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FEATURE


Controlling Water- Borne Pathogens


Richard Sinden, Life Sciences Product Innovation and Regulation Director at SUEZ, urges healthcare facilities to pay attention to the risk of bacterial contamination of their water systems.


It has been 40 years since the first identified outbreak of Legionnaires’ Disease, yet infections caused by water-borne bacteria in healthcare facilities and public buildings continue to make headlines.


Legionella bacteria are found naturally in low numbers in rivers, lakes and reservoirs. They can also grow in man-made water systems if water temperatures stay between 20°C and 50°C, there is the availability of nutrients, and the conditions are stable. If they are inhaled in droplets of water, legionella bacteria can cause Legionnaires’ disease, a severe and difficult to treat form of pneumonia. Once on the surface of the lungs, the bacteria are attacked by our immune cells, but they can overcome the immune system of susceptible individuals, including the elderly, infants and immunosuppressed patients. For hospital-acquired cases, the fatality rate is close to 50%.


Pseudomonas aeruginosa is a common bacteria found in soil and water. Between 3,700 and 4,000 of these types of infections are reported to the Health Protection Agency every year. The bacteria can infect wounds, the respiratory tract, the central nervous system, the gastrointestinal system, urinary tract, bones and joints, as well as the eyes, ears and skin.


Legislative Frameworks Bacteria can thrive in man-made water systems when such systems are poorly designed, or when precautionary monitoring schedules fail. A number of regulatory frameworks exist to prevent the growth and transmission of water- borne pathogens. The HSE document ‘Legionnaires’ disease: The control of Legionella in Water Systems’ is the approved code of practice in the UK. The document has legal status under the Health and Safety at Work


Act and the Control of Substances Hazardous to Health Regulations.


Health Technical Memorandum HTM- 04-01 from the Department of Health outlines the principles involved in the design, installation and testing of hot and cold water supply, storage and distribution systems in healthcare premises. The HTM-04-01 Addendum provides best practice advice for augmented care units: locations where users may be particularly vulnerable to infection. Its guidance is aimed at those involved with patient safety, specifically estates and infection prevention and control teams focusing on measures to minimise the risk from P. aeruginosa and other opportunistic pathogens.


Tackling Water-Borne


Bacteria Best practice control measures for legionella and P. aeruginosa differ in some significant ways. It is generally accepted that legionella originate from the incoming water supply. Control measures focus on preventing the conditions that promote growth of the bacteria. In particular, throughput of water should be sufficient to prevent stagnation, water systems should be designed to minimise the occurrence of contaminants that might promote bacterial growth and temperatures in all parts water supply system should be below 20°C (in the case of cold water supply) or above 55°C (for hot water).


Technical measures to ensure the appropriate temperatures in hot water systems include minimising the overall length of pipe work, removing dead-legs or rarely used


- 14 - www.tomorrowscare.co.uk


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