Preventing Legionella Bacteria in Healthcare Water Systems
Few of us would bother to think about the quality of the water that comes out of our taps, showers, and other outlets. We think little – if anything – of it at home, and probably don’t give such matters a second thought if we are anywhere else either.
However, maintaining good and safe water quality is an integral part of operating any building, be it a home, office or hospital. In this article, we’re going to look at how to keep waterborne bacteria such as legionella under control, specifically in hospitals and general healthcare settings. Such locations pose greater risks from Legionella bacteria and outbreaks of Legionnaires’ disease owing to several factors. Those present in hospital settings may be in poor health or be older, falling within one or two at risk groups associated with Legionnaires’ disease.
Let’s see where the risks from legionella lie in hospitals and healthcare settings and focus on what can be done to mitigate such risks. Some elements are more obvious than others, but by recognising and adopting them all, we can help maintain a safe water system within any healthcare setting.
Focusing on water temperatures to prevent legionella in healthcare
Ensuring the water stored or used in a hospital is at the correct temperature is a sensible place to start, as Legionella bacteria can easily multiply and spread if given the chance. The bacteria can most easily do this with water temperatures between 20 – 45 degrees Celsius. Keeping cold water below the lower limit and hot water above the range minimises the chance of Legionella bacteria being able to colonise a water system. Hot water storage should be at 60 degrees Celsius as a minimum, while hot water at outlets should be delivered at 55 degrees Celsius. Cold water should always be below the 20-degree legionella growth zone.
The legionella growth range you must avoid is 20 – 45 degrees Celsius
Regular testing of hot and cold water temperatures should occur at different places in the system and the results recorded. This helps identify where there are any risks, and whether adjustments need to be made. It can also help alert those in control of the water system whether there are any other issues that might be present. If the temperature of any part of the water system is found to be outside of the ideal hot or cold range, further testing may be required.
Flushing little used outlets and areas of the water system that are infrequently used
A legionella risk assessment can help identify areas of low water flow, and those water outlets and pipes that are far less commonly used. If a particular outlet such as a shower or area of pipework is no longer in use, this should be removed to get rid of the risk. However, if occasional usage is identified, a regular process of flushing through the water in these pipes and outlets will be required. This helps to keep the water moving and avoid stagnation, making it much more difficult for biofilm (slimy colonies of bacteria) to form inside the pipes and outlets. Furthermore, it makes it much harder for legionella, pseudomonas and other bacteria to establish and colonise that part of the system.
Keeping your water, plumbing systems and outlets clean and legionella free
We mentioned biofilm above, and how regular flushing through of little-used used outlets can help prevent the build-up of such biofilms. However, regular cleaning is another tool that can be used to help prevent this.
If outlets, pipes or storage tanks become scaled up as a result of hard-water, there is an increased risk from legionella. Indeed, limescale works just as well as a biofilm, providing legionella and other waterborne bacteria with the opportunity to establish themselves within that area.
The nature of the cleaning processes used in a hospital water system will depend on the individual system and the area in question. For example, it is relatively easy to disassemble a shower head and to clean and de-scale the separate parts before putting it all back together again. However, the pipework that forms part of the water system would require a different approach.
It can help to regularly sample the water for legionella and other bacteria at several points in the system, enabling you to see the exact composition of the water. Such sampling, done by a professional such as Water Treatment Services, could also help identify whether some areas are in greater need of cleaning or treatment than others. Even something as simple as whether the water system is in a hard or soft water area can make a difference to the subsequent approach taken. Water samples can also help provide a more specific approach to treating the water in individual water systems, since no two systems are ever identical. Many factors can affect the overall health and cleanliness of a water system in a hospital or healthcare setting.
Water treatment for hospital water systems
Treating a hospital water system requires extensive knowledge and expertise. The person in control of managing a hospital water system (indeed, any water system), referred to as the Responsible Person should have such knowledge. If this is not the case, it is prudent to ensure that suitable training is carried out and to enlist the services of someone who does.
The role of the Water Safety Group
Furthermore, a Water Safety Group should be formed to take overall responsibility of all such matters and to develop a site-specific Water Safety Plan. A Water Safety Group is typically made up of several individuals who are supported by an independent water safety expert. Each member of the group will have specialist knowledge of the part of the hospital they are working in. For example, someone with specific infection control experience working in certain areas would have specialist knowledge about that area and the heightened risks that may be present.
One example might involve someone working on a specific ward or with the elderly. They know how the water system is used in that area each day and can therefore highlight certain risk factors others may not think about.
Understanding water safety risks in healthcare settings
We can see that risk assessment, good water hygiene, temperature and the frequency of use of outlets and pipework form crucial parts of the water safety process in a hospital or other healthcare setting. Reducing the legionella risks associated with biofilms, disused or little-used outlets, low-flow conditions, bacterial colonisation, and so on can help maintain a much safer water system, and so keep people safe.
Even with relevant experience and qualifications in managing a safe water system, it can be beneficial to seek advice from an expert in dealing with legionella, water hygiene and safety. A specialist company or individual Authorising Engineer (AE) like this can also contribute to the Water Safety Group, and development of a Water Safety Plan, providing information and advice on how to maintain the system’s safety.
In every case, a Water Safety Plan can help improve the safety of a water system. Furthermore, an expert AE can highlight topics that may go unnoticed among other members of the Water Safety Group. In this sense, seeking professional advice from an outside party can be a major benefit, in many ways.
Expert Water Treatment and Water Safety Solutions
Water Treatment Services provide a comprehensive range of water and wastewater treatment, water quality analysis, consultancy, and water engineering solutions to support business owners and those responsible for the safe and efficient operation of water systems in the workplace.
Contact us today to learn how our water treatment specialists can help you manage your water systems, maintain regulatory compliance, and ensure safe, reliable performance.
With offices in London serving the South and South East England, Manchester (North West), Birmingham (Midlands), Bristol (South West England and Wales), Leeds (North and North East), and Glasgow (Scotland), supported by regional teams of highly trained technicians and engineers, we deliver specialist consultancy, water quality analysis, engineering support, and risk management solutions across the UK and internationally.
