WATER HYGIENE AND SAFETY
ensuring components, equipment and fittings comply with Water Regulations; and that water temperatures are maintained. The guidance stipulates hot water must be distributed to arrive at the outlet at a temperature of 55°C within seconds (ideally well within 15 seconds). Cold water temperature must be maintained below 20°C. If cold water temperature is likely to rise above 18°C, potentially during an exceptionally warm spring or in later summer, then facilities should consider cooling mechanisms.
Existing buildings’ schematics must be updated, factoring in any changes of use to remove dead-legs or areas of stagnation. If wash-hand basins or showers are moth-balled, the pipe run must be closed off to avoid any stagnation, especially since underutilised outlets can also have an impact on line temperature and biocide efficiency. Where there is any doubt about the efficacy of thermal and chemical treatment, the guidance states that a correctly fitted sterilising-grade POU filter will act as an additional barrier for both tap and shower outlets.
Point of use filters – a convenient solution Studies have shown that POU filtration can significantly reduce NTM counts at the outlet, protecting professionals and patients alike.4
However, in augmented care settings,
NETB No. 2024/3 sets out certain criteria. The filter, with a sterilising-grade 0.2 µm absolute-rated, must be effective for its stated lifespan, considering the specific water charge, usage patterns, water pressure and system temperatures. It must be robust, with a no-leak connection (air-pressure tested). There must be sufficient activity space beneath a POU fitted to a mixer tap to allow for its intended use; to avoid surface contact with the filter, tap and basin; and to prevent any retro-contamination from splashing. Filter technology has advanced, even over the past
10 years. Compact point-of-use filters are a simple and convenient way to ensure patient safety even for the most vulnerable groups. Microfiltration targets these pathogenic bacteria and physically separates elements between 0.1 and 10 micrometres in the water by passing it through filter membranes. Point-of-use filters are typically rated to 0.2 µm, removing suspended matter and bacteria as well as minerals, fungi and mycobacteria (such as NTM).
Tubular membrane microfiltration and its unique benefits The two types of membranes currently used in point-of- use filters are pleated membranes or tubular membranes. In the medical world, tubular membrane microfiltration is commonly used to eliminate water contamination at the point of use as it is an effective means of protecting patients and residents against waterborne pathogens. Second-generation tubular membrane filters, made from several porous tubes arranged parallel to one other, provide a larger exchange surface and, therefore, result in a higher flow rate at the outlet. There are numerous other benefits to tubular membrane
microfiltration compared to other filtration methods. Firstly, it is very reliable, eliminating all bacteria and other waterborne microorganisms (with the exception of viruses). Their reliability is guaranteed by the standard ASTM F 838-20 which assesses the membrane’s ability to retain Brevundimonas diminuta, the smallest known bacterial species which measures 0.3 µm. Secondly, the hollow fibre membrane is very compact, allowing low-volume devices to contain a large filtration surface area. Finally, they have a good tolerance to clogging as suspended
matter remains on the surface of the tubular membrane, extending the filters lifespan.
The technology behind the solution Hollow-fibre technology delivers a compact, effective filtration device. The point-of-use filter is made up of a collection of polyethylene hollow fibres grouped together into a unit. These fibres are extremely fine and flexible, with an exterior diameter of 0.6mm and a thickness of several tens of microns. The fibres are hollow and shaped like a straw or tube.
The hollow fibre membranes have multiple pores which vary in size from 0.01 - 0.1 micron. Each membrane consists of several surfaces with microporous structures (micro slits). Bacteria and any particles in suspension that are larger than 0.1µm are trapped by these structures and retained permanently on the external surface of the membrane. The water requiring treatment flows at right angles to
the filter surface and passes through the membrane due to the pressure difference on either side of the membrane, causing the water to flow from the external to the internal surface of the fibre. Bacteria and other microparticles that cannot pass
through the gaps in the membrane structure are retained on the outer surface and therefore do not penetrate the membrane. The filters’ hollow-fibre filtration area makes it possible to filter a larger volume of water. Consequently, the storage capacity for bacteria and impurities trapped inside the filter is much greater. In the face of this growing threat to patient health, it
is imperative that healthcare facilities take initiative to protect the most vulnerable. Aquatools point-of-use filters offer 1, 2, 3 and 4 month point-of-use filters for taps and showers. Their tubular membrane microfiltration technology offers protection for users, and peace of mind for facilities managers.
References 1 NHS Estates Technical Bulletin (NETB) No.2024/3, doi. 27 August 2024.
2 Health Technical Memorandum 04-01: Safe water in healthcare premises. First published May 2016.
3 NICE. (2024). Healthcare-associated infections: prevention and control in primary and community care. https://tinyurl. com/ycy54a99.
4 Norton G. J., Williams M., Falkinham J. O., 3rd, & Honda J. R. (2020). Physical Measures to Reduce Exposure to Tap Water- Associated Nontuberculous Mycobacteria. Front Public Health, 8, 190. doi:10.3389.
Carole Armstrong
Carole Armstrong is the Senior Marketing and Communications manager for Aquatools in the UK, with 16 years’ experience in point-of-use filters and water controls for healthcare facilities. She is responsible for media relations, events and technical translations for the UK, US and English- speaking export markets. Aquatools, expert in POU water hygiene, is a French company with subsidiaries in the UK, Germany and America. The company specialises in the manufacture of point-of-use filters and accessories for healthcare and public buildings.
Aquatools POU tap and shower filters feature tubular microfiltration to provide a larger filtration surface area.
October 2025 Health Estate Journal 51
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