Q&A with Alex Peck, 鶹TVվ National Director of Industrial Hygiene & Building Science
What isLegionella,and why is it dangerous?
In 1976,one of the topnewsstories was themysterious pneumoniaoutbreak at the landmark Bellevue-Stratford Hotel in Philadelphia, Pennsylvania.
Approximately 4,000 representatives from the stateAmerican Legion metfor a bicentennial conventionat the hotelthatJuly.The meeting went off without any issues, but several daysfollowing the event,hundreds ofattendeesbegan coming down with pneumonia-like symptoms.By August,approximately30 people haddiedfrom complications. Following the outbreak, a research microbiologist fromthe Center forDiseaseControl and Prevention (CDC) determined the cause to be anewbacterium, known today asLegionellapneumophilia, which is commonlyfound in water pipes and air conditioning units.
This first outbreakidentifiedapublic healththreatforlarge facilities like hotelsand hospitals, where watermoves slowly through a complex web of pipes, valves and other plumbing fixtures, and the threat is still veryreal today.Yearly outbreaks ofLegionnaire’s diseaseand Pontiac fever(a milder case oflegionellosis)occur,including recent casesinCalifornia,New Yorkand Florida.
While the threat is realand likely increasingdue to a combination of increased surveillance, aging populations, increased urban densityandwarmer temperaturesthat create a prime environment for increased bacteria growth(especially inAmerica’sagingbuildings and their watersystems), it is imperative for businesses to focus on prevention, rather than mitigation.Not only is prevention less costly,but itcanmost importantly helpsave livesandprotect yourcompany’s reputation.Not to mention, outbreaks can lead to extended closures and loss of business, which can be costly too.
Is Legionnaire’sdisease preventable?
Yes, Legionnaire’s disease is preventable if businesses take proper precautions tomaintaintheir water systems.The CDC reported 6,000 cases in 2015and predicts annual cases range from 10,000 to 15,000.
How can your business protect itself fromlegionella outbreaks in your facilities?
Legionellaoutbreaks are likely to occur in buildings withlarge,complex water systems, such as hospitals, nursing homes,hotels, office buildings,manufacturingfacilitiesand inengineered water systems like cooling towers, waterfountainsand hot tubs.
The mostcommonplacesto breed bacterial growth include:
- Cooling towers.
- Water features (falls, foundations, ponds, misters).
- Swimming pools and hot tubs.
- Drinking water fountains.
- Aging water systems.
- Unused plumbing.
- Ice machines.
- Water heating and hot water distribution.
- Shower heads and faucets.
However, by conducting formal evaluations toidentifyplaceswhereLegionellagrowthis likely to occur in your facility, you can proactively mitigate your risk by taking a basic approachthat involves:
- Creatinga team.
- Diagramingwater systems.
- Evaluatingsystems for risks.
- Implementingcontrols.
- Monitoringcorrective actions.
- Assessingprogram effectiveness.
- Documentation.
How is Legionella regulated?
Unfortunately,notmanyregulations specific toLegionella(although the number is increasing)exist, and currently no federal regulationsare in place.TheCenters for Medicare and MedicaidServices (CMS)has issued amemothat requiresall Medicaid facilitiesnationallyto develop andmaintainaLegionellamanagement program,in accordance withtheCDC recommendations.
Some state agencies have adopted their ownLegionellaregulations.For instance, in 2015 and 2016, New York published rules for cooling towers and medical facilities, whichinclude registration of cooling towers, monitoring, notification,maintenanceand reporting.
More recently,New Jerseypassedacomprehensiverule,requiringcommunity water systems toalwaysmaintaina minimum detectable disinfectantlevel inall active parts ofitspublic water system.Thislawalsorequires owners or operators of covered buildings or facilities (including hospitals, certain health care facilities,prisonsand certain senior housing facilities) to develop a water management program to minimize the growth of LDzԱ bacteria in the facility’s water system and to include periodic sampling and testing for the presence of bacteria. It also includes fines for non-compliance.While some state regulations exist, more can be done to protect public health.
What is 鶹TVվ’ Experience in Addressing Legionella?
鶹TVվ’ team of highly qualifiedindustrial hygiene and building science experts have worked with businessesand organizationsfor many years to mitigate the potential risk ofLegionella.Our teamhelps bycreatingwater management plans,as well asconductingsamplingto identifyLegionellaand makerecommendations to helpmitigateanyissues.
鶹TVվ recently helped a25-storyoffice building by performing initial water sampling.WeidentifiedLegionellain one of the kitchen sinks. Our team helpedthe client remediate the issue until theLegionellabacteria weregone.
We have many case studies like this; however,to understand the real risks,weconsiderseveral factors.This might includethe number and age ofwater and plumbingfixtures, as well as how the systems have been maintained.For example, a hotel has moreriskthan an office, and an old hotelis more likely to haveconditions favoringLegionellagrowththan a newly constructed hotel. Also, occupants of a retirement community are more likely to be susceptible toLegionellosis disease than the occupants of a high school.
If you are curious as to whether your business might be at risk for aLegionellaoutbreak, justremember,ifa building hasawater system, there is a risk forLegionellagrowth. While there arenumerousfactors at play, the key to preventingLegionellagrowth ismaintainingproper water quality,disinfectionresiduals, temperatures and flow-through—all pieces of an effective water management program.
Alex Peck, CIH, MBA
National Director of Industrial Hygiene and Building Science
Alex Peckserves as鶹TVվ’ National Director of Industrial Hygiene and Building Science, responsible fordelivering industrial hygiene and safety to a variety of client groups, including heavy industry, mining companies, oil companies, railroads, manufacturing, military, government agencies, construction companies, insurance companies, schools,attorneysand healthcare providers. He bringsnearly23years of experience to his role as an industrial hygienistexpert, with specialemphasis on health and safety program development and implementation.