P01 1 Legionella Awareness Training - PEEP - 18-08-19...2019/08/18  · î o o À µ r^ ( } , } o W...

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1 The Control of Legionella Bacteria in Water Systems 18 th of September 2019 Background & The Bacteria 1 2 3

Transcript of P01 1 Legionella Awareness Training - PEEP - 18-08-19...2019/08/18  · î o o À µ r^ ( } , } o W...

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The Control of Legionella Bacteria in Water Systems

18th of September 2019

Background & The Bacteria

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Bellevue-Stratford Hotel Philadelphia – July 1976

34 People Died

221 Hospitalised

Air Conditioning System, Cooling Towers on Roof

Traces found in Nuclear Bunker

Air Force veteran Ray Brennan became the first person to die

The Villain of the Piece

Legionella pneumophila serogroup 1 subtype Pontiac causes 90% of all cases of Legionnaires’ Disease [PHE 2015].

Legionella: named after the first victims.

pneumophila: meaning lung loving.

Legionnaires’ Disease Outbreaks in the UK

1985 Stafford District General Hospital 101 cases, 28 Deaths

1980 Kingston-upon-Thames 11 Cases, 0 Deaths

1988 BBC 92 Cases, 2 Deaths

1989 Piccadilly Circus 33 Cases, 5 Deaths

2002 Barrow-in-Furness 172 Cases, 7 Deaths

2003 Bulmers, Hereford 28 Cases, 2 Deaths

2010 South Wales 22 Cases, 2 Deaths

2012 Edinburgh, Scotland 99 Cases, 3 Deaths

Cost Scottish NHS £750,000 in Treatment & Training Staff

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Legionnaires’ Disease

Potentially fatal form of pneumonia.

Incubation period 2-10 days (usually 3-6 days).

Legionnaires’ disease has an infection rate of <5% with a fatality rate of approx. 12%.

Some will not develop the full blown disease but acquire flu-like symptoms.

Contracted by inhaling aerosols contaminated with Legionella bacteria.

Pneumonia

So what is an Aerosol?

An aerosol is a suspension of small particles in the air

Small enough to be inhaled deep into the lungs

Big enough to carry viable bacteria Particles of 1μm to 3μm meet this

criteria A true aerosol is not normally visible

and may not be wet

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Legionnaires’ Disease Higher Risk Groups

Men appear more susceptible than women;

Immuno-suppressed people;

People aged over 45;

Alcoholics, smokers; and

People suffering from cancer, chronic respiratory disease or kidney disease

Confirmed Legionnaires disease cases by month and year of onset: 2013-2015

Source: HPE Annual Report 2017

Legal Architecture, Risk Assessments & Competency

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Legal Architecture - Overview

Act of Parliament

• Health & Safety at Work Act 1974

Regulations

• Management of H&S at Work Regulations 1999, COSHH Regulations 2002

Approved Code of Practice

• The control of legionella bacteria in water systems – ACoP L8

Guidance Notes• HSG 274 Parts 1 to 3

Legionella Control Association - LCA

Independent, not for profit organisation

Sets out Code of Conduct and Standards of Service Delivery for service provider members to comply with

LCA audits members annually for compliance

LCA – Escalation ProcedureMost Important Slide of the Day!Stage 1 – Initial Report to Responsible Person

Raise the concern in the normal way via the normal channels. Record in writing on the usual service documentation and seek a commitment to act.

Stage 2 – Escalation to Duty Holder

If no action is taken or planned within a reasonable timescale, repeat stage 1 and indicate that if no action is taken then a formal escalation will be initiated. If it is necessary to escalate the matter, write to the Duty Holder, formally outline the concerns and seek a commitment to act.

Stage 3 – Report to the Regulator

If after formal escalation of the issue and explanation in writing to your client they still continue to ignore the problem this process is required by the LCA for its Members;

When all other communication processes with your client have been exhausted and you feel there is still a risk of serious personal injury or risk to health, you should report your concerns to the relevant enforcing authority (i.e. HSE/EHO).

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Record Keeping2nd Most Important Slide of the Day!

Site personnel are required to keep adequate records of tasks completed & temperatures taken and these should be filed in the site log book

Risk Assessments are carried out on a two year rolling programme

Records of monitoring, testing and inspection should be kept for five years.

Design & ConstructionHot & Cold Water Systems

Blind Ends, Dead Ends or Deadlegs?

Dead end / Blind end:

A length of pipe closed at one end through which no water passes.

Blind end should be no more than twice diameter of the pipework

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Blind Ends, Dead Ends or Deadlegs?Deadlegs:

A length of pipework leading to a fitting through which water only passes infrequently when there is draw off from the fitting, providing the potential for stagnation.

Typical flow to a hand-wash basin of 4.5 L/m. 50 m dead-leg of 15 mm pipe would take 2

minutes to flush.

Temperature – Traditional Approach to Legionella Control

GW Brundrett (2003)

<20OC- Bacteria are dormant but remain

viable

>20OC & <45OC Legionella Bacteria will multiply

rapidly

50OC - 90% Kill Rate within 2 hours

60OC – 90% Kill Rate within 2 minutes

70OC - Rapid Kill to 100%

Service Task Frequency

All Systems Risk Assessment Review 2 yearly

Hot Water Services

Check temperatures of the flow and return at the calorifiers

and representative taps on a rotational basisMonthly

Check water temperatures up to 1 minute tosee if it has reached 50oC in the sentinel taps Monthly

Internal Check of the calorifiers for scale and sludge Annually

Note condition of the drain water Annually

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Service Task Frequency

Cold Water Services

Check temperatures are below 20oC after running the water for up to 2 minutes in sentinel taps. Check

representative taps on a rotational basis.Monthly

Check Tank water temperatures in the tank remote from the ball valve. Check mains temperature at the ball valve. Annually

Visually inspect cold water storage tanks and carry out remedial work where necessary. Check representative

taps for temperature as above on rotational basis.Annually

Disinfect CWS tanks and services in accordance with L8, BS EN 806 & DWI (Drinking Water Inspectorate)

Guidance Document

Annually

(Drinking Water Tanks Only)

Service Task Frequency

Showers and spray tapsDismantle, clean and descale removable parts, heads, inserts and

hoses where fittedQuarterly

Little-used outletsFlush through and purge to drain immediately before use,

without release of aerosolsWeekly

Thermostatic mixing Valves

Check operation of fail-safe Annually

De-scale (if necessary) and disinfect Annually

– HSG 274 Part 2

Risk from Irrigation Systems

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Source > Pathway > Receptor

Source Stagnant Lake Blind End Pipework

Once water stagnates, it provide an ideal environment for legionella bacteria to proliferate (given the correct temperatures and nutrients)

Source > Pathway > Receptor

Pathway Spray Guns

Spray Nozzles

Aerosol generated can spread over a large area, can also be carried by breeze.

Source > Pathway > Receptor

Receptor Susceptible Person

Groundsmen

Employees / Staff

Local Residents

Visitors

Contractors

Difficult to quantify risk to individuals (due to varying health factors which change from time to time), but the potential risk exists when you have people in the vicinity

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Blind Ends / Stagnant Water

What Should You Do?Frequencies of below will be dependent on risk assessment findings

Take caution on first start-up following long periods of no use

Stay ‘up-wind’ when operating

Operate when minimal persons present (e.g. early morning)

Remove redundant pipework on irrigation loop or purge weekly

Note water source temperatures (Lake / reservoir)

De-scale of irrigation nozzles

Periodic sampling or dip slides (Summer months)

Keep records

Spa Pools

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Spa PoolsHSG 282 (2017) - The control of legionella and other infectious agents in spa-pool systems

Spa Pools

Spa Pools

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Spa Pools

Spa Pools

Spa Pools

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Microbiological Monitoring

The frequency and extent of the microbiological sampling strategy should be determined by the risk assessment but at least monthly for ACC, coliforms, E coli and P aeruginosa and quarterly for legionella.

Sampling should be done when the spa pool is in use, preferably when heavily loaded or immediately afterwards.

Additional microbiological sampling should also be taken: when a spa pool is first used or recommissioned; after a report of ill health following spa-pool use; where there is doubt about the effectiveness of the control regime; where there has been a contamination incident; where alterations are made to the treatment or maintenanceregimes.

Case Studies

G4S fined £1.8 million after Legionella failureG4S Cash Solutions has been fined £1.8 million after failing to reduce the risk of Legionnaires’ disease from its water systems.

In October 2013, a G4S worker was reported to have contracted Legionnaires’ disease, which causes flu-like symptoms and can, in some cases, lead to life-threatening problems.

Harlow Council investigated but environmental health officers were unable to prove that the worker had contracted the disease from the site.

However, the council did uncover a serious lack of compliance in maintaining water systems at the workplace.

The council began prosecution proceedings and G4S pleaded guilty to two charges under the Health and Safety at Work etc Act 1974 in June.

The judge at Chelmsford Crown Court sentenced G4S to pay £1.8 million in fines and court costs of £34,000.

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Stephen Clements, a granddad from Cromer, Norfolk , was a keen gardener who died just a week after he inhaled the toxic bacteria.

The 63-year-old is thought to have breathed in poisonous spores that had grown in stagnant water inside the hose.

Stephen had cleaned the patio earlier in the year and left the hose out across the lawn filled with water.

"In the winter sun, it was the perfect temperature for the bacteria to breed. He was cleaning the terrace with a stiff broom and the garden hose on spray. The sweeping of the broom caused the perfect aerosol.”

Mrs Clements said her husband had a heart condition but was otherwise "active and well", explaining that within a week symptoms of an upset stomach had rapidly developed into pneumonia.

To Clarify

• Keep it hot >50°C

• Keep it cold <20ᵒC

• Keep it clean (tanks, calorifiers, showers, taps etc)

• Keep it moving (regular use or weekly flushing)

• Complete items listed in your risk assessment (in order of priority) High to Low

Questions and Answers

Services• Building Services • HVAC, Refrigeration & Air Conditioning• Electrical Testing, Services & Compliance • Outsource Management • Water Treatment & Legionella Control• Closed System Flushing, Dosing and Analysis• Swimming & Spa Pool Analysis• Kitchen Extract & Ductwork Cleaning• Local Exhaust Ventilation Testing• Ventilation Hygiene• Independent Auditing, Consultancy & CPD Training

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Contact Details

Leigh Wallis – MBIFM, M.W.M.Soc

M: 07921 575979

E: [email protected]

@VectorAirWater

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