Mohammad T Islam (BSc, MBA, MEd)

Maintaining proper hygiene within domestic environments is crucial, and one everyday item frequently overlooked in this regard is the humble towel. Towels, while serving as key tools for personal cleanliness, can ironically become breeding grounds for bacteria and fungi when not properly cleaned. This article explores how often we should wash our towels based on microbiological evidence, hygiene standards, and dermatological health, drawing upon guidance from health authorities, peer-reviewed journals, and scientific textbooks. The Science Behind Dirty Towels Towels readily absorb moisture and retain warmth, providing an ideal environment for microbial proliferation. Research shows that bath towels can harbour a wide range of microorganisms including Escherichia coli, Staphylococcus aureus, and moulds if left damp and unwashed for extended periods (Bloomfield et al., 2011). These microbes thrive in the fibrous material of the towel, particularly when hung in poorly ventilated bathrooms. A 2024 study by Enchill et al. analysed towels used by university students and found high contamination with faecal coliforms and skin flora, suggesting that towels can act as reservoirs for pathogenic bacteria if not laundered regularly. They recommended that towels be washed at high temperatures and dried thoroughly to reduce bacterial load (Enchill et al., 2024). What Do Experts Say? Several health organisations have issued recommendations on towel hygiene. The Mayo Clinic and Healthline suggest washing bath towels every three to four uses, or at least twice per week, especially in humid climates where towels take longer to dry (Huang et al., 2012; Healthline, 2020). The NHS does not provide an explicit rule on towel washing frequency but recommends regular laundering of all household linen to prevent the spread of infections. Cleveland Clinic further highlights that people with compromised immune systems, skin conditions, or acne should consider washing towels after every use, as bacteria and oils can exacerbate dermatological issues (Cleveland Clinic, 2021). Skin Health and Towel Hygiene Towels, when not washed frequently, can contribute to skin irritation, clogged pores, and even fungal infections. A systematic review by Blume‐Peytavi et al. (2012) indicated that using clean, dry towels supports skin barrier function and prevents secondary skin infections, particularly in infants and elderly populations. The American Journal of Infection Control underscores that frequent laundering of towels reduces skin bacteria by over 90% (Aiello & Larson, 2008). Furthermore, the rough texture of used towels can cause microabrasions that allow bacteria to penetrate the skin more easily. This is especially concerning for individuals with eczema or open wounds, where clean towels are essential for infection prevention (Bissett, 2007). Microbiological Risks in Towel Usage Microbiologists have examined towel contamination in both domestic and clinical settings. Vandegrift et al. (2017) studied bacterial communities in household towels and found that coliform bacteria can survive several wash cycles if not washed at ≥60°C. Similarly, a 2021 study from Springer showed that residual bacteria and fungi could persist even after machine washing if low temperatures or insufficient detergent were used (Suen et al., 2019). Reusable hand towels in shared environments, such as gyms or dormitories, present even higher microbial risk. Bloomfield et al. (2006) highlight how shared towels can transmit methicillin-resistant Staphylococcus aureus (MRSA) and other pathogens, particularly when hygiene compliance is low. Towel-Washing Guidelines Based on Use The frequency of washing towels should be determined by their use case: Type of Towel Recommended Washing Frequency Rationale Bath towels Every 3 uses Accumulate sweat, skin cells, and bacteria Face towels Daily Touch sensitive facial skin; risk of acne and eye infections Gym towels After every use Exposure to sweat and communal surfaces Kitchen towels Daily or after food prep Risk of cross-contamination with foodborne pathogens Guest towels After each use or each visitor Ensure hygiene for multiple users Source: Adapted from recommendations by Healthline (2020), Mayo Clinic (2012), and Bloomfield et al. (2011). Best Practices for Washing Towels To ensure towels are effectively cleaned and disinfected: Wash towels at 60°C (140°F) with detergent; add bleach or vinegar for added disinfection (Bloomfield et al., 2011). Dry towels completely using a tumble dryer or in sunlight to eliminate residual moisture. Avoid fabric softeners as they reduce towel absorbency and may leave residue. Separate towels from underwear or heavily soiled items to prevent cross-contamination. Use a clean towel after illness or skin infection to avoid reinfection. Environmental and Practical Considerations While frequent washing is hygienic, it can raise concerns about energy and water use. Konya et al. (2021) recommend that individuals who live alone and maintain good hygiene may safely extend the interval between washes if towels are hung to dry completely after each use. The European Tissue Symposium also notes that drying and airing towels in sunlit, ventilated environments can reduce microbial load without a full wash (Bloomfield et al., 2011). Eco-conscious laundering practices, such as using cold cycles with disinfectants or natural drying, may offer a middle ground between hygiene and sustainability. Towels, though often overlooked in household hygiene routines, can harbour a significant microbial burden if not washed frequently and correctly. The general consensus among healthcare experts and researchers suggests that towels should be washed at least every three uses, more often for facial or gym towels, or when used by individuals with compromised immunity or skin conditions. The balance between hygiene, skin health, and environmental sustainability should inform individual laundering habits. Ensuring proper towel hygiene is not only a matter of cleanliness—it is a simple, yet powerful act in infection control and skin protection. References Aiello, A.E., Larson, E.L., & Sedlak, R. (2008). Personal health bringing good hygiene home. American Journal of Infection Control, 36(10), S152–S165. https://www.ajicjournal.org/article/S0196-6553(08)00741-4/pdf Bissett, L. (2007). Skin care: an essential component of hand hygiene and infection control. British Journal of Nursing, 16(16), 1020–1024. Bloomfield, S.F. et al. (2011). The infection risks associated with clothing and household linens. International Scientific Forum on Home Hygiene. https://europeantissue.com/wp-content/uploads/The-infection-risks-associated-with-clothing-and-household-linens.pdf Cleveland Clinic. (2021). How Often Should You Wash Your Towels? https://health.clevelandclinic.org Enchill, G.A., Nyamson, J., Larbi, E. & Arko, C.O. (2024). Bath Towel Bacterial contamination and Hygiene practices among Tertiary Students. West African Journal of Applied Ecology. … Read more

The cardiovascular system plays a vital role in maintaining homeostasis by ensuring the effective transport of oxygen, nutrients, and waste products. Central to this system are three closely related physiological parameters: blood pressure, pulse rate, and heart rate. Although these terms are sometimes used interchangeably in lay discussions, they represent distinct but interlinked aspects of cardiovascular function. Understanding their physiology and clinical significance is essential not only for healthcare practitioners but also for individuals monitoring their health. 1.0 Blood Pressure Blood pressure (BP) is defined as the force exerted by circulating blood on the walls of blood vessels, particularly arteries. It is measured in millimetres of mercury (mmHg) and expressed using two values: systolic pressure, which occurs during heart contraction, and diastolic pressure, measured during heart relaxation (Marieb and Hoehn, 2019). A typical normal adult BP reading is around 120/80 mmHg. BP is regulated through complex mechanisms involving cardiac output, vascular resistance, blood volume, and neurohormonal responses (Hall and Guyton, 2020). The autonomic nervous system plays a critical role in short-term regulation, while the renal system and endocrine factors such as the renin-angiotensin-aldosterone system (RAAS) contribute to long-term control (Klabunde, 2012). 2.0 Pulse Rate and Heart Rate: A Distinction Heart rate (HR) refers to the number of times the heart beats per minute (bpm), while the pulse rate is the number of palpable pulses detected in a peripheral artery, usually matching the HR under normal conditions (Moorhead and Cook, 2020). However, in conditions such as arrhythmias or atrial fibrillation, the pulse rate may not accurately reflect the true heart rate due to irregular ventricular responses. Pulse is typically measured manually at the radial artery, while heart rate can be assessed more accurately using electrocardiography (ECG) or photoplethysmographic sensors, such as those in modern wearable devices like the Apple Watch (Zhang et al., 2019). 3.0 Normal Ranges and Variability For healthy adults, the following ranges are generally considered normal: Blood Pressure: 90/60 mmHg to 120/80 mmHg Resting Heart Rate: 60–100 bpm Pulse Rate: Usually equal to heart rate unless in arrhythmia Factors influencing these values include age, sex, fitness level, body size, emotional state, and medications (NICE, 2019). 4.0 Physiological and Pathological Influences 4.1 Exercise and Activity During physical exertion, HR and BP increase to meet the elevated oxygen demand of muscles. This is a normal physiological response. After exercise, HR and BP return to baseline, and the speed of this recovery can be a marker of cardiovascular fitness (Thompson et al., 2010). 4.2 Stress and Hormonal Influences Emotional stress stimulates the sympathetic nervous system, increasing HR and BP via adrenaline release. Chronic stress can contribute to hypertension and cardiovascular disease (Dimsdale, 2008). 4.3 Pathological Conditions Hypertension: Persistent elevation of BP above 140/90 mmHg is associated with increased risk of stroke, myocardial infarction, and renal failure (WHO, 2023). Bradycardia: HR below 60 bpm, which may be normal in athletes but pathological in others. Tachycardia: HR above 100 bpm at rest can indicate fever, anaemia, or cardiovascular abnormalities. 5.0 Monitoring Tools and Technology Advancements in technology have enabled non-invasive, continuous monitoring of HR and BP. Devices such as automated blood pressure monitors, wearable fitness trackers, and smartwatches utilise sensors and algorithms to estimate physiological parameters (Shcherbina et al., 2017). The Apple Watch, for example, uses photoplethysmography to detect changes in blood volume and estimate HR (Apple, 2024). While convenient, wearable devices may lack the precision of clinical-grade equipment and are best used for trend analysis rather than diagnostic purposes (Bent et al., 2021). 6.0 Clinical Importance Accurate measurement and interpretation of BP, HR, and pulse are critical for diagnosing and managing cardiovascular disorders. For instance: Elevated BP can suggest hypertension, requiring lifestyle changes or pharmacotherapy. Irregular pulse may indicate arrhythmias, such as atrial fibrillation, which increases the risk of stroke. Monitoring HR is essential in exercise prescription, particularly for cardiac rehabilitation patients. In primary care, these metrics are essential screening tools, while in intensive care units, they are continuously monitored for acute changes in patient status (Peate and Nair, 2017). 7.0 Public Health Implications Hypertension affects over 1.28 billion adults worldwide and is a major risk factor for premature death (WHO, 2023). Regular monitoring of BP and HR enables early intervention, potentially reducing morbidity and mortality. Government and health agencies recommend routine checks, particularly in at-risk populations. The UK National Health Service (NHS) encourages adults over 40 to have their BP checked at least every five years (NHS, 2022). Understanding the interplay between blood pressure, pulse rate, and heart rate is fundamental to cardiovascular physiology and health monitoring. These parameters offer insights into the heart’s function, vascular health, and systemic balance. Whether measured manually or via modern wearable technology, they serve as critical indicators for clinical assessment, disease prevention, and personal health management. Ongoing public education and the use of reliable monitoring tools are essential to empower individuals and reduce the global burden of cardiovascular diseases. References Apple (2024) Heart rate notifications and Apple Watch. Available at: https://support.apple.com/en-gb/HT208931 (Accessed: 20 July 2025). Bent, B. et al. (2021) ‘Investigating sources of inaccuracy in wearable optical heart rate sensors’, NPJ Digital Medicine, 4(1), pp. 1–9. https://doi.org/10.1038/s41746-021-00421-8 Dimsdale, J.E. (2008) ‘Psychological stress and cardiovascular disease’, Journal of the American College of Cardiology, 51(13), pp. 1237–1246. Hall, J.E. and Guyton, A.C. (2020) Guyton and Hall Textbook of Medical Physiology. 14th edn. Philadelphia: Elsevier. Klabunde, R.E. (2012) Cardiovascular Physiology Concepts. 2nd edn. Philadelphia: Lippincott Williams & Wilkins. Marieb, E.N. and Hoehn, K. (2019) Human Anatomy & Physiology. 11th edn. Harlow: Pearson. Moorhead, S. and Cook, N. (2020) Vital Signs for Nurses: An Introduction to Clinical Observations. 2nd edn. Chichester: Wiley-Blackwell. NHS (2022) Check your blood pressure. Available at: https://www.nhs.uk/conditions/blood-pressure-test/ (Accessed: 20 July 2025). NICE (2019) Hypertension in adults: diagnosis and management. NICE guideline [NG136]. Available at: https://www.nice.org.uk/guidance/ng136 (Accessed: 20 July 2025). Peate, I. and Nair, M. (2017) Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students. 2nd edn. Chichester: Wiley-Blackwell. Shcherbina, A. et al. (2017) ‘Accuracy in wrist-worn, sensor-based measurements of heart rate and energy … Read more