WATER SYSTEM HYGIENE AND SAFETY
and feel, of handwashing stations. A person is less likely to make use of a dirty basin, prone to splashing and located in a poorly lit part of a hospital, than an easily accessible and visibly clean one, for example. Also bear in mind that an overworked healthcare employee racing to meet the daily demands of their job may not prioritise washing their hands for a full 20 seconds. One of the biggest issues affecting handwashing regimes, however, is the temperature of the water coming out of the taps at the point of discharge – an issue which can be somewhat difficult to address from a health and safety perspective. Legionella bacteria, the key cause of Legionnaire’s disease, proliferate at temperatures between 20˚C and 45˚C, meaning that in healthcare environments, where infection control is prioritised, hot water needs to circulate at temperatures as high as 55˚C.3
At the
same time, Pseudomonas aeruginosa is another common bacterium that puts hospital staff, patients, and visitors at risk. While healthy individuals can usually fight it off, immunodeficient or immuno- suppressed people can be vulnerable. This bacterium can thrive in water systems, especially in the last two metres before the outlet. This means that pipes, isolation valves, strainers, and the taps themselves, are at risk of becoming contaminated if the water temperature isn’t managed effectively.
Safe temperatures vital
Although circulating the water at such a high temperature can help to reduce the presence of these dangerous types of bacteria throughout the water system, it does result in the rapid delivery of scalding hot water from taps. HTM 04-01 advises that handwashing is ‘best performed under running water at a safe, stable and comfortable temperature’. High water temperatures are likely to lead to
people quickly withdrawing their hands and not immersing them long enough to effectively wash and rinse. Consider the effect that this has on people needing to wash their hands up to 40 times a day.
Research-driven innovation Our research has led to the creation of new a healthcare standard for thermostatic taps and mixers, with the outcome being our Markwik 21+ range, one of the most innovative brassware collections of its kind on the market. These products are specifically designed to address key concerns around infection control and thermostats. Thermostats are designed to ensure that water is delivered at reliable and consistent
108 Health Estate Journal October 2018
temperatures to allow users to wash effectively and
safely. While lower temperatures are comfortable for humans, they also provide the perfect environment for bacteria to grow in. The conundrum is how a healthcare facility has safe water to facilitate effective handwashing to cut down on cross-contamination, while at the same time reducing the opportunity for bacteria to grow inside and around taps.
Our answer is Markwik 21+, a
thermostatic hospital tap range designed with lots of features that help deter bacteria growth, coupled with an effective maintenance and cleaning system that ensures bacteria can be removed on a regular basis. Markwik 21+ is designed for easy maintenance. Mixers can be easily demounted and dismantled, and the system is then ready for disinfection, with internal components designed to withstand 80˚C, and detachable outlets able to hold up to 135˚C for autoclaving.
There are still fittings within hospitals that have separate thermostats to protect against high temperatures. Often placed behind an IPS panel, they create a ‘deadleg’ of water between the
‘‘
HTM 04-01 advises that handwashing is ‘best performed under running water at a safe, stable and comfortable temperature’
thermostat and the fitting. We would not recommend this type of installation, as it creates an unnecessary building up of static water. We would always recommend thermostatic taps, such as Markwik 21+, with built in thermostats as near to the point of outlet as possible. This takes out the deadleg, and with the added benefit with Markwik 21+ of a self-draining spout, stagnant water is reduced to a minimum.
Narrow waterways To reduce stagnant water further, Markwik 21+ has been designed with narrow waterways which cut down on the amount of water in the tap by 34 per cent. The combination of narrower and smoother waterways means that water flows through the fitting faster and with more turbulence, making it more difficult for bacteria to stick when compared with traditional rough castings.
Antimicrobial materials Traditional outlets also have flow straighteners that can become contaminated over time and provide a haven for bacteria. Markwik 21+ mixers feature ‘BioGuard’, a patented copper- lined outlet that helps prevent biofilm attachment and reduces the risk of infection. The antimicrobial effect of copper has long been known. In fact, ancient civilisations exploited the antimicrobial properties of copper long before the concept of bacteria became understood. Within the cartridge itself, further attention has also been given to the materials being used in Markwik 21+. Unlike other thermostatic valves, the thermostat uses a minimal amount of plastic in favour of brass, another naturally antimicrobial material. Markwik 21+ fittings are now 85 per cent brass, with polymers reduced by 66 per cent compared with the previous models.
Armitage Shanks says the latest thermostatic taps address any criticisms levelled at, or issues with, such products.
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