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ELAINE WAGGOTT - DIRECTOR OF OPERATIONS, ANGEL GUARD, UK WATER SYSTEM SAFETY


Reducing waterborne pathogens in premises


Bio-aerosols containing harmful pathogens can come from a number of apparatus within healthcare premises including showers, taps, washbasins, sinks, and toilets. This article explains the risks of waterborne pathogen risk in healthcare premises and outlines how to prevent it.


The need to reduce the risks of splashing and airborne pathogenic aerosol has never been more important. In the wake of COVID-19 recent research findings have starting to confirm what many already suspected – that COVID-19 acts like many existing pathogens in the ways it can be transmitted via water-borne particles and poor hand hygiene. Unacceptable levels of sickness and


deaths have long been associated with poor hand hygiene, close contact with infected people and inadequate cleaning. In many countries, initiatives addressing education, cleaning and audit, together with compulsory reporting of infections, have brought about benefits leading (in some cases) to the reduction of headline rates of infections, such as methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. difficile) and Legionnaires’ disease. It is now readily accepted that a common mode of transmission is contact between the patient, the staff and the environment. Inappropriate hand hygiene practice has been identified as a significant contributor to numerous disease outbreaks. Several studies have shown the impact of improved hand hygiene on the risk of healthcare associated infection and multi- resistant pathogen cross-transmission. To date, most studies have focused on MRSA. Bacteria present on human skin can be considered as belonging to one of two


How coronavirus is spread through aerosol through the air.


groups: resident and transient flora. Transient flora colonises the superficial layers of the skin. It has a short-term persistence on skin, but a high pathogenic potential. It is usually acquired by healthcare workers during direct contact with patients or contaminated environmental surfaces adjacent to the patient, and is responsible for most healthcare associated infections and spread of antimicrobial resistance resulting from cross-transmission. Resident flora is attached to deeper


skin layers and has a low pathogenic potential unless introduced into the body by invasive devices. It is also more difficult to remove mechanically. Hand hygiene decreases colonisation with transient flora and can be achieved either through hand washing or hand antisepsis.1 While this and other studies have


Elaine Waggott


Elaine is director of operations for both of Angel Guard and Water Kinetics. Over the last three years, Elaine has been fully involved in the setting up of both of companies having just launched cutting-edge and highly innovative plumbing products. Elaine began her working career working in the building and


construction sector and co-owned a distribution company by the age of 24. Elaine is Six Sigma trained, has written articles for


newspapers and magazines, been editor of a leadership magazine, and has done both television and radio work. Elaine has extensive experience in public speaking and has recently been awarded membership of the Royal Society of Public Health.


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shown that outbreaks can be reduced by improved hand hygiene compliance and better cleaning of the environment. Transmission of infection by the air has often been less well investigated, leading sometimes to a complacency in this mode of transmission. It has been proven already that


norovirus can be transmitted by aerosol and is difficult to contain in a hospital ward without sufficient single rooms with ensuite toilets. Now with the additional battle against COVID-19, the transmission by aerosol now needs to be urgently considered and the risks substantially reduced.


Although the direct transmission from


infected person(s) is the primary source of aerosols and droplets, other scenarios such as medical procedures, surgeries,2 fast-running tap water and toilet flushes3 also generate aerosols contaminated with infectious pathogens. The most common types of viruses causing infections in the respiratory tract through aerosol transmission are influenza viruses, rhinoviruses, coronaviruses, respiratory syncytial viruses, and parainfluenza viruses.4


Some articles have postulated


three modes in which the influenza virus can be transmitted: aerosol transmission, droplet transmission, and self-inoculation of the nasal mucosa by contaminated hands. Historically, natural ventilation was seen


to be beneficial in hospital wards and was part of hospital design. With the advent of sealed high-rise buildings and forced ventilation, expensive negative pressure rooms have been sometimes been introduced to house patients with infections thought likely to be transmitted by aerosol. Aerosols can be defined as liquid or solid particles suspended in the air by humans, animals, instruments, or machines. Bio-aerosols are aerosols consisting of particles of any kind of organism. The characteristics of bio- aerosols differ depending on


IFHE DIGEST 2021


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