In First Nations communities across rural and remote Australia, the simple act of washing clothes has become a frontline public health tool—and researchers have now identified the exact settings needed to make it work.
A comprehensive systematic review has found that temperature is the critical factor in preventing the spread of skin infections through contaminated fabrics. The research shows clothes and bedding must be laundered at a minimum of 60°C (140°F) for at least 15 minutes to effectively kill the pathogens and parasites that cause skin disease. This temperature can be reached either in a washing machine set to hot, or through a conventional dryer.
The timing matters. First Nations communities bear a disproportionately high burden of skin infections—a legacy rooted in the consequences of colonization, socioeconomic marginalization, and housing inequity. These infections carry serious consequences. Strep A skin infections can lead to acute rheumatic fever and rheumatic heart disease, conditions that cause inflammation throughout the body and can permanently damage the heart, especially in children. Corynebacterium diphtheriae, a toxin-producing bacterium, is driving a current diphtheria outbreak that has already claimed one life. Severe untreated cases can result in serious disability or death.
Yet reaching the effective 60°C temperature presents a real barrier. Current safety regulations limit hot tap water to a maximum of 50°C (122°F) to prevent scalding. Many washing machines lack internal water heaters, so even a "hot" cycle falls short. Heating water and running dryers is also energy-intensive and expensive—a particular burden in communities where purchasing a reliable washing machine itself is already a struggle. Washing machines cost roughly twice as much in remote areas as in urban Australia, and electricity costs are prohibitively high. Environmental factors like dust, wet seasons, and hard water damage machines and shorten their lifespan.
The result: in some areas, as many as 70% of First Nations households operate without a functional washing machine. Even fewer have access to a dryer.
Community laundries have emerged as a practical solution. Over the past decade, more than 50 communal laundry facilities have been established in at least 38 rural and remote First Nations communities. These facilities provide free access to industrial-grade washing machines, machine dryers, hot water, and detergent—eliminating the barriers that prevent families from reaching effective wash settings. Last November, recognizing the importance of this infrastructure, the federal government committed A$11.4 million in funding for new or upgraded communal laundries.
Researchers also found that detergents containing activated oxygen bleach can effectively kill some skin pathogens at lower temperatures, though more research is needed to determine whether such products can make cold-water washing truly effective. For now, the evidence points clearly: when communities have access to the right machines and the right temperatures, washing becomes what it has always been meant to be—a practical, accessible tool for health.