Transcript Document
IOSH Essex Branch Event Event Subject: Legionella Awareness Date: 8 December 2010 IOSH Essex Branch Event • • Welcome Essex Branch Executive Committee • • • Events Legionella Awareness Timing IOSH Essex Branch Event Legionella Awareness HOW2 Training Services (division of H2O Chemicals Limited) IOSH Essex Branch Event Background • • • • • 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 IOSH Essex Branch Event How legionella multiplies • Favourable pH & temperature 20 – 45C • Ideal is 37C (human body) • Stagnation provides time for multiplication • Key nutrients are free iron & L cysteine • Biofilm protection IOSH Essex Branch Event Single Bacteria IOSH Essex Branch Event Facts About Legionnaires’ Disease • 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 IOSH Essex Branch Event Cases reported Legionnaires’ disease in residents of England and Wales by category of exposure 1980-2004 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 IOSH Essex Branch Event Infection and symptoms • Inhalation of Bacteria, size is important • Incubation Period 2-10 Days • Can be diagnosed but difficult to – 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 IOSH Essex Branch Event Legionella colonising Amoeba IOSH Essex Branch Event Susceptibility of Individuals • • • • • Increasing age, especially over 45 Gender; men Smokers, alcoholics Chronic respiratory or kidney disease Diabetics, cancer sufferers IOSH Essex Branch Event Types of System • Cooling systems (if applicable) • Domestic water services – Hot water systems – Cold water systems • Spa Baths • Other systems IOSH Essex Branch Event Hot and cold water systems Cause the most cases IOSH Essex Branch Event Cold Water Storage Tanks IOSH Essex Branch Event Types of water heaters IOSH Essex Branch Event Showers IOSH Essex Branch Event Legionella Control Regulation & Legislation IOSH Essex Branch Event Legislation • 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) IOSH Essex Branch Event Approved Code of Practice • 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 IOSH Essex Branch Event Legionella Control Association • Code of Conduct for Service Providers – – – – – – – – – Allocation of Responsibilities Training & Competence of Personnel Control Measures Communication & Management Record Keeping Review Meetings Internal Auditing Subcontractors Distribution of the code IOSH Essex Branch Event 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 IOSH Essex Branch Event 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 IOSH Essex Branch Event When should it be repeated? • 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. IOSH Essex Branch Event Typical written scheme: H & C Water Systems checks • • • • • 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 IOSH Essex Branch Event Dirty Tanks = clean & disinfection IOSH Essex Branch Event Management & Training • 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. IOSH Essex Branch Event Appropriate Records • 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 IOSH Essex Branch Event Typical log book records • • • • • • 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 IOSH Essex Branch Event Why keep records? • 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 Questions Any questions?