WATER SYSTEM HYGIENE AND SAFETY
‘Innovative alternatives’ to cistern-flush WCs
An increase in cases of Legionnaires’ disease in the UK has prompted research into toilet cisterns as a potential source of infection. Eve Wellard, Marketing and Communications manager at Delabie, looks at some of the innovative alternatives to cistern-flush WCs in mental healthcare facilities, to prevent the problems associated with stagnant water.
One of the primary concerns in mental healthcare facilities is keeping the users comfortable, safe, and infection-free during treatment. They may be experiencing a wide range of differing symptoms, and it is important that they be afforded space and privacy during recovery. For this reason, it is important that intervention be kept to a minimum. Is it possible to limit infection risk, while also reducing maintenance? First of all, it is important to assess
where the risks are presented. Typically, infection control in mental health facilities, and in healthcare in general, is concentrated on taps and showers, and there is little awareness of other contamination sources. Toilet cisterns must also now be recognised as a potential source of infection, as they contain around 9 litres of water stagnating at room temperature. Scale and rust build- up results in biofilm, providing an ideal environment for bacterial proliferation.
Risk from toilets intensifies In mental healthcare facilities this risk intensifies if the toilet is also used to dispose of vomit and faecal deposits when a resident becomes unwell. Until recently, very few studies have been able to provide an accurate picture of the situation, and there has been a lack of viable alternatives to the cistern-flush system. Received wisdom suggests that when we flush the toilet harmful pathogens are flushed away, and that regular cleaning will remove any bacteria from contaminated surfaces. However, in 2015 an American study reinforced the hypothesis that flush toilets play a role in the airborne transmission of infectious disease by producing microbe- contaminated bioaerosols when flushed.1 According to new research,
Legionnaires’ disease can be spread through toilet flushing, which releases invisible aerosol ‘plumes’ of contaminated water bioaerosols up to 1.5 m into the air.2
These bacteria can also spread back
through the pipes and colonise the system. This poses a severe risk to vulnerable
people, as seen in a Parisian hospital, where two patients contracted Legionnaires’ disease through inhaling
38 NOVEMBER 2024 | THE NETWORK
contaminated toilet water that was aerosolised during flushing.3
The hospital
found that the epidemiological source of infection was the toilet cistern, as Legionella bacteria was found in the room’s toilet bowl water, but not the room’s shower or sink. Cisterns increase the contamination risk because water is stored at ambient temperatures in ideal conditions for biofilm development. This, in turn, provides a safe haven for bacteria such as Legionella to develop.
Right: A self-supporting fire retardant Tempofix 3 frame system for WCs.
Below: Delabie’s Tempomatic direct flush WC. The company says that with no cistern, the direct flush WC system avoids both water stagnation and build-up of scale or impurities in the installation.
Inset: The recessed waterproof housing for Tempomatic WCs.
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