WATER HYGIENE AND SAFETY
Simple designs and low maintenance prioritised
Access to a safe water supply is critical in healthcare environments, and complying with the Department of Health and Social Care’s Technical Memorandum, HTM 04-01, is crucial for estates and facilities managers, suppliers, and NHS management teams. Simon Russell, National Sales manager, Commercial and Corporate Specification, at Heatrae Sadia, outlines the key challenges in delivering water into a clinical setting, and explains how the latest technology can help to ensure safety for patients, visitors, and staff.
Providing patients, staff, and visitors with free access to safe drinking water is high on the list of priorities for healthcare estates and facilities managers. Water is a critical element of recovery, and to put patients who are already vulnerable at risk of diseases such as Legionnaire’s disease is something that cannot be permitted. The Department of Health and Social Care provides guidance that governs safe water provision in public healthcare, and Health Technical Memorandum (HTM) 04-01 represents the gold standard for water compliance. It is a substantial document that covers design, installation, commissioning, and operational management, paying close attention to the risk of waterborne pathogens such as Legionella. While its length is important in ensuring it thoroughly addresses all the issues, it does mean that compliance is an arduous process. Consequently, healthcare facilities can sometimes find their water provision lagging behind the latest innovations, as management teams struggle to keep pace with technological changes.
The risks
Water has multiple points of contact with patients and staff, as it is used for a plethora of different applications, ranging from handwashing to simply hydrating throughout the day. This means that potentially dangerous water has several opportunities to pass between individuals, and a brief look through the news highlights a long list of water-related incidents. There has been a worrying increase in the prevalence of Legionnaire’s disease in the UK. As of September last year, there
Heatrae Sadia has created a guide that outlines the most important technology to look out for to comply with HTM 04-01.
had been 311 confirmed cases in the year, and 85 reported during the month of September alone. This highlights the importance of managing water supply, and there are also other potentially lethal pathogens and bacteria, such as
Cupriavidus pauculus, that are liable to find their way into unsafe water supplies. The dangers of water are not just limited to bacteria; care must also be taken with how water is dispensed. The young and elderly are at greater risk from scalding or burns, which necessitates a considered approach to the specification of on-wall boiling water units. HTM 04-01 refers to something called a ‘never event’. This is defined as a serious incident that is wholly preventable due to the availability of
nationwide guidance that
provides systemic protection against it. Although ‘never events’ largely cover surgical and medical accidents, such as the incorrect administration of medicine, the term also includes general workplace threats, such as scalding. In line with the guidance, this dictates that healthcare management personnel must ensure that preventable injuries linked with water supply do not occur in their facility.
Infection prevention
The optimum temperature range for Legionella, the bacterium that causes Legionnaire’s disease, is between 20˚C and 45˚C This has obvious implications for hot water provision, as this is the natural temperature range at which many heating, ventilation, and air-conditioning (HVAC) units store water.
Water has multiple points of contact with patients and staff, as it is used for a plethora of applications – ranging from handwashing to simply hydrating throughout the day.
68 Health Estate Journal July 2020
To combat this, the Health and Safety Executive recommends that cold water is kept below 20˚C at all times, while hot water should be stored at a temperature above 60˚C. Some of the latest hot water systems, such as Heatrae Sadia’s Multipoint Eco, incorporate functionality which specifically protects against the disease, and a pasteurisation cycle can help the maintain the freshness of
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