Healthcare design choices: Is polyurethane upholstery fabric the best option in hospitals?

When polyurethane upholstery fabrics first came onto the market many designers said: “Finally there is an environmentally friendly viable alternative to vinyl.” In the past couple of years, however, I’ve begun to question whether this is true or not, especially as it applies to healthcare environments.

Our team had an experienced healthcare client in the Middle East show us graphic and widespread delamination failures throughout her facilities. This was followed by evidence from another client that several of the polyurethane fabrics we selected for a large medical center here in California started delaminating after less than three years of use.

There can be many factors for why the occasional fabric failure happens—whether due to a defect in the manufacturing process or being used outside of its intended applications—but when one type of contract-grade fabric is failing in mass quantities it’s a red flag. Why is this happening?

Our team did a deep dive to find out the truth around the use of polyurethane fabrics in healthcare settings. The results may be surprising.

Why use polyurethane fabrics?

Simply put, the benefits of using polyurethane can be grouped into three categories.

Aesthetics:

• Can be textured to look like leather or woven textiles and has a soft supple feel unlike vinyl.
• Comes in a variety of colors, textures, and printed patterns.
• Offers some breathability (vapor transmission) so the fabric remains comfortable to a person even after they sit for a long time.

Performance:

• Has high abrasion and stain resistance, making it very durable for commercial use.
• Inherent moisture barrier surface allows liquid spills to be easily wiped away and cleaned.
• Can be cleaned with commonly used commercial cleaners and disinfectants as well as most alcohol and bleach-based solutions.

Environmental:

• Will not emit hazardous chemical toxins when burnt, unlike vinyl.
• Contains a significantly lower level of volatile organic compounds (VOCs) than vinyl, which means better indoor air quality for the occupants.
• It is free of harmful phthalates, BPA (Bisphenol A), lead, and other heavy metals.
• Is biodegradable and will eventually decompose over time.

Polyurethane fabric’s Achilles heel

To understand why polyurethane fabrics delaminate, you have to know how it is manufactured. Without getting too technical, the typical polyurethane fabric is made by coating a textile fabric backing (or substrate) with a polyurethane resin base layer. Once the base layer is adhered to the fabric backing, it is laminated to a polyurethane resin skin (or surface) layer. When delamination occurs, it is because the polyurethane resin skin or base layer has separated from the backing.

What can cause the delamination? Polyurethane fabric’s greatest enemy: humidity and heat. And in an indoor air-conditioned, high traffic environment, this can come from body heat and sweat, which over time is enough to break down a lesser-quality polyurethane fabric.

A perfect storm of intersecting factors …

Coinciding with the proliferation of polyurethanes, increasingly powerful hospital-grade cleaners and disinfectants have been introduced to the healthcare market in the past several years. They are typically used to clean the furniture, including wiping down the upholstery fabric. While these cleaners are effective and essential in killing harmful bacteria and viruses that are known to cause healthcare-associated infections, they may also be playing a part in expediting the delamination of polyurethane fabrics.

All polyurethane fabric manufacturers have a disclaimer that says after these types of disinfectants are used, the fabric must be rinsed with clean water and dried with a clean towel to remove any chemical residue that could eventually discolor or degrade the fabric surface. If this last step is skipped—and I have heard from several healthcare facilities where they admit getting cleaning staff to come back and do a second round of rinsing and drying is nearly impossible based on time—you have a combination of body heat, body sweat, and a buildup of powerful chemical residues, which over time all contribute to the rapid degradation of the polyurethane fabric, especially in a high-traffic area.

How to counter the Achilles heel: Lessons learned

Now that our team is more informed about polyurethane fabrics, there are steps we will take the next time we select them on our projects.

1. Check the type of resin used in the manufacturing process. Not all polyurethane fabrics are created equal and the type of resin used determines its performance. The highest quality of resin is polycarbonate, and it should be used in both the base and skin layer.
2. Look for the hydrolysis-resistance results. This test is the single most important factor in determining the suitability of a polyurethane fabric for commercial seating applications. Hydrolysis is the process by which humidity and heat breaks down the cell structure of a polyurethane, resulting in the flaking, brittle surface you see when delamination occurs. Polycarbonate resin-based polyurethane fabrics should withstand seven-plus weeks of hydrolysis testing.
3. Check with the manufacturer regarding which cleaners and disinfectants have been tested on the polyurethane fabric with passing results.
4. Find out from the client what the furniture-cleaning protocol is for the facility. Also ask about what cleaners and disinfectants are used to wipe down the furniture, including upholstery fabric, and make sure they understand their cleaning protocols may conflict with manufacturers’ instructions.
5. Confirm with the furniture manufacturer that the selected polyurethane fabric is approved for upholstery on the specific furniture item. Upholstery methods can prevent wear points for fabric failure, such as waterfall fronts and avoidance of welting.

The future of polyurethane and hospitals

Do I still think polyurethane fabric is an environmentally friendly viable alternative to vinyl? Yes.

While there’s no way to predict exactly how any fabric will perform under real world conditions with its many variables, knowing how to select the highest quality fabric will help make a difference in prolonging the life of both furniture and fabric.

My conversations with leading coated fabric manufacturers (or leaders in the coated fabric industry), leads me to believe we can have hope that evolving technologies will lead to more holistic performance characteristics. In the meantime, the best thing we can do as designers is to continue to educate ourselves and our clients about the benefits of using polyurethane and be aware of its inherent weaknesses.

Former Stantec designer Mary Lee contributed to this content.