Transcript Legionella Control - IONOSPHERE HOME PAGE

Legionella Awareness
East Anglia Construction Safety Group
23 April 2009
Background
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American Legion Convention 1976
Philadelphia, Bell Vue Stratford hotel
182 cases with 29 deaths
Discovered by Dr Joseph McDade
Bacteria common in water and soil
How legionella multiplies
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Favourable pH & temperature 20 – 45C
Ideal is 37C (human body)
Stagnation provides time for
multiplication
Key nutrients are free iron & L cysteine
Biofilm protection
Single Bacteria
Facts About
Legionnaires’ Disease
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Between 320-375 cases per year
Under reporting is believed to occur
Legionella Pneumophila accounts for
most cases
At least 50 other species are known
Cases reported
Legionnaires’ disease in residents of England
and Wales by category of exposure 19802004
450
Travel Abroad
400
Travel UK
350
Community acquired
300
Nosocomial
250
200
150
100
50
0
'80
'82
'84
Data from CDSC
'86
'88
'90
'92
'94
'96
'98
'00
'02
'04
Infection and symptoms
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Inhalation of Bacteria, size is important
Incubation Period 2-10 Days
Can be diagnosed but difficult to
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severe pneumonia: dry cough, diarrhoea,
vomiting, breathing difficulty, high fever, chills,
headache, some become confused or delirious
Fatality rate is about 12%
Can be treated effectively with antibiotics
Legionella
colonising Amoeba
Susceptibility of Individuals
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Increasing age, especially over 45
Gender; men
Smokers, alcoholics
Chronic respiratory or kidney disease
Diabetics, cancer sufferers
Types of System
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Cooling systems (if applicable)
Domestic water services
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Hot water systems
Cold water systems
Spa Baths
Other systems
Hot and cold water systems
Cause the most cases
Cold Water Storage Tanks
Types of water heaters
Showers
Legionella Control
Regulation & Legislation
Legislation
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Health & Safety at Work etc Act 1974 (HSAWA)
Management of Health & Safety at Work Regulations
1999 (MHSWR)
Control of Substances Hazardous to Health
Regulations 2002 (COSHH)
The Notification of Cooling Towers and Evaporative
Condensers 1992
The Control of Legionella Bacteria in Water Systems
Approved Code of Practice & Guidance 2001 ACoP L8
Reporting of Injuries, Diseases and Dangerous
Occurrences Regulations 1995 (RIDDOR)
Approved Code of Practice
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Identification and assessment of risk
Prepare a scheme for preventing or
controlling the risk
Implement, manage and monitor
precautions
Keep records
Appoint a person to be managerially
responsible
Legionella Control Association
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Code of Conduct for Service Providers
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Allocation of Responsibilities
Training & Competence of Personnel
Control Measures
Communication & Management
Record Keeping
Review Meetings
Internal Auditing
Subcontractors
Distribution of the code
Risk assessment & control
measures
Why does it matter ?
The HSE views Legionnaires’ Disease as
preventable
• To satisfy regulation and legislation
• To show due diligence
• To protect employees and public
Schematics example
O LD S D
IE
CW ST 1
SECOND
F LOOR
ROOM 2
FR
I ST
F LOOR
ROOM 1
CW ST 2
ROOM 3
ROOM 8
GROUND
F LOOR
CW ST 3
ROOM 4
ROOM 9
ROOM 1 4 TO
ROOM 1 0
DS
I AB LED
TO ILET
CW ST 6
ROOM 1 7
ROOM 1 1
LAD E
IS
TO ILE T
ROOM 1 8
ROOM 1 2
MAN
I
KT
I CHEN
ROOM 2 0
ROOM 5
KT
I CHEN
S TAF F
GENTS
ROOM 2 1
S TA F F
BATHROOM
ROOM 6
KT
I CHEN
S TAF F
LAD E
IS
CW ST 5
ROOM 2 2
ROOM 2 3
ROOM 2 4
ROOM 7
OUTS D
IE
KEY :fol w o m
f a ni s w a et r
CA L 8
fol w o fc o dl w a et r
CA L 7
fol w o fh o tw a et r
MAN
I SW ATER
T TI LE
EXAM P LE H O TE L W A TER SC H EM A T CI , AS SEEN
kc
D A TE O
: C T 2003
R EF A
: BC H O TE L
H 2O C H EM CI A LS L TD
When should it be repeated?
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At least every 2 years or when NO
longer valid e.g.
 Changes to the use of the building.
 Availability of new information.
 Control measures are no longer
effective.
 Case of LD associated with system.
 Changes to the system or its use.
Typical written scheme:
H & C Water Systems checks
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Weekly - flushing little used outlets
Monthly – temperature checks
Quarterly - shower cleaning
Six monthly - CWS Tank temperatures
Annually - CWS Tank inspections,
calorifier checks
Other systems as required
Dirty Tanks = clean & disinfection
Management & Training
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Inadequate management, lack of training and
poor communication have all been identified
as contributory factors in outbreaks of
Legionnaires Disease.
Those who are appointed to carry out control
measures and strategies should be suitably
informed, instructed, properly trained and
their competency assessed.
Appropriate Records
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Responsible persons
Significant findings of the risk assessment
Written scheme of actions and control
measures
Results of any monitoring, inspection, test
or check carried out
Typical log book records
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Training records
Lines of communication
Current state of operation
Signature of person that did the work
Plans or schematic drawings
Visit log for contractors, council staff
annual check
Why keep records?
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To demonstrate compliance with the law
Show what control measures are being taken
Monitor water temperatures, system
cleanliness, bacteria levels (if appropriate)
Show trend analysis learn more about the
systems
Review performance
Provide evidence of reducing the risk
Open Forum