Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz,...
Transcript of Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz,...
![Page 1: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/1.jpg)
Legionella Control
in Building Systems
Carl Schultz, PE
National Healthcare Engineering Leader
![Page 2: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/2.jpg)
![Page 3: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/3.jpg)
Legionella Basics
• Bacterium that causes respiratory diseases such as Legionellosis and Pontiac Fever
• Present widely in water and soil
• The Philadelphia outbreak in 1976 attributed to hotel’s air conditioning system
– Sickened 200 and killed 34
• Transmission: aerosolized water droplets inhaled by a susceptible host
![Page 4: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/4.jpg)
Favorable Conditions
• Temperature
– Grows and multiplies: 68 to 122 deg F
– Reproduces and thrives: 95 to 115 deg F
– @131 deg F takes 5 to 6 hours to die
– @140 deg F takes 32 minutes to die
– @151 deg F dies instantly
• Stagnation
• Scale, Sediment, Biofilms
• Presence of amoebae
![Page 5: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/5.jpg)
Growth Influences
• Natural rubbers: washers,
hoses, spray attachments
• Some plastics
• Wood (think large water tanks)
• Carbon: think twice about providing carbon filtration at ice machines! Carbon also removes chlorine from the water!
![Page 6: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/6.jpg)
Why is this topic important?
• Health of Building occupants
• New guidelines
• Preventable
• Increasing risk of litigation
![Page 7: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/7.jpg)
Cases up 400% since 2000
![Page 8: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/8.jpg)
Health of Building Occupants
• More than 20 outbreaks were reported in 2015 resulting almost 5,000 diagnosed
cases of Legionnaire’s disease
• 12% of population is susceptible
– Heavy cigarette smoking, chronic lung disease, weakened immune system from cancer, diabetes, kidney failure, organ transplantation
![Page 9: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/9.jpg)
Wrongful Death Suit• 53 year old Allstate insurance employee
contracted Legionnaires Disease in Dec 2004
• Died in January 2005
• Used bathroom on ground floor of office building regularly
• Coworker testified that he saw him splash water on his face
• Defense said he drank alcohol and smoked cigarettes
• Summary judgement against plaintiff family
• Absence of statute, regulation, or industry standard
![Page 10: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/10.jpg)
Barrow-in-Furness Case
• 2002 outbreak from cooling tower
• 7 deaths and 188 cases of illness
• A senior architect with the government council was charged with 7 counts of manslaughter
• Technical Manager for government was fired
• Architect was found not guilty but she and her employer paid significant fines
• Contractor settled for 1.5M British Pounds
![Page 11: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/11.jpg)
Legionella Laws
• Bronx Legionnaires’ Outbreak summer 2015
• 12 deaths: Opera House Hotel cooling tower
• NYC Local Law 77: Registration, inspection, cleaning, disinfection, testing of all towers
• Owners: annually certify “in compliance” of law
• $25,000 fine, 1 year in prison for non-compliance
• New crisis = new laws, regulations
• Standards and guidelines used to craft laws and regulations
![Page 12: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/12.jpg)
ASHRAE Standard 188
“Prevention of Legionellosis Associated with Building Water Systems”
• Much of this document is more useful to building owners and operators
• Gives insight on what O&M staff will need to be doing and how to design accordingly
• Presents opportunities for consultants: – Mapping water systems
– Designing remedies for proper system operation
– Writing risk mitigation plans
![Page 13: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/13.jpg)
ASHRAE Standard 188
• Determining building Risk Characterization
• Conducting a hazard analysis
• Determining critical control points & limits
• System monitoring
• Establishing corrective actions
• Verification and documentation
![Page 14: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/14.jpg)
Standard 188: Risk Characterization
• Multiple housing units with common water heater(s)
• Building with more than 10 stories
• Inpatient healthcare facility
• Occupants over 65 or receiving chemo or bone marrow transplant
• Whirlpool, spa, or aerosolizing water feature
• Less than 0.5 ppm Cl2 on incoming water supply
![Page 15: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/15.jpg)
ASHRAE Guideline 12-2000
“Minimizing the Risk of Legionellosis
Associated with Building Water Systems”
• Should be updated soon and the information will be used to supplement Standard 188
• More practical guide for the building engineer
![Page 16: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/16.jpg)
ASHRAE Guideline 12-2000
Recommended Treatment (Control Limits)
In healthcare facilities, nursing homes, and other high risk facilities:
• Cold water stored and distributed at temperatures below 68 deg F
• Hot water stored above 140 deg F
• HW circulated with a minimum return temperature of 124 deg F
![Page 17: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/17.jpg)
• Washington DC office
• Updated primarily for Legionella Mitigation
• Impetus: 6 deaths at Pittsburgh VAMC in 2011
VA Plumbing Design Manual
![Page 18: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/18.jpg)
VA Plumbing Design Manual
• Physical Security Manual: 4 day water supply
• Entering potable water monitored for:
• Pressure, temperature, pH, oxidant levels
• Temperature measured throughout hot & cold water systems
• Hot & cold water to be continuously re-circulated
![Page 19: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/19.jpg)
VA Plumbing Design Manual
• Minimization of dead ends and fixture run-outs
• DHW must be available within 15 seconds
• Run-out volume and length - International Green Energy Code:
![Page 20: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/20.jpg)
Limiting Pipe Volume In Patient Rooms
![Page 21: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/21.jpg)
VA Plumbing Design Manual
• Taps for booster heater for thermal eradication and shock chlorination
• No PVC for sanitary due to thermal eradication
• 30 minutes at 160 to 170 deg F
• Water heaters to develop 180 deg F
• TMV to have bypass
![Page 22: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/22.jpg)
New Hospital Case Study
VA Medical Center, Louisville, KY
- 1.1 million SF
- Mission critical design
![Page 23: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/23.jpg)
Chill your Cold Water?
![Page 24: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/24.jpg)
![Page 25: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/25.jpg)
![Page 26: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/26.jpg)
![Page 27: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/27.jpg)
Domestic Water System
Upgrades
• Hand-over-hand pipe
investigation
• Mapped the entire
domestic hot and cold
water systems: 450,000 sf
• Identified dead legs and
abandoned piping
• Designed remedies
• Legionella management
program
Renovation Case Study
VA Medical Center Clarksburg, WV
![Page 28: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/28.jpg)
Field Investigation
• HEPA Containment Cart
• Infection Control Risk Assessment (ICRA)
• Work with Infection Control Staff
![Page 29: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/29.jpg)
Piping Details
![Page 30: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/30.jpg)
Building Automation System
Domestic hot water supply and return systems
• Graphic displays
• Temperature sensors
• Trending
• Alarm
![Page 31: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/31.jpg)
Water Balancing
• Plumbing professionals need to craft a detailed water balancing specification similar to the HVAC colleagues
• Contractor needs to have credentials and provide a report at the end of the balancing exercise
• This will ensure that hot water is circulating properly throughout the facility
![Page 32: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/32.jpg)
Commissioning
• Water heating equipment: 140 Deg F or above
• ASSE 1017 Master Mixing Valve
• Point-of-use ASSE 1070 mixing valves at lavatories
• Shower temperature limit stops
• Recirculation systems:
– System temps above 124 deg F
![Page 33: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/33.jpg)
Energy Codes
• 120 deg F storage temperature
• Cycling of circulation pumps and heat trace based on occupancy schedule or demand
• Don’t have to comply if it affects health/safety
• International Energy Conservation Code
– Maximum allowable pipe length method
– Maximum allowable pipe volume method
• Veterans Administration has adopted similar pipe volume restrictions
![Page 34: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/34.jpg)
International Energy Conservation Code
Maximum allowable pipe length method
• 2 foot maximum runout to a public lavatory faucet with 1/2” HW (from the nearest source of heated water)
Maximum allowable pipe volume method
• Volume from the nearest source of heated water to a public lavatory faucet is 2 ounces. A 3/8” pipe has 0.75 ounces/ft.
![Page 35: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/35.jpg)
2015 IECC Compliant
![Page 36: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/36.jpg)
Take Aways
There is going to come a day when people and organizations will be held to a higher level of accountability for:
• Designing
• Constructing
• Operating
• Maintaining
Domestic hot water systems
![Page 37: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/37.jpg)
Take Away for Critical Facilities
• DHW distribution: 130 deg F minimum
• Generation and storage: 140 deg F minimum
• DHW return: 124 deg F minimum
• Use of TMVs throughout
• Extend return lines DEEP into system
• Minimize dead legs & stagnant area
![Page 38: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/38.jpg)
Other Considerations
• Create schematics of water systems
• Include temperature and chlorine monitoring
• Access to water hammer arrestors, trap primers
• Building Automation System
• Water balancing
• Commissioning
![Page 39: Legionella Control in Building Systems€¦ · Legionella Control in Building Systems Carl Schultz, PE National Healthcare Engineering Leader](https://reader035.fdocuments.in/reader035/viewer/2022062317/5b2a82fa7f8b9a6b3c8b497d/html5/thumbnails/39.jpg)
Other Approaches
• Copper-Silver Ionization
– Optimal concentration of ions is not know (ASHRAE Guideline 12-2000)
– Was used at Pittsburgh VAMC where 6 died of LD
• Chlorine Dioxide
– Used by municipal water providers
– Secondary treatment in buildings requires EPA approval
– Has been used in UK and continental Europe