likely to follow just one cleaning procedure for most surfaces.

As healthcare designers, it is our responsibility to design spaces that protect the health, safety, and welfare of patients, visitors, and staff. This dedication makes healthcare interior designers indispensable in assisting facilities with the specification of interior finishes as well as educating their teams in the best cleaning practices.

Common cleaners used in healthcare environments include bleach, hydrogen peroxide, alcohol, and quaternary ammonium (quats). But how do these cleaners react when used on commercial upholsteries? Each institutionally appropriate fabric includes a product data sheet or “memo tag” with the product’s content (what it’s made of), any topical finishes, the width and pattern repeat, the intended application, abrasion testing, lightfastness, environmental compliances, flammability testing, and approved cleaning methods. Often, you will find that commercially rated fabrics will state WS as the cleaning method. As a cleaning method, WS includes spot cleaning with upholstery shampoo or dry cleaning solvent designed for furniture. More often than not, this cleaning method will not be followed as EVS teams are cleaning in the quickest, most effective way possible, which likely includes heavy-duty cleaning agents or disinfecting wipes likes Cavi-Wipes. These intense cleaners successfully eliminate microorganisms and viruses but over time lead to the breakdown of materials that cannot withstand this level of cleaning.

So, what fabric types should healthcare facilities and designers be specifying? The simplest answer is Durable Coated Fabrics, which are defined as fabrics that are constructed of vinyl, polyurethane, thermoplastic elastomers, or silicone. While many healthcare systems still allow traditional woven fabric upholsteries (i.e., porous woven materials that often include only a topical coating applied to the face of the yarn), the best performing and most cleanable materials are durable coated fabrics that are nonporous.

But simply specifying durable coated fabrics isn’t enough in healthcare environments or those utilizing advanced COVID cleaning protocols. Designers should closely examine the approved cleaning codes for each fabric they intend to specify and cross-reference those codes with a list of cleaning agents supplied by a facility’s EVS team to ensure that what is being selected is appropriate. One benefit to our recent pandemic is that several fabric manufacturers have published lists of their fabrics with corresponding approved cleaners. Arc-Com, a major commercial textile manufacturer, has a particularly user-friendly website that allows one to narrow down their materials by approved EPA cleaners and other healthcare-related criteria such as those free of phthalates and flame retardants and that meet NFPA 701.

Designers must also discern between the various types of durable coated fabrics to make selections that meet the needs of the space for which they are intended and the client’s goals. For instance, polyvinyl chloride (PVC or vinyl) upholsteries are the most commonly used coated fabric type, as they have been available in the market for much longer than other coated fabrics. With growing concern over the use of PVC and harmful plasticizers in our built environments, many designers opt for healthier materials like polyurethanes (PU). PU upholsteries are soft to the touch and more flexible than vinyl fabrics, but without the plasticizers of a PVC fabric for stability they often lose shape and are prone to “puddling” as they stretch.

Further advancements in the coated fabric sector have led to a rise in silicone fabrics. Silicone textiles are produced when sand is processed into organic silicone monomers and polymers. These are then compounded, mixed, cast, coated, and then heated to produce a textile that is flexible, soft to the touch, and durable and offers more elasticity than a PU textile. The production of silicone has the least environmental impact of any coated fabric as it releases no pollution or off-gassing, uses very little water, and has no solvents, heavy metals, phthalates, or formaldehyde in its construction. While silicone is a somewhat new material in the textile market, its cost is still relatively high. As these products become more available and technologies advance, we will likely see a reduction in the price.

Unfortunately, there is no perfect fabric material for every environment. Designers must balance the function of interior spaces, cleaning practices, and aesthetic goals with a client’s budget to offer selections that are the best fit for their needs. Thankfully, organizations like the Durable Coated Fabrics Task Group (DCF) are consistently reviewing coated fabrics through a series of checklists and designer evaluations to provide transparency and clarity in the specification of these materials. As interior designers face new challenges and requirements in the ever-evolving landscape of healthcare design, it is our responsibility to respond with designs that support the health and wellbeing of us all.