What you need to know about Legionnaires’ disease and your water management program
The number of Legionnaires’ disease cases has nearly quadrupled in the U.S. in the last 15 years. All might have been prevented by proper measures taken in each water management program, such as use of disinfectant, correct water temperatures and other health measures, said federal health officials as reported in The Washington Post.
Just last year, some 5,000 Americans were diagnosed with this severe and sometimes fatal pneumonia; more than 20 outbreaks were reported to the Centers for Disease Control & Prevention (CDC). Both Legionnaires’ and its milder cousin, Pontiac fever, are spread when one breathes small droplets of water contaminated with the bacteria Legionella. The most widely reported recent outbreaks have been in New York City and Flint, Michigan.
The annual cost of treating Legionnaires’ disease, based on hospital claims, is about $434 million, said CDC Director Tom Frieden, as reported in the Post article.
Is your facility at risk for Legionella?
The most common sources of the bacteria were water in showers, cooling towers and hot tubs, Frieden said. The bacteria grow well in warm water but can be killed by disinfectants, such as chlorine. About half of outbreaks examined were the result of a single failure, such as a broken disinfection system or human error.
Use the CDC’s risk assessment tool here.
Last year ASHRAE (American Society of Heating, Refrigerating and Air Conditioning Engineers) developed a new standard, ASHRAE 188, to help prevent the disease’s growth and spread. This voluntary standard can be adopted into local plumbing codes, and is provided for those who maintain and manage building water systems for potable (water used for drinking and showering), non-potable, and recreational water. This includes building owners and managers, as well as those who operate, maintain, and repair existing buildings, and people involved in the design, construction, and commissioning of new buildings. The standard may also be used by tribal municipalities to make recommendations about prevention of Legionnaires’ disease or in the writing and enforcing of local codes.
ASHRAE 188 defines
- Types of buildings and devices that need a water management program
- Minimum components of a water management program
- Devices (e.g., hot tubs, cooling towers) that need to be controlled in order to prevent the growth and spread of Legionella
- Who should be on a water management program team
- When and how often water management programs should be reassessed and updated
It also includes an appendix with special considerations, such as clinical surveillance, for healthcare facilities.
CDC’s new resource for creating a safe water management program
CDC has recently released a toolkit providing practical guidance on how to implement ASHRAE 188 by identifying areas or devices in buildings where Legionella might grow or spread, so that risk can be reduced through effective water management.
The toolkit provides an easy-to-understand interpretation of ASHRAE Standard 188 to help building owners and managers evaluate the water system and devices in their building(s) to see if they need a program, and then develop an effective water management program if one is needed. It includes:
- A simple yes/no worksheet to determine if an entire building or parts of it are at increased risk for growing and spreading Legionella
- A basic walkthrough of the elements of a Legionella water management program (where, what and when to implement control measures)
- Scenarios describing common water quality problems and examples of how to respond to them to reduce the risk for Legionella
- Water management program monitoring (periodic surveillance), verifying and documenting compliance with the water quality goals
- Special sections and considerations for those who work in healthcare facilities
If you as a building owner or manager determine that your property may indeed be susceptible, we highly recommend you download both the CDC’s toolkit and ASHRAE’s standard, and begin taking precautionary measures now. Your adherence to these requirements would clearly demonstrate a proactive strategy supporting your comprehensive risk management program, minimizing your exposure to allegations of negligence liability, should an outbreak of Legionnaire’s disease occur at your facility.