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What substantiation can you give to support a policy for wearing lab jackets or disposable gowns for gowns for only one work day? 

Ask ADS can provide you with some general information on this topic. The 2003 CDC guidelines for infection control in dentistry states as follows:

Protective Clothing
Protective clothing and equipment (e.g., gowns, lab coats, gloves, masks, and protective eyewear or face shield) should be worn to prevent contamination of street clothing and to protect the skin of DHCP from exposures to blood and body substances (2,7,10,11,13,137). OSHA bloodborne pathogens standard requires sleeves to be long enough to protect the forearms when the gown is worn as PPE (i.e., when spatter and spray of blood, saliva, or OPIM to the forearms is anticipated) (13,14). DHCP should change protective clothing when it becomes visibly soiled and as soon as feasible if penetrated by blood or other potentially infectious fluids (2,13,14,137). All protective clothing should be removed before leaving the work area (13). ¹

 And,

B. Protective Clothing

1. Wear protective clothing (e.g., reusable or disposable gown, laboratory coat, or uniform) that covers personal clothing and skin (e.g., forearms) likely to be soiled with blood, saliva, or OPIM (IB, IC) (7,8,11,13,137).

2. Change protective clothing if visibly soiled (134); change immediately or as soon as feasible if penetrated
by blood or other potentially infectious fluids (IB, IC) (13).

3. Remove barrier protection, including gloves, mask, eyewear, and gown before departing work area (e.g., dental patient care, instrument processing, or laboratory areas) (IC) (13) ¹

Infection Control and Management of Hazardous Materials for the Dental Team states the following regarding protective clothing:

Protective Clothing
Appropriate protective clothing such as gowns, aprons, laboratory coats, clinic jackets, or similar outer garments are to be worn in occupational exposure situations. The employer must evaluate the task to determine the appropriate nature of the protective clothing to be used. Examples of different levels of exposure given by OSHA are “soiled” (low level, requiring laboratory coats), “splashed, splattered, or sprayed” (medium level, requiring fluid-resistant garments), and “soaked” (high level, requiring fluid-proof garments).

Protective clothing must not permit blood or saliva to pass through or reach the employees’ work clothes, street cloths, undergarments, or skin. If an item of clothing is intended to protect the employees’ person or work clothes or street clothes against contact with blood or saliva, then it would be considered as personal protective clothing. If a uniform is used to protect the employee from exposure, the uniform is considered personal protective equipment. If a laboratory coat or protective gown is placed over the uniform, the uniform is not protective clothing: the laboratory coat or protective gown is. Thus the outer covering is the protective clothing that the employer must provide.

The employer is also required to maintain, clean, launder, and dispose of all personal protective equipment including protective clothing at no cost to the employee. Furthermore, employees cannot launder the protective clothing at home. Thus employers must provide disposable protective clothing or reusable protective clothing laundered in the office or cleaned by a laundry service. OSHA reasons that, with these options, the employer has control over the protective clothing to ensure proper disposal or cleaning. ²

And,

A convenient approach to office management of protective clothing involves use of disposable gowns with long sleeves and a high neck to cover regular work clothes…”Scrubs” have short sleeves and a low neckline and are not good protective clothing. For routine dental procedures, one may change protective clothes at least once a day (e.g., over the lunch hour) or more frequently if they become visibly soiled.

Another approach is use of reusable protective clothing such as uniforms, laboratory coats, or other attire that may be put on at the beginning of the day, but it must be changed for lunch, changed when it becomes visibly soiled, and removed before one leaves the office. Use of protective clothing that is pulled on and removed over the head is not wise because removal may contaminate the face and head with the outside of the clothing. ²

The CDC also states in an FAQ section on its Website:

When should protective clothing be worn?
Dental health care personnel (DHCP) should wear protective clothing (e.g., gowns, jackets) to prevent contamination of street clothing and to protect the skin from exposure to blood and body fluids. Sleeves should be long enough to protect the forearms. Protective clothing should be changed when it becomes visibly soiled by blood or other body fluids. DHCP should remove protective clothing before leaving the work area.³

Resources

1) Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease Control and Prevention (CDC). Guidelines for infection control in dental health-care settings—2003. MMWR Recomm Rep 2003;52(RR-17):1-61. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm Accessed on February 17, 2020.

2) Miller CH. Infection Control and Management of Hazardous Materials for the Dental Team, 6th edition. Elsevier/Mosby Publishers. Pages 72 & 109-110.

3) US Centers for Disease Control and Prevention. Best Practices for Personal Protective Equipment. Accessed on February 17, 2020.

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