Legionnaires Disease Prevention
Chemstar WATER has developed and fine-tuned its proven microbiological control program focused on helping mitigate many microbiological challenges. Legionella control is no other. We recommend our customers adopt a robust water management program to control microbiological activity, especially Legionella Pneumophila, through effective biocidal biofilm control in their cooling water treatment and potable water systems.
We use state-of-the-art technologies to detect microbiological activity while partnering with world-renowned infectious disease experts. We know the challenges you face in fighting Legionella, microbiological, biofilm, and fungal activities, and we are ready to partner with you in creating a customized solution to mitigate them.
LEGIONELLA IN HUMANS
What is Legionella?
Every year on average, 1000 people still die in the U.S. due to an infectious disease called Legionnaire’s Disease caused by a bacteria group called Legionella. Outbreaks are more common in large and complex cooling systems and potable water distribution systems, like hospitals and health care facilities. People with weakened immune systems are most at risk, have lung conditions, and are over 65. The ensuing complications lead to respiratory failure, septic shock, and acute kidney failure. Given that hospitals and other healthcare facilities have patients that fall into overlapping high-risk categories, there is a much higher risk of a Legionella outbreak.
Although it is deadly, compared to the other infectious disease challenges, Legionella is relatively easy to inactivate, and with simple steps, it can be kept under control.
Legionella is a ubiquitous, naturally occurring bacteria found in freshwater sources. While in nature, such as rivers or lake streams, it can be innocuous. It becomes a health concern when it grows in water distribution systems. Inhaled aerosolized Legionella could lead to severe pneumonia called Legionellosis or Legionnaire’s disease. Legionella can grow in water supply lines if temperatures are suitable if the disinfectant residual is lost, and/or if the system contains low or no-flow conditions. Active flow-through water supply lines minimize the potential for these conditions to develop. When water is pulled through faucets and showerheads, droplets are aerosolized and inhaled by humans, possibly causing severe lung infections and inflammation.
Symptoms and Complications
Symptoms can come on 2-10 days after exposure. The shortlist includes:
- fever
- cough
- chills
- or muscle aches
- See the Center for Disease Control’s website for more signs and symptoms.
People most at risk are those with weakened immune systems, current or former smokers, have lung conditions, and are over 65. The ensuing complications lead to respiratory failure, septic shock, and acute kidney failure. Given that hospitals and other healthcare facilities have patients that fall into overlapping high-risk categories, there is a much higher risk of a Legionella outbreak.
Legionella Control in Facilities
While Legionella outbreaks are more common in healthcare facilities due to high-risk occupants, legionella is just as likely to be found in office buildings, apartment buildings, industrial cooling systems, or any potable water system, especially when some faucets and showers are not in regular use. The ANSI/ASHRAE Standard 188-2018 has outlined the buildings and systems most at risk of harboring Legionella. It is our job as water treatment professionals to guide our customers toward best practices that will minimize the threat of Legionella in their systems. We strive to protect our customers from Legionella and all associated risks, including the legal challenges that can ensue if an outbreak occurs. Outbreaks are more common in large and complex cooling and potable systems, like hospitals and healthcare facilities.
Ripe Conditions in the Water Distribution Systems
Certain criteria have been found to heighten the growth of Legionella:
- Sediment build-up: The presence of sludge, scale, and organic matter leads to biofilm creation.
- Wide temperature ranges: Without adequate biocontrol, Legionella can remain viable even in cool water but flourishes in 68°F to 113°F.
- Like stagnant zones: Stagnant conditions like those in a water tank reservoir, pipings, fittings, and basins make it hard to eradicate.
- Grow alongside other microorganisms: The presence of untreated algae or other bacteria and protozoa, which serve as hosts, may lead to the proliferation of Legionella.
Mitigation and Prevention
In potable water systems, the percentage of distal hot water outlets (faucets and showers) that test positive for Legionella effectively indicates Legionnaires’ disease risk in healthcare facilities. This calculation is known as distal site positivity. The risk for healthcare-acquired Legionnaires’ disease increases if ≥30% of distal sites test positive for Legionella, especially L. pneumophila serogroup 1 is established as a rule of thumb by industry experts. In a non-potable water system, such as cooling towers, spas and pools, decorative water features, or other aerosol-generating equipment, the presence or concentration of Legionella is used as an indicator of risk.
Legionella control can be achieved by first establishing a comprehensive Water Management Plan (WMP). WMP should be developed in line with ANSI/ASHRAE Standard 188-2018, Centers for Medicare and Medicaid Services (CMS) requirements, American Water Works Association (AWWA) C651/652, and compliance with applicable national, regional, and local regulations. More importantly, maintaining a strict operating rhythm with the facility staff will be crucial to success.
Additional resources:
- CDC GUIDANCE
- AIHA Standard
- ASSE/IAPMO/ANSI #12080-2020
- NY CITY – CH8 TITLE24
- NY STATE – COOLING TOWER REGULATION
- NY STATE ADVISORY
WATER MANAGEMENT & SAFETY PLAN
What is a Water Management & Safety Plan?
Water management and safety plans regarding legionella typically include measures to identify and control the sources of Legionella in water systems and strategies for preventing the growth and spread of the bacteria. These measures may include:
- Risk assessment: An assessment of the risks of Legionella growth and spread in the water system, including an analysis of the types of water systems in use, the water temperature, and the presence of other factors that may promote the growth of Legionella (such as sediment or biofilm).
- Water treatment: The use of water treatment techniques, such as chlorination or UV light disinfection, to kill Legionella bacteria and prevent their growth.
- Water system design and maintenance: Strategies to ensure that water systems are designed and maintained in a way that minimizes the risk of Legionella growth, including the use of low-risk materials, frequent cleaning and flushing of systems, and proper water temperature control.
- Employee training: Training programs for employees who work with water systems to ensure that they understand the risks of Legionella and how to prevent its growth and spread.
Overall, a water management and safety plan regarding Legionella is important for protecting public health and minimizing the risk of outbreaks of Legionnaire’s disease.
Our certified, trained staff is here to support you around the clock. We will reduce your risk by helping you build a WATER MANAGEMENT & SAFETY PLAN, including a full risk assessment. See our SOLUTIONS for industry-specific capabilities to see how we can directly serve you.
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Sources:
Mayoclinic.org/diseases-conditions/legionnaires-disease
Special Pathogens Laboratory
Newsweek: “Mystery of the Killer Fever” cover image
TIME Magazine: “How Legionella Got Its Name”
