WATER HYGIENE AND SAFETY
procedures and records to support its stance. Analysis of domestic hot and cold storage temperatures showed that these had all been suitable during the 12-month period, with all storage temperatures being at the recommended levels. However, analysis of the water distribution temperatures showed a significant drop in compliance from April of that year – from 8% non-compliant to 50% non-compliant.
Alterations to the pipework As with case study 1, during the period there had been no significant change of use from the outlets. However, when the root cause analysis was completed, it was found that 90% of the non-compliant temperatures could be associated with significant alterations to the water pipework services that were completed by the Trust’s Capital Project Team. These had resulted in the creation of significant deadlegs, gross over-capacity of water storage, inappropriate design and material use, and reduced flow and distribution to outlets.
The poor designs and installations had once again hampered the efficacy of the storage water temperatures in controlling Legionella, and created significant pockets where the trace amounts of the bacterium that had managed to reach them were able to grow and proliferate.
A common problem
So, how frequent or common is the inappropriate design and installation of water services? To answer this question, I have reviewed several root cause analyses, where inadequate water storage temperatures were found not to be the route cause. This review found that, on average, 65.5% of failures and problems that were not associated with poor water management had instead been designed into the water services through poor design and installation (see Fig 3). It is also my experience that while Estates, Microbiology, and Infection Control teams are often regular contributors to a Trust’s Water Safety Group (WSG), the Projects team is not always well represented. It is important to stress, however, that this is only the case where good management systems are not already in place. Many of the Trusts that the author works with have fully engaged and well-trained project team members that are well represented on the Water Safety Group, and operating to clearly documented minimum design standards.
Conclusions
Where trained, competent, and engaged within an active Water Safety Group (WSG), the Projects team is an active and essential part of the water management scheme. As indicated in this article, however, poor design and installation of
62 Health Estate Journal January 2019 100 90 80 70 60 50 40 30 20 10 0 A B C D
Figure 3: Percentage of problems at five sites attributed to poor design and installation of water services.
water services can cancel out all the good work completed by the estates team (and other members of the Water Safety Group) in managing Legionella (and other waterborne microorganisms). As such it is important to ensure that: n The Capital Projects team and any designers and installers of water services are trained and competent, as specified in HTM 04-01 (2016);
n The roles and responsibilities of all such individuals are clearly documented in the ‘Organisation’ section of your water safety policy, and that these are clearly communicated and understood by all relevant staff members. Ensure that all such roles are tangible and clear;
n The Projects team is represented on the Water Safety Group (WSG), and that an individual is formally appointed and trained to act as the lead for projects;
n All designs, materials, and alterations to the water services are brought before the Water Safety Group (WSG) for review and approval/acceptance. Obtain agreed sign-off for any alterations to standards, materials, or designs;
n A preferred minimum standards document is developed and employed to ensure that projects conform consistently to the agreed and accepted standards for design and installation;
n A full and formal risk assessment of any new designs and installations is completed as soon as possible on completion of a new water system. Proper design and installation will ensure that the principal control strategy of ‘Keep It Hot/or Cold, Keep it Flowing, And Keep it Clean’ is achieved. To ensure that this is achieved requires both a good standard of training, and active engagement in the Water Safety Group (WSG).
Alan Hambidge
Alan Hambidge has almost 30 years’ experience in the field of health and safety risk management, and is a leading expert in Legionellosis and water hygiene.
He is lead trainer on Eastwood Park’s health and safety portfolio, and also develops and delivers the training establishment’s current portfolio of water hygiene training courses. An Independent Auditor/ Authorising Engineer on water and health and safety, and an active member of various organisations and institutes, including IHEEM, HefmA and IFHE, he is a three-times winner of the IHEEM John Bolton Memorial Prize, and runs his own company, Empathy Environmental Consultancy. He runs the online ‘Safety Solutions’ website resource, and has published ‘hundreds of articles’ and a health and safety book.
hej E Total
n Problem not directly associated with poor design n Problem attributed to poor design
Percentage
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