Think twice about a cloth covered chiropractic table

As a DC, you want to run a successful practice.

Your success often greatly depends upon where you place your practice values. For example, you should place high value on the comfort of your patients. After all, if a patient is not comfortable during their visit to your office, it is highly unlikely (if not a complete certainty) that they will not be back again.

You also place a great deal of value on patient safety for much the same reasons. If you do not consider safety as an integral part of your practice, it will not be very long until you no longer have a practice at all. Of course, your patient care is also balanced by your desire to increase your bottom line and reduce unnecessary costs.

That being said, you may run into instances in which all three of these integral elements to a successful practice will clash. A good example is the use of paper as a sanitary covering for your table and face rest.

On the one hand, paper that is changed between every patient is considered a best practice for reducing infectious pathogens.^1,2 On the other, paper covers for the table and face rest can be uncomfortable for patients, and incur a certain cost because the paper cannot be reused.

While you may consider cloth covers for your table to be a good balance between comfort and economics, the truth is that such covers present more of a health risk than the use of paper.³

Are tables themselves disease vectors?

There is a rich body of research that points to examination tables, and chiropractic tables in particular, as being vectors for microbial diseases and infectious pathogens.^2,4 A 2006 study in the American Journal of Infectious Control found the presence of various microorganisms on chiropractic tables that were sampled at random. These microorganisms included the methicillin-resistant Staphylococcus aureus.⁴

A later study in the journal Chiropractic & Osteopathy found similar microorganisms.² The researchers concluded that simple disinfection techniques, including use of disinfectant wipes and fresh paper between each patient drastically reduced the risk of microbial infection.

What are the dangers of cloth covered chiropractic tables?

A 2008 study in the Journal of Chiropractic Medicine, specifically looking at whether or not cloth table covers can be a source of allergens and microbes.³ Using methods similar to their previous study,² the researchers tested cloth coverings on chiropractic tables as a potential source of both microbial infection and allergens. They found many of the same microorganisms as in their previous study, as well as mold spores and Candida colonies.^2,3

The researchers concluded that indeed, cloth table covers did pose a risk of transmitting both allergens and microbial pathogens to either the patient or the DC.³ Because the tested cloth covers were thick and porous, and not fully cleaned on a regular basis, they could easily trap dirt, make-up, secretions, and other pathogens. Even if the covers are laundered at the end of each day, there may still be a buildup between patients.

Alternatives to cloth table covers

The study recommend using tables with vinyl or some other nonporous surface, as well as paper because it is also nonporous.^1-3 A disinfectant should be used between each patient, providing adequate time for it to dry.

Paper should be used on the table, face rest and arm rests, all of which should be changed after each patient use.^1-3 For those patients with sensitive skin, cotton gowns can be provided, which should only be used one time before being set aside for laundering.

There is a large body of research that shows that while you may think cloth table covers will be more comfortable for your patients and save you money, the safety risks are simply too high. Fortunately, there are other options that will provide your patients with safety and comfort, while at the same time improving your bottom line by not putting your patients at risks for microbial pathogens or allergens.

References

1. Evans MW, Ramcharan M, Floyd R, et al. A proposed protocol for hand and table sanitizing in chiropractic clinics and education institutions. Journal of Chiropractic Medicine. 2009;8(1):38-47.
2. Evans MW, Breshears J, Campbell A, et al. Assessment and risk reduction of infectious pathogens on chiropractic treatment tables. Chiropractic & Osteopathy. 2007;15:8.
3. Evans MW, Campbell A, Husbands C, et al. Cloth-covered chiropractic treatment tables as a source of allergens and pathogenic microbes. Journal of Chiropractic Medicine. 2008;7(1):34-38.
4. Bifero AE, Prakash J, Bergin J. The role of chiropractic adjusting tables as reservoirs for microbial diseases. American Journal of Infectious Control. 2006 Apr;34(3):155-157.