Legionella

Ensure you are ready to combat Legionnaires’ disease

The worry of a Legionella outbreak is of constant concern to care home operators. The NHS Choices website states that in 2010 there were 359 reported cases and 38 deaths in England and Wales. Simon Hilton, of Brodex, a water treatment company, discusses the misconceptions about the risks, the frequency of control procedures and the role of inspectors.

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egionella bacteria can grow in purpose-built water systems where water is maintained at a temperature high enough to encourage growth - between 20-45° centigrade. People catch Legionnaires’ disease by inhaling small droplets of water, suspended in the air, containing the bacteria. A s hower that creates an aerosol or spray is a prime example.

Unfortunately the most vulnerable are the elderly and infi rm. The symptoms are similar to those of fl u. Legionnaires’ disease is not known to spread from person to person.

The Health & Safety Executive (HSE) have created an Approved Code of Practice for Legionnaires’ disease, more commonly known as ‘L8’. This outlines what you need to have in place for assessing the risk and control measures. It can be downloaded for free from the HSE website http:// www.hse.gov.uk/pubns/books/l8.htm. There is also a new British Standard for Legionella Risk Assessment known as BS8580:2010, ‘Water Quality – Guide to risk assessments for Legionella control’. You should have a Legionella risk assessment in place. It will look at your system as a whole and any current monitoring procedures. It should provide a risk rating and any corrective actions that need to be addressed. Alongside this you need to have ongoing monitoring procedures. Full details are in the code. It is good practice to have in place microbiological sampling, tested by a UKAS registered laboratory. It means you will be providing an excellent duty of care to your residents and staff. There are numerous factors that increase the risk of Legionnaires’ disease but two of the big ones are having hot and cold water stored at an incorrect temperature and having dead legs. Cold water storage tanks should always have water stored below 20°c and Hot Water calorifi ers should always be at 60°c or above. Dead legs are pipework that water fl ows through that has been capped off. The water inside becomes stagnant and bacteria can multiply.

One area of confusion concerns temperatures at hot outlets and scalding control measures. The temperature of water at a hot outlet should be 50°c or above, if the supply is stored water. However in relation to the risk for scalding, hot temperatures are typically 38-43°c. A lot of sites

26 Care Home Management | March/April 2013

now have Thermostatic Mixing Valves. This is a valve, normally under a sink, that allows cold and hot water to mix together before coming out of the hot tap, thereby reducing the temperature. If you have this installation then hot water leading to the valve should be 50°c or above. The valve should be installed as near as possible to the outlet. For the purposes of Legionella monitoring a temperature reading can be taken off the hot pipework. Risk assessments should be carried out by a competent person. Homes may have maintenance people with previous plumbing experience or people that have been on external Legionella training courses. Always make sure the person fully understands the approved code of practice and BS 8580. If you appoint an outside contractor ensure they have a current Legionella Control Association certifi cate and a good track record. Governing bodies, such as CQC, HSE and local authorities, regulate and check if you have a risk assessment and control measures in place. Even if these are not picked up on recent visits they may well be in future. For peace of mind, ensure you are proactive in reducing the risk of Legionnaires’ disease at your home. www.brodexuk.com