The Legionella Standard 188 proposed by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) can have a widespread affect on not only how healthcare operations run but also the overall safety of employees and patients alike. Below are a few facts that organizations should know about this pending Standard.
Legionella bacterium was first publicized in 1976 when conference attendees became sick and died. Over the years, testing and inspections were required for cooling towers and other locations with hot water. In 2015, another notable outbreak occurred in NYC when more residents in a hotel got sick and died. NYC DEP was the first governmental agency to require the registry of all cooling towers and implementation of a comprehensive maintenance, inspection and test schedule for the presence of Legionella bacterium in water. Learn more about the field testing and analytical method for Legionella.
This document provides an overview of Legionnaires' disease, including its causes, symptoms, potential sources of infection, and methods for prevention and control. It discusses Legionella bacteria and the diseases it causes. Potential sources of infection discussed include cooling towers and domestic water systems. The document outlines risk assessment processes and reviews current legislation and standards regarding Legionnaires' disease prevention. Preventive measures for cooling towers and domestic water systems are also reviewed.
Legionella testing is the key to preventing Legionnaires' disease. Studies show that taking a proactive approach through routine environmental monitoring is effective. Presentation by Dr. Janet E. Stout, director of Special Pathogens Laboratory.
Legionella Control Health and Safety Training CourseArcher + Stone
With over 10 years experience delivering legionella control training courses, Archer + Stone can make sure your facilities staff have the skills they need to carry out effective legionella control independently. By having the skills to carry out legionella control in-house, you'll save money year after year and minimise the risk of an outbreak of legionnaires disease on your site. This legionella control training course is an example of the health and safety training we offer.
Akvo - the control of legionella bacteria in bakery water systemsMatt Tudge
The control of legionella bacteria in bakery water systems code has been approved by the health and safety commission with the consent of the secretary of state. It gives practical advice on how to comply with the law.
Legionella bacteria poses risks in water systems where conditions allow it to proliferate. Employers have legal duties to assess water systems for risks and implement control measures. Systems at higher risk include those with cooling towers, evaporative condensers, or outlets that may release water spray. Control measures include regular sampling, chlorination of tanks, flushing outlets, and maintaining hot and cold water temperatures outside the bacteria's growth range. Peligro Risk Management offers water risk assessments and assistance implementing recommended controls.
Legionella bacteria can be living in your water supply, in fact anywhere in your building where water collects. It causes Legionellosis, a pneumonia like illness; the most well known form being Legionnaires' disease
The bacteria are common in water systems, such as rivers and lakes but rarely in such concentrated quantities for people to catch Legionnaires' disease.
This normally occurs when Legionella bacteria is found in purpose built water systems, such as those within your building. This is why it's essential to understand your obligations and requirements around Legionella and the L8 guidelines laid down by the HSE.
This presentation comes from the first in a series of educational seminars hosted by Acorn Maintenance, specifically to help existing clients and customers keep abreast of current legislation and best practice guidelines.
This document discusses Legionella bacteria found in building water systems and the risks posed to occupants, especially in schools. It notes that many school buildings have been unoccupied since March due to the coronavirus pandemic, allowing water to stagnate in plumbing and increasing Legionella growth risks. While Legionnaires' disease is rare in children, the document reviews CDC data on reported pediatric cases and risks to immunocompromised individuals of any age. It emphasizes the importance of testing water systems before reopening buildings and having plans to disinfect water if needed to prevent exposure to Legionella.
Legionella bacterium was first publicized in 1976 when conference attendees became sick and died. Over the years, testing and inspections were required for cooling towers and other locations with hot water. In 2015, another notable outbreak occurred in NYC when more residents in a hotel got sick and died. NYC DEP was the first governmental agency to require the registry of all cooling towers and implementation of a comprehensive maintenance, inspection and test schedule for the presence of Legionella bacterium in water. Learn more about the field testing and analytical method for Legionella.
This document provides an overview of Legionnaires' disease, including its causes, symptoms, potential sources of infection, and methods for prevention and control. It discusses Legionella bacteria and the diseases it causes. Potential sources of infection discussed include cooling towers and domestic water systems. The document outlines risk assessment processes and reviews current legislation and standards regarding Legionnaires' disease prevention. Preventive measures for cooling towers and domestic water systems are also reviewed.
Legionella testing is the key to preventing Legionnaires' disease. Studies show that taking a proactive approach through routine environmental monitoring is effective. Presentation by Dr. Janet E. Stout, director of Special Pathogens Laboratory.
Legionella Control Health and Safety Training CourseArcher + Stone
With over 10 years experience delivering legionella control training courses, Archer + Stone can make sure your facilities staff have the skills they need to carry out effective legionella control independently. By having the skills to carry out legionella control in-house, you'll save money year after year and minimise the risk of an outbreak of legionnaires disease on your site. This legionella control training course is an example of the health and safety training we offer.
Akvo - the control of legionella bacteria in bakery water systemsMatt Tudge
The control of legionella bacteria in bakery water systems code has been approved by the health and safety commission with the consent of the secretary of state. It gives practical advice on how to comply with the law.
Legionella bacteria poses risks in water systems where conditions allow it to proliferate. Employers have legal duties to assess water systems for risks and implement control measures. Systems at higher risk include those with cooling towers, evaporative condensers, or outlets that may release water spray. Control measures include regular sampling, chlorination of tanks, flushing outlets, and maintaining hot and cold water temperatures outside the bacteria's growth range. Peligro Risk Management offers water risk assessments and assistance implementing recommended controls.
Legionella bacteria can be living in your water supply, in fact anywhere in your building where water collects. It causes Legionellosis, a pneumonia like illness; the most well known form being Legionnaires' disease
The bacteria are common in water systems, such as rivers and lakes but rarely in such concentrated quantities for people to catch Legionnaires' disease.
This normally occurs when Legionella bacteria is found in purpose built water systems, such as those within your building. This is why it's essential to understand your obligations and requirements around Legionella and the L8 guidelines laid down by the HSE.
This presentation comes from the first in a series of educational seminars hosted by Acorn Maintenance, specifically to help existing clients and customers keep abreast of current legislation and best practice guidelines.
This document discusses Legionella bacteria found in building water systems and the risks posed to occupants, especially in schools. It notes that many school buildings have been unoccupied since March due to the coronavirus pandemic, allowing water to stagnate in plumbing and increasing Legionella growth risks. While Legionnaires' disease is rare in children, the document reviews CDC data on reported pediatric cases and risks to immunocompromised individuals of any age. It emphasizes the importance of testing water systems before reopening buildings and having plans to disinfect water if needed to prevent exposure to Legionella.
Legionella risk assessments (LRAs) are required by law for all dental practices to identify risks from Legionella bacteria in water systems. An LRA involves a qualified assessor thoroughly examining a practice's hot and cold water systems to test for potential Legionella growth. Areas like water tanks, pipes, dental unit waterlines and any places water is stored between 20-45°C are inspected. The assessor provides a comprehensive report afterwards detailing any risks found, control measures required, and a monitoring schedule to maintain compliance. While an initial LRA may be expensive, ongoing compliance is important for staff and patient safety and can help practices avoid legal and health issues.
This document provides an overview of Legionella and Legionnaires' disease, including background information on outbreaks, transmission, and at-risk populations. It discusses how building water systems can support Legionella growth and introduces new standards from organizations like The Joint Commission, CMS, ASHRAE and ASSE regarding water management programs to prevent healthcare-associated Legionnaires' disease. The document emphasizes the importance of certified specialists and knowledgeable water management teams to implement effective prevention practices through tools like risk assessments, monitoring, corrective actions and documentation.
Non-tuberculous mycobacteriums (NTM) are small, rod shaped bacilli that are found in the environment and generally cause infection or disease in individuals with preexisting conditions. NTM is a category of mycobacteria, and as the name states, these species do not cause tuberculosis. NTM can cause lymphadenitis, pulmonary disease resembling tuberculosis, skin disease, or disseminated disease. These bacteria have occasionally been isolated from drinking water distribution systems. Disease caused by M. avium complex has been linked to hospital drinking water in HIV patients.
This document summarizes Janet Stout's presentation on proactive Legionella water management. Stout advocates for preventing Legionnaires' disease through comprehensive water safety programs rather than just focusing on having zero Legionella in water systems. She gives the current state of Legionnaires' disease prevention in the U.S. a "D" grade for issues like missed diagnoses, denial of the Legionella risk, and lack of environmental detection and disinfection. Stout argues that being proactive with water management plans following standards like ASHRAE 188 and the CDC toolkit can help organizations avoid painful and costly disease outbreak investigations.
This document discusses approaches for managing risks from Legionella bacteria in potable water systems and cooling towers. It notes that high levels of organic materials can increase biofilm formation, and stagnant or slow-moving water poses the highest risk for outbreaks. Multiple barriers like disinfection, maintenance plans, and indicator monitoring are recommended. Cooling towers present unique challenges as the same bacteria can be pathogenic in towers but harmless in water. The Quebec law requires documentation and signed maintenance plans, though it is missing some elements like penalties. District cooling systems that circulate non-potable water can eliminate Legionella risk while improving energy efficiency.
This document discusses guidelines for microbial monitoring and control in cooling towers to prevent Legionnaires' disease. It provides an overview of various guidelines from organizations like OSHA, ASHRAE, and the Cooling Technology Institute. The numbers and thresholds in the guidelines are not health-based but rather aim to show the current condition and trends in cooling tower systems. The CTI 2020 guideline is praised for taking a performance-based approach with measurable targets and examples of response plans. Microbial monitoring plays an important role in verification and confirmation of effective prevention programs by tracking Legionella levels and growth trends over time.
This document discusses healthcare-acquired Legionnaires' disease. It notes that 20% of Legionnaires' disease cases are healthcare-acquired, with the majority associated with long-term care facilities. Potable water systems, especially in complex hospital water systems, are identified as a major source of transmission. The document emphasizes that Legionnaires' disease in hospitals is widespread, deadly, and preventable. Effective prevention requires a comprehensive water management program following guidelines from ASHRAE and the CDC.
PUZZLED BY POINT OF USE FILTERS?
Michael Castro, MPH, Director of Healthcare Services
Why are point-of-use filters necessary for case investigations, outbreaks and high-risk units? Get practical information on developing a POU water filtration preparedness plan, a review of considerations for selection, and installation and deployment of microbiological water filtration during an outbreak.
Hidden Threats: Legionella and Managing Risk through PMSchoolDude
Recently, Legionella has been a hot topic for educational institutions in the news. Check out the recording of our recent Partner Webinar with Brady Services, Inc. to learn about how an effective preventive maintenance program can help prevent Legionnaires' Disease and other similar dangers. To learn more about how to implement a strong preventive maintenance program at your school, visit www.schooldude.com
This document discusses NYC regulations for cooling towers and offers solutions for compliance. It summarizes that NYC Law 77 and Chapter 8 require routine inspections, Legionella testing, and response to elevated results. Towers must be disinfected twice yearly by certified technicians. By November 1st, a certification stating compliance with the maintenance plan is required. Violations incur fines up to $10,000 and failures to disinfect can be misdemeanors. It then offers an unbiased inspection and maintenance program development service to help buildings comply.
Points to Consider for Molecular Detection for Respiratory VirusesIan M. Mackay, Ph.D
Lecture given by me as a WHO-EMRO Temporary Advisor, to the First WHO-EMRO Training Workshop on MERS-CoV Laboratory Diagnostics, 14th-16th December 2015, Dubai, UAE.
The City of Dania Beach routinely monitors its drinking water supply and submits reports on water quality. Testing in 2012 found the water safe within regulatory limits, except the City failed to complete all required lead and copper sampling between July and December. The water source is underground aquifers accessed by wells 65 feet deep. Water is treated through lime softening, filtration, disinfection and fluoride addition. About 17,000 customers receive water meeting health standards, though some groups may be at higher risk and should take precautions.
This document discusses managing risks in aquatic facilities. It highlights that swimming is a top cause of injury lawsuits and these lawsuits are increasing. It also notes that the CDC found many health and safety violations in aquatic facilities. Finally, it emphasizes the importance of proper water treatment, ventilation, and staff training to prevent disease transmission and exposure to chemicals.
The document discusses the Centre for Ecology & Hydrology's (CEH) trial of using electronic lab notebooks. It describes CEH's large-scale, long-term monitoring networks that generate significant data. CEH scientists traditionally used paper lab notebooks that have issues like not being accessible, searchable, or easily archived. The trial involved volunteers maintaining parallel paper and wiki-based electronic notebooks to evaluate features. The wiki format provided many benefits over paper, though additional functionality is still needed to fully replace paper notebooks. CEH aims to select a permanent electronic notebook solution to improve data management.
This document summarizes the risks associated with the IDRIS LIS-01 Project. It provides an overview of the project and risk workshop goals. The top 12 high risks are then detailed, including risks around construction delays, handing over works, flooding, groundwater ingress, noise levels, water inflow, health and safety hazards, emergency response, traffic accidents, and permit approvals. Mitigation strategies are proposed for each high risk. Additional sections review acceptable and closed risks, and the risk management process and categories.
This document provides an overview of water quality parameters that are analyzed to assess water quality. It discusses pathogenic microorganisms that can contaminate water and cause disease. The presence of coliform bacteria, specifically E. coli, is used to indicate contamination with sewage and potential pathogens. Organic matter in water is categorized as biodegradable or non-biodegradable, which are measured by biochemical oxygen demand, chemical oxygen demand, and volatile solids. Biochemical oxygen demand measures the amount of oxygen used by microorganisms to break down organic matter. Dissolved oxygen levels are an important indicator of water quality, as sufficient oxygen is required to support aquatic life.
The document outlines policies and procedures for minimizing the risk of Legionellosis at Angus Consulting Management Limited facilities. It requires site project managers to implement measures such as utilizing a qualified water treatment specialist, regularly maintaining and disinfecting water systems, using corrosion and scale inhibitors, conducting inspections, alternating biocides, keeping treatment records, and monitoring bacteria levels. Project managers must submit a form every six months confirming these measures are in place.
Battles with the Legion - Colin Purnell - Safety & Health Expo 2014SHExpo
The document provides information on Legionnaires' disease, including what causes it, common symptoms, and risk factors. It discusses how Legionnaires' disease outbreaks occur when Legionella bacteria grows in water systems and is inhaled. Major past outbreaks in the UK are reviewed, along with investigations that found failures to properly implement control measures as required. The presentation outlines the Approved Code of Practice and guidance on controlling risks from Legionella, including requirements for risk assessments, written control schemes, and ongoing monitoring and inspection of water systems.
Legionella risk assessments (LRAs) are required by law for all dental practices to identify risks from Legionella bacteria in water systems. An LRA involves a qualified assessor thoroughly examining a practice's hot and cold water systems to test for potential Legionella growth. Areas like water tanks, pipes, dental unit waterlines and any places water is stored between 20-45°C are inspected. The assessor provides a comprehensive report afterwards detailing any risks found, control measures required, and a monitoring schedule to maintain compliance. While an initial LRA may be expensive, ongoing compliance is important for staff and patient safety and can help practices avoid legal and health issues.
This document provides an overview of Legionella and Legionnaires' disease, including background information on outbreaks, transmission, and at-risk populations. It discusses how building water systems can support Legionella growth and introduces new standards from organizations like The Joint Commission, CMS, ASHRAE and ASSE regarding water management programs to prevent healthcare-associated Legionnaires' disease. The document emphasizes the importance of certified specialists and knowledgeable water management teams to implement effective prevention practices through tools like risk assessments, monitoring, corrective actions and documentation.
Non-tuberculous mycobacteriums (NTM) are small, rod shaped bacilli that are found in the environment and generally cause infection or disease in individuals with preexisting conditions. NTM is a category of mycobacteria, and as the name states, these species do not cause tuberculosis. NTM can cause lymphadenitis, pulmonary disease resembling tuberculosis, skin disease, or disseminated disease. These bacteria have occasionally been isolated from drinking water distribution systems. Disease caused by M. avium complex has been linked to hospital drinking water in HIV patients.
This document summarizes Janet Stout's presentation on proactive Legionella water management. Stout advocates for preventing Legionnaires' disease through comprehensive water safety programs rather than just focusing on having zero Legionella in water systems. She gives the current state of Legionnaires' disease prevention in the U.S. a "D" grade for issues like missed diagnoses, denial of the Legionella risk, and lack of environmental detection and disinfection. Stout argues that being proactive with water management plans following standards like ASHRAE 188 and the CDC toolkit can help organizations avoid painful and costly disease outbreak investigations.
This document discusses approaches for managing risks from Legionella bacteria in potable water systems and cooling towers. It notes that high levels of organic materials can increase biofilm formation, and stagnant or slow-moving water poses the highest risk for outbreaks. Multiple barriers like disinfection, maintenance plans, and indicator monitoring are recommended. Cooling towers present unique challenges as the same bacteria can be pathogenic in towers but harmless in water. The Quebec law requires documentation and signed maintenance plans, though it is missing some elements like penalties. District cooling systems that circulate non-potable water can eliminate Legionella risk while improving energy efficiency.
This document discusses guidelines for microbial monitoring and control in cooling towers to prevent Legionnaires' disease. It provides an overview of various guidelines from organizations like OSHA, ASHRAE, and the Cooling Technology Institute. The numbers and thresholds in the guidelines are not health-based but rather aim to show the current condition and trends in cooling tower systems. The CTI 2020 guideline is praised for taking a performance-based approach with measurable targets and examples of response plans. Microbial monitoring plays an important role in verification and confirmation of effective prevention programs by tracking Legionella levels and growth trends over time.
This document discusses healthcare-acquired Legionnaires' disease. It notes that 20% of Legionnaires' disease cases are healthcare-acquired, with the majority associated with long-term care facilities. Potable water systems, especially in complex hospital water systems, are identified as a major source of transmission. The document emphasizes that Legionnaires' disease in hospitals is widespread, deadly, and preventable. Effective prevention requires a comprehensive water management program following guidelines from ASHRAE and the CDC.
PUZZLED BY POINT OF USE FILTERS?
Michael Castro, MPH, Director of Healthcare Services
Why are point-of-use filters necessary for case investigations, outbreaks and high-risk units? Get practical information on developing a POU water filtration preparedness plan, a review of considerations for selection, and installation and deployment of microbiological water filtration during an outbreak.
Hidden Threats: Legionella and Managing Risk through PMSchoolDude
Recently, Legionella has been a hot topic for educational institutions in the news. Check out the recording of our recent Partner Webinar with Brady Services, Inc. to learn about how an effective preventive maintenance program can help prevent Legionnaires' Disease and other similar dangers. To learn more about how to implement a strong preventive maintenance program at your school, visit www.schooldude.com
This document discusses NYC regulations for cooling towers and offers solutions for compliance. It summarizes that NYC Law 77 and Chapter 8 require routine inspections, Legionella testing, and response to elevated results. Towers must be disinfected twice yearly by certified technicians. By November 1st, a certification stating compliance with the maintenance plan is required. Violations incur fines up to $10,000 and failures to disinfect can be misdemeanors. It then offers an unbiased inspection and maintenance program development service to help buildings comply.
Points to Consider for Molecular Detection for Respiratory VirusesIan M. Mackay, Ph.D
Lecture given by me as a WHO-EMRO Temporary Advisor, to the First WHO-EMRO Training Workshop on MERS-CoV Laboratory Diagnostics, 14th-16th December 2015, Dubai, UAE.
The City of Dania Beach routinely monitors its drinking water supply and submits reports on water quality. Testing in 2012 found the water safe within regulatory limits, except the City failed to complete all required lead and copper sampling between July and December. The water source is underground aquifers accessed by wells 65 feet deep. Water is treated through lime softening, filtration, disinfection and fluoride addition. About 17,000 customers receive water meeting health standards, though some groups may be at higher risk and should take precautions.
This document discusses managing risks in aquatic facilities. It highlights that swimming is a top cause of injury lawsuits and these lawsuits are increasing. It also notes that the CDC found many health and safety violations in aquatic facilities. Finally, it emphasizes the importance of proper water treatment, ventilation, and staff training to prevent disease transmission and exposure to chemicals.
The document discusses the Centre for Ecology & Hydrology's (CEH) trial of using electronic lab notebooks. It describes CEH's large-scale, long-term monitoring networks that generate significant data. CEH scientists traditionally used paper lab notebooks that have issues like not being accessible, searchable, or easily archived. The trial involved volunteers maintaining parallel paper and wiki-based electronic notebooks to evaluate features. The wiki format provided many benefits over paper, though additional functionality is still needed to fully replace paper notebooks. CEH aims to select a permanent electronic notebook solution to improve data management.
This document summarizes the risks associated with the IDRIS LIS-01 Project. It provides an overview of the project and risk workshop goals. The top 12 high risks are then detailed, including risks around construction delays, handing over works, flooding, groundwater ingress, noise levels, water inflow, health and safety hazards, emergency response, traffic accidents, and permit approvals. Mitigation strategies are proposed for each high risk. Additional sections review acceptable and closed risks, and the risk management process and categories.
This document provides an overview of water quality parameters that are analyzed to assess water quality. It discusses pathogenic microorganisms that can contaminate water and cause disease. The presence of coliform bacteria, specifically E. coli, is used to indicate contamination with sewage and potential pathogens. Organic matter in water is categorized as biodegradable or non-biodegradable, which are measured by biochemical oxygen demand, chemical oxygen demand, and volatile solids. Biochemical oxygen demand measures the amount of oxygen used by microorganisms to break down organic matter. Dissolved oxygen levels are an important indicator of water quality, as sufficient oxygen is required to support aquatic life.
The document outlines policies and procedures for minimizing the risk of Legionellosis at Angus Consulting Management Limited facilities. It requires site project managers to implement measures such as utilizing a qualified water treatment specialist, regularly maintaining and disinfecting water systems, using corrosion and scale inhibitors, conducting inspections, alternating biocides, keeping treatment records, and monitoring bacteria levels. Project managers must submit a form every six months confirming these measures are in place.
Battles with the Legion - Colin Purnell - Safety & Health Expo 2014SHExpo
The document provides information on Legionnaires' disease, including what causes it, common symptoms, and risk factors. It discusses how Legionnaires' disease outbreaks occur when Legionella bacteria grows in water systems and is inhaled. Major past outbreaks in the UK are reviewed, along with investigations that found failures to properly implement control measures as required. The presentation outlines the Approved Code of Practice and guidance on controlling risks from Legionella, including requirements for risk assessments, written control schemes, and ongoing monitoring and inspection of water systems.
The document provides information on water management programs for preventing Legionella growth. It discusses the basics of Legionella bacteria and legionellosis disease. Key points covered include the importance of temperature control, disinfectant residuals, and preventing stagnation in building water systems. The presentation emphasizes that a comprehensive water management program per ASHRAE Standard 188 is necessary to systematically control risks from Legionella.
This document discusses Legionnaires' disease and the control of Legionella bacteria in water systems. It provides an overview of UK guidance on Legionella, which establishes requirements for risk assessments, management responsibilities, and appointing competent persons. The document also presents a case study of Legionella control for a housing group's properties and outlines the role of the Legionella Control Association in establishing standards for service providers.
This document discusses Legionnaires' disease and the control of Legionella bacteria in water systems. It provides an overview of UK guidance on Legionella, which establishes requirements for risk assessments, management responsibilities, and competent personnel. The document also presents a case study of Legionella control for a housing group's properties and outlines the role of the Legionella Control Association in establishing standards for service providers.
The Multi-barrier Approach to Address Water Quality and Disease PreventionMadelyn Skinner
How can you eliminate waterborne hospital acquired infections (HAIs) by choosing the right water treatment? Popular chemical treatments, like monochloramine, cause harmful byproducts and have little effect. Learn about copper silver ionization, and how the multi-barrier approach protects the people in your facility. Get introduced to the CDC and ASHRAE 188 and learn how to follow ethical practices.
Severn Trent specializes in providing multi-site water hygiene management services for public sector, industrial, and commercial clients. They help customers ensure compliance with health and safety legislation regarding water systems, which requires protecting people from risks like Legionnaires' disease. Severn Trent's services include legionella risk assessments, ongoing water system monitoring and sampling, remedial work, and complete water hygiene management programs. With over 25 years of experience, Severn Trent has the expertise to effectively manage customers' water hygiene risks and ensure their water systems are safe and compliant.
This document discusses approaches for managing risks from Legionella in potable water systems and cooling towers. It notes that biofilm formation and stagnant or slow moving water increase risks. Multiple barriers like disinfectants, filtration and maintenance plans are recommended, but zero risk does not exist and risks differ between potable water and cooling towers. Lessons from a 2012 Quebec outbreak highlight the need for thorough cleaning before disinfection and validating biocide dosing. The Quebec law requires documentation and maintenance plans to be signed by professionals. Increased water consumption or switching to air cooling can occur when risks are difficult to control. District cooling systems avoid Legionella risk and reduce energy use.
This document discusses water supply and purification for haemodialysis. It begins by explaining that haemodialysis machines use large volumes of water that must be very clean to avoid contaminating patients' blood. A multi-step water purification system is used, including particle filtration, ion exchange to soften water, carbon filtration to remove chlorine, and reverse osmosis to remove dissolved ions and produce high-purity water for dialysis. Regular maintenance and monitoring of the water purification system is needed to ensure patient safety.
The document discusses India's efforts to provide safe drinking water to its population. It notes that in 1975, over 1 billion people globally lacked access to safe water. In response, India developed various five-year plans from 1980-1997 to expand access, with the goal of supplying safe water to all rural villages. Key aspects of ensuring water safety discussed include water quality standards, testing for contaminants, monitoring programs, and strategies like water treatment and sanitation inspections. The document also examines health impacts of contaminated water and international targets for access to improved water sources.
Have you ever wondered about the quality of water flowing into your home or business? Backflow, a potential plumbing issue, can compromise the safety of your water supply. Backflow prevention is a critical aspect of plumbing systems that ensures clean and potable water remains uncontaminated. In this blog, we'll delve into the importance of backflow prevention, the risks it addresses, and the methods employed to safeguard your water supply.
This document provides a summary of a presentation on Legionella. It discusses updates from international Legionella conferences, including trends seen in outbreaks and new research findings. Methods like whole genome sequencing are now being used to type Legionella strains during outbreak investigations. Guidelines and standards are in development from groups like ASHRAE to help minimize Legionella risks. The presentation emphasizes that while Legionella can pose legal risks, facilities can protect themselves by familiarizing with industry best practices and recommended methods for maintaining building water systems.
Bs water-treatment-presentation-1-1 finalsDaphne Tan
Water treatment is crucial for safe consumption and usage. It removes contaminants like chlorine, fluoride, parasites and dioxins that can be hazardous to health. For haemodialysis patients who use large volumes of water, treatment is essential to avoid health complications. Reverse osmosis is commonly used as it removes bacteria, endotoxins and dissolved solids. Strict water quality monitoring and disinfection is needed, as contaminated water could be life threatening for haemodialysis patients. Proper equipment, storage and process design are important to ensure safe, effective water treatment.
Bs water-treatment-presentation-1-1 finalsDaphne Tan
Water treatment is important for haemodialysis patients who are exposed to large volumes of water directly through their bloodstream. Reverse osmosis (RO) is commonly used to treat water for haemodialysis as it removes contaminants, bacteria and endotoxins. Proper design, monitoring and maintenance of the RO system is required. Storage tanks must be designed to prevent bacterial growth and reject water can be recycled to reduce wastage. Regular testing is needed to ensure water quality meets Association for the Advancement of Medical Instrumentation standards to protect patient safety.
This document discusses water treatment for hemodialysis units. It notes that water quality significantly impacts patient outcomes. The summary is as follows:
1. Proper water treatment is essential for hemodialysis patients who are exposed to large volumes of water each week through dialysis.
2. The water treatment system uses various processes like carbon filtration, softening, reverse osmosis, and deionization to remove contaminants.
3. Strict policies, documentation, and staff education are needed to ensure the water treatment system operates safely and provides water that meets quality standards.
The document discusses water systems for the pharmaceutical industry. It provides an overview of key water purification processes like reverse osmosis and distillation. It also summarizes USP specifications for purified water and water for injection. The document outlines various design considerations for water storage and distribution systems, including the need to minimize microbial growth and enable effective sanitization. It emphasizes the importance of validation to demonstrate that water systems consistently produce the desired quality when operated according to standard operating procedures.
Presented by IWMI's Maha Halalsheh as part of a series of training workshops held in 2021 entitled 'The safe use of wastewater' explaining the modules in the ' Governance and Reuse Safety Plans' handbook developed as part of our ReWater-MENA project. More about our work: https://rewater-mena.iwmi.org/
The document discusses updated recommendations for preventing surgical site infections, including adhering to guidelines for maintaining asepsis in the operating room, having patients use chlorhexidine for preoperative skin cleansing, and maintaining normothermia during and after surgery. Key factors that can reduce SSIs are proper skin preparation techniques, use of antibiotic prophylaxis, and keeping patients warm to avoid hypothermia which compromises the immune system's ability to fight infection.
I have one mission, To BE THE BEST CLINICAL IAQ TEAM!
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2. BIO
AMI Environmental
AMI Environmental is a full-service environmental consulting and remediation firm,
specializing in facility-based environmental problems affecting facility operations,
renovation and demolition activities. Established in 1986 and headquartered in
Omaha, Nebraska, AMI services clients nationally and internationally.
Jamie Hilger
Industrial Hygiene Professional
A.S Liberal/Health Sciences (2008)
B.S. Environmental Studies –University of Nebraska (2011)
Member – American Society for Healthcare Engineering
ASHE Infection Control Training (2012)
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3. OBJECTIVES
Introduction
Legionella
ASHRAE Standard 188P
Summary
Q&A
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4. WHAT IS LEGIONELLA?
• Pathogenic gram negative bacterium common in many environments
• Primarily warm water environments
• Approx. 50 species 70
serogroups
• Include species that
cause Legionellosis
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5. LEGIONELLOSIS
• Legionellosis: any illness caused by exposure to legionellae.
Legionnaires 'disease and Pontiac fever most common types.
• Legionnaires’ disease: multisystem illness
including deadly type of pneumonia.
• Pontiac fever: flulike illness, without
pneumonia
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6. LEGIONELLOSIS (CONT.)
• 80 - 90% of all cases of legionellosis are caused by a single species:
Legionella pneumophila
– 65 – 70% serotype 1
• One of the top three
causes of community-
acquired pneumonia
• Transmission is not person
to person
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7. DISCOVERY OF LEGIONELLA
• July 1976
• American Legion Convention
• Bellevue Stratford Hotel in Philadelphia
• 221 fell ill, 34 died
• 1965 St. Elizabeth Hospital
• 81 patients developed pneumonia,14 died
• Frozen specimens confirm Legionella 12 yrs later
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8. LEGIONELLOSIS (CONT.)
• 8,000 – 18,000 US
(cases/year)
• Death rate: 5 – 30%
• Many infections are not diagnosed or reported
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9. LEGIONELLOSIS (CONT.)
Risk Factors
Age
Highest risk in elderly >65
Not common in people <50
Very rare in people <20
Smoking
Pre –existing COPD, or diabetes
Compromised immune system
WWW. AM I ENVI RO NM ENTAL. CO M
10. HEALTHCARE COSTS
Waterborne diseases cost over $500 million annually in the U.S.
Legionnaire’s disease $101 – 321 million
$34,000 per case
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12. HOW IS LEGIONELLA TRANSMITTED?
• Inhalation: Airborne water droplets containing legionellae are inhaled.
• Aspiration: contaminated water or liquid enter the lungs.
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13. HOW IS LEGIONELLA TRANSMITTED? (CONT.)
Contaminated Source
Transmission
Susceptible Host
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14. COMMON SOURCES OF LEGIONELLA
Typical manmade water sources:
• Plumbing systems
• Cooling towers
• Humidifiers
• Showers
• Hot tubs
• Decorative fountains
• Evaporative condensers
• Misters, air washers
Environmental Sources include freshwater ponds, rivers, and creeks
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15. LEGIONELLA GUIDELINES
• ASHRAE 2000
• CDC 2003
• AIA 2001
• EPA 1991
• WHO 2007
• OSHA 1996
• JCAHO 2001
• UK L8 2000
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16. WHAT IS ASHRAE STANDARD 188P?
• A standard that presents methods for the prevention of legionellosis
associated with building water systems.
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17. WHY IS ASHRAE 188P DIFFERENT?
• Standard vs. Guideline
Law
• Consensus
Standard
Guideline
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18. ASHRAE STANDARD 188P
• “Prevention of Legionellosis associated with building water systems”
• Purpose: identify specific practices in prevention of Legionellosis
• Scope: it provides methods of risk management for the prevention of
legionellosis associated with centralized industrial and commercial
building water systems.
• Intended for: facility owners/manager
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19. STANDARD 188 REQUIRES HACCP WATER PLAN
FOR BUILDING WITH ANY OF THESE FACTORS:
• Centralized hot water heater
• More than 10 stories high
• Inpatient healthcare facility
• Occupants over age >65
• Whirlpool/spa
• It has one or more water features
• Free chlorine <0.5 ppm
• Cooling towers and or evaporative condensers
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20. WHAT TO DO?
Does your building have any of the risk factors
No Yes
Resurvey Establish a
annually HACCP water plan
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21. HACCP PRINCIPLES
- risk management method that prevents hazards form harming
people.
1. Conduct hazard analysis
2. Identify critical control points
3. Establish critical limits for each ccp
4. Establish critical control point monitoring
5. Establish corrective action
6. Verify and validate
7. Document the plan
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22. ACTIONS INVOLVED IN DEVELOPING AN HACCP
WATER PLAN:
1. Form a water management team
– One who understands HACCP
– Building water system
– Employees
– Suppliers
– Consultants
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23. 2. DEVELOP FLOW DIAGRAMS
Objectives:
• Identify end-point uses and processing steps in the water systems
• Construct at least two flow diagrams
• Confirm accuracy
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25. 3. HAZARD ANALYSIS SUMMARIES
HACCP requires hazard analysis summaries that identify the chemical,
physical, or biological hazards. For each of the water systems.
Chemical
Biological Physical
Hazard
Analysis
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27. 4. ESTABLISH CRITICAL CONTROL POINTS
(CCP’S)
CCP’s are points at which legionella control measures can and should be
applied.
Use process flow diagrams and hazard
analysis summaries to identify points
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28. 5. CONTROL MEASURES
• Monitoring frequency, critical limits, and corrective actions at the ccp’s.
• Measures must be
– Evidence based
– Up to date
– Reasonable in cost
– Simple and practical
– Clearly written
Include measures for: routine maintenance of applicable water
systems, design/construction, and incidents.
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29. 6. DEVELOP VALIDATION, VERIFICATION, AND
DOCUMENTATION PROCEDURES
Validate
Verify
Document
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30. ASHRAE STANDARD 188P 2ND PUBLIC REVIEW
DRAFT
https://osr.ashrae.org/Public%20Review%20Draft%20Standards%20Lib/St
d-188P-PPR2%20Final%206%2010%202011.pdf
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31. RECAP
Legionella
Steps to ASHRAE Standard I88 Compliance
Water management team
Process flow diagrams
Hazard analysis summaries
Critical Control Points
Control measures
Validate, Verify, and Document
How AMI can help
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32. REFERENCES
ASHRAE Guideline 12-2000, “Minimizing the Risk of Legionellosis Associated
with Building Water Systems”, American Society of heating, Refrigerating
and Air-Conditioning Engineers, Inc.
Center for Disease Control and Prevention. “Legionellosis Resource Site”
July 23rd 2012. http://www.cdc.gov/legionella/
American Society for Healthcare Engineering. “Prevention of Legionellosis
Associated with Building Water Systems” , February 23, 2012
http://www.ashe.org/resources/pdfs/HACCP_Plan_Legionellosis_Building_
Water_Systems.pdf
Freije, Matthew .“Legionella Control in Healthcare Facilities” A Guide for
Minimizing Risk. 1997
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