Water Management Society Conference – 4th June 2013

Water Management Society are pleased to present a one day conference in London on 4 June 2013.

 

Re-circulating Closed Heating and Chilled Water Systems in Buildings. Meet the Experts.

 

Topics include:-

• Legal implications.

• System problems and solutions.

• Minimising risks.

• Monitoring.

• Updates from BSRIA.

• Corrosion issues.

• Factors affecting sampling and testing.

• Maintaining serviceability of water and heating systems.

• Requirements from early stage management system to building occupation.

 

Interested?

 

Booking form, full programme details, prices and venue information at conferences

Risk Assessment for Legionella – Do they Require a List of Every Outlet

Risk Assessment for legionella – A debate about whether every outlet should be included or documented.

We have been part of a debate about whether a list of every outlet is required to be included in the legionella risk assessment. The debate has been so interesting that we felt we had to blog about it.

Firstly it was really interesting the way the discussion morphed from – do you need a list of every outlet in the risk assessment, to do you need to check every outlet? Then do you need to record the temperature at every outlet and then to Point of use filtration which seemed to be a real curve ball in the discussion.

As such we thought it best to submit this blog for clarity of our opinions for the wider community and prospective clients.

Risk Assessment of outlets Point 1

The main purpose of a risk assessment is to assess the likelihood or potential for legionella bacteria to colonise and proliferate in the system, the potential for legionella to be disseminated in aerosol form and the subsequent risk of exposure including the susceptibility of those exposed. It should also provide actions to take to reduce the foreseeable risks identified.

If we are honest about the nature of our work, “in the real world” it is not always possible to gain access to every outlet at the time of survey. As such, the importance of access needs to be clarified upfront as failure to gain access to all of the water services will mean it is not possible to identify or list every outlet.

However, in our opinion the intentions of any good risk assessor must always be to visibly check and flush test every accessible outlet if possible. This action means each outlet is assessed for its potential to cause colonisation, (dead leg, broken, isolated, temp gain or loss etc) it’s potential to disseminate a breathable aerosol and it’s potential for subsequent exposure.

Failing to have this fundamental intention from the offset of the legionella risk assessment means there is a compromise in quality and the risk assessment process.

In line with the Legionella Control Association (LCA) standards for risk assessment, this type of issue should be discussed upfront with the client and an agreement documented on what is to be included in the risk assessment to demonstrate that a sufficient assessment has been done.

The Legionella Control Association requires documented clarification and a detailed scope of works to be drafted prior to the commencement of the works. This acts as an agreement between the client and service provider and will define the detail to be included in the risk assessment and indeed whether a full list of every outlet is required etc.

In real terms it is not enough just to say in compliance with L8 or BS8580! and to be totally frank, a very simple assessment without a full asset register can and has been in the past considered compliant by Regulatory Authorities.

In our opinion, the devil is in the detail and the detail should be identified in the agreed scope of works. In our opinion, it is the difference in the scope of works offered between organisations that can partly explain the variable prices available in the market. As such we feel the industry would benefit from a standard but very simple minimum scope of works to be included as part of a risk assessment agreement. In doing this we would have a unified scope from the Regulators that define clearly whether every outlet must or should be listed in the risk assessment.

In our opinion, whilst failing to gain access and list every outlet does not mean a poor assessment was done, we believe failing to try and gain access to every outlet does mean there is a compromise in quality and the risk assessment process. Therefore the intention of the risk assessor must always be to at least try to list every accessible outlet inspected.

An asset register and schematic should be produced where required not only to provide a guide on the system but also to confirm the assets identified and assessed as part of the survey. In our opinion a sincere attempt to must be made to collect and record this data within the risk assessment.

Again, missing assets can mean the assessor failed to gain access at the time of survey for a justifiable reason. Nonetheless where access was denied, not possible, or additional services are suspected to be present this needs to be stated in the report with a recommendation to facilitate access to certain identified restricted areas for assessment going forward.

Risk Assessment of outlets Point 2

Taking temperatures from every outlet is by no means absolutely essential particularly if you have already confirmed there is a single source. However any good Assessor will know and be aware that temperature checking every accessible outlet will provide them with a great deal of information about the system as a whole and the individual asset they are inspecting. It will indicate suspect areas of a system, any anomalies to be investigated further, and help to build a picture for the provision of rational recommendations in direct context to the site being risk assessed.

In our view, temperature checking every accessible outlet is one of the assessors most valuable tools whilst onsite and holds more importance for the Assessor to formulate the risk rating and rational recommendations than it does for the client.

Whilst a list of assets and temperatures may mean little to the client. This information is essential to enable the development of a control regime, schematics and provision of rational explanations and recommendations for actions or remedial works etc going forward.

All our assessments are initially priced to risk assess and temp check every asset and outlet where access is provided. This is only compromised where there is an agreement between the client and ourselves to curtail the requirement to do this whilst ensuring the assessment itself will still be deemed adequate.

Nonetheless there is a big difference between an adequate or sufficient risk assessment and a comprehensive one and what type is required should be clarified before works are undertaken. Further to this, there is naturally a difference in price between what is considered an adequate risk assessment and a comprehensive risk assessment

As such defining the scope of works prior to commencement of the assessment or as part of the proposal phase provides an agreed level of service between client and service provider.

The price offered by an organisation big or small should be based on the level of service provided and or expected and the expertise of the individual providing that service. With risk assessments the price is normally based on time allocated and expertise required to complete the job competently. The assessment process itself is typically a low overhead process regardless of the organisations size.

In real terms price should be defined by how much time and material or resource is spent executing the work from start to finish alongside expertise of the individual executing the work, additionally the margin the organisation needs to continue offering a progressive and effective service to the client should be considered and that’s about it.

When other factors creep in like greed (as it does for some) then it distorts the focus and purpose of the service and this is a different ball game altogether. Nonetheless we all know there are rouge traders out there so who you choose to conduct your risk assessment is a very important decision. In our opinion it is vital that the organisation is both independent and registered with the legionella control association as a minimum.

If any Organisation is worth its weight and understands its own liability in providing the risk assessment, then the assessment should always be sufficient enough to demonstrate compliance.

Curtailing the scope or works so far as to render the assessment useless increases the assessors and or organisations liability greatly so any curtailing from the standard fully comprehensive approach needs to be discussed up front and agreed by both parties.

In some cases the assessor or organisation may decline such work if the curtailing of essential elements mean the assessment will be useless or non compliant and this does happen.

However, like I said earlier a sufficient or adequate assessment does not necessarily mean a comprehensive one.

If I didn’t make it clear, price does not reflect quality. However, the execution of certain tasks as part of the assessment and identification and provision of certain issues and information included in the assessment does and considering that all assessors should be “competent” the time spent onsite to identify the issues is the thing that often makes the difference in report quality.

In an honest and ideal world, the time and resources needed and allocated to the work should be the fundamental issue that reflects the price paid.

The scope of work in our opinion is what defines the time and detail to be provided and needed to complete the service competently and therefore the scope will enable the organisation to price the work appropriately. Consequently the scope of works will normally always define the price to be paid.

This is why we say an industry standard scope of work for risk assessment would be useful from the Regulators to support the Industry. This would support organisations and assessors in ensuring that there is not this debate on whether you need to check every outlet or not or whether a temperature check should be done from every outlet or not. It would standardise the items that must be included as a minimum and allow for a more standardised pricing structure for the industry would product a minimum level of risk assessment quality.

In reflection of the debate it is easy to understand that the time it takes to check and list every outlet in a large hotel for example against checking an obligatory 10% the outlets which tends to be the minimum acceptable level when using a more pragmatic approach will have a significant reflection on the time spent doing the survey and subsequently the price.

Halls of residents or social housing for example can be priced to inspect and list every outlet or priced for the more pragmatic approach of 10% of outlets, rooms or apartments for example. The cost will be clearly defined by the strategy taken as this defines the time allocation needed to complete the service.

The time allocation can vary from a day or even a few hours to a week or months work for the same site depending on the scope and strategy being used and this is the point being raised within the industry as some companies will initially price to take a pragmatic approach and some a comprehensive one.

As such we think it is important for the client to understand upfront what type of service or risk assessment they require. Is a basic risk assessment, sufficient or adequate assessment required or is a more pragmatic approach needed due to the size of the portfolio or does the assessment need to be fully comprehensive. Understanding what type of assessment is needed should dictate the price the client is prepared to pay.

However, it is important to confirm that the strategy implemented or type of assessment needed will depend on the expertise and competence of the client and risk assessor or organisations involved. It will depend on the size of the portfolio or property and whether the 10% approach for example can be justified as reasonably practical in the context of the site.

If the client only requires a basic or adequate risk assessment to tick the box then this will be reflected in the price they are prepared to pay and believe us there are purchasers who are prepared to pay no more than £100 for the complete job! Unfortunately it is unlikely to provide a risk assessment that would be deemed adequate or comprehensive and simply not enough time could be allocated to the service at this price.

We cannot emphasise enough that there are many sub standard risk assessments out there but the industry should ask itself why. Is it because the assessors are incompetent? Is it because the client curtailed the requirements of the assessment due to budget constraints? Or is it because the organisation covertly cut corners to create the margin?

If you look deep enough into the service there is normally a reason for the poor risk assessments out there and from our experience it is often a combination of the above that result in the substandard risk assessments we see out there.

However, whilst we can all mud sling at one another and believe me it’s very easy to do so, the truth is that if the scope of works is defined prior to commencement of work, then the reasons for sub standard risk assessments would be much more obvious to the industry.

Risk Assessment for Legionella Bacteria

 

Legionella Free Christmas

Season’s Greetings to all and every one!

From Aqua Legion UK Ltd.Seasons Greetings from the UK Leading Legionella Company

 

 

Legionella Management in Sheltered Accommodation

Sheltered Accommodation Providers

Hi All,

Have you heard the storey about the Legionella positive results obtained from a sheltered accommodation block in Lincoln?

No one was infected, but drastic steps have been taken to prevent any of the 51 elderly residents catching the disease.

Well done to the Council, we take our hats off to you for implementing what seems to be the most robust safety measure of all which is to provide an alternative water supply! This step is normally considered the ultimate precaution, and if at the time the team considered this measure proportionate to the risk then who are we to say it was the wrong or right one.

However, thousands of samples and sites water supplies test positive and in some situations high count positives for Legionella every year but they seem to manage the situation without any infections, change of water supply or public notoriety.

Whilst any response that prevents an infection should be seen as a positive one. The response should be measured, effective and in our opinion discreet if possible. If managed properly a high positive count doesn’t necessarily need to mean likely to cause infection. For example, once the result was identified, if residents were prevented from any significant exposure to aerosol, then the likelihood of infection would be significantly reduced or even practically eliminated.

It would also be interesting to know whether the positive counts were found in the hot water supply, the cold water supply, mains supply or all of them as the measures implemented could be different for each.

There are also many products on the market today that can be used to disinfect water systems safely without major disruption to building occupants or the water supply. Whilst the appropriate product to use depends on the situation, it is quite possible to disinfect a system without evacuation or restriction on general domestic water use or even drinking.

Pasteurising hot supplies for example is a quick way of treating a hot water system that has a Legionella positive count. Simply turning the boilers and water heater thermostats up to 70°C and then circulating this hot water throughout the system and holding the temperature in the entire system at 70° for a minimum of one hour can eradicate Legionella.

Cold water systems can be treated with chemical disinfection products that allow the water services to remain live and in use. Once the bacteria is killed, further control measures could be put in place to conduct more deeper cleaning if particular areas have raised concerns.

By implementing the above, the only restrictions on water use during the process would be exposure to aerosol, and the exposure to very hot water, as such supervised water use or careful instructions to residents could be sufficient to keep everybody safe.

Maybe a few bottles of drinking water for any inconvenience during the “water hygiene management and disinfection works” would be a nice compliment but providing a complete alternative water supply is a major undertaking.

Providing an alternative supply of water can be a logistical nightmare and can create a bit of hysteria as residents begin to speculate. This in itself often creates unnecessary attention that can escalate to unwanted or needed notoriety.

The Legionella bug can be dangerous one and we all need to understand that. However with careful planning, a clear understanding of the risks and an effective control and risk management regime, it is possible to manage the risk of Legionella in a way that protects you, your organisation and visitors and occupants of the buildings you manage.

http://www.bbc.co.uk/news/uk-england-lincolnshire-20565875

 

Legionella Control – Cooper and Silver Ionisation

Copper ionization ban!

Are you prepared for the copper ionization ban to be imposed on the 1st February 2013. After the 1st February 2013 it becomes illegal to sell or use water treatment products or systems that add copper ions into the water as a biocide under new EU ruling.

However, it is understood that to ensure Legionella control is not compromised the HSE have stressed that it is essential systems continue to be suitably managed and maintained to control the risks. It is also understood that the HSE will pursue an “Essential use derogation” which will mean relaxations or appeals for use of copper for Legionella Control in the UK. Nonetheless, the decision for special use is unlikely to be heard in time for the ban not to be implemented.

There are many organisations using copper and silver ionization techniques to control Legionella in their water systems. To simply switch them off after this date would be a real difficult decision.

We suggest you review your current water treatment programme and determine whether this could affect you. If so speak to your water treatment contractor who will help to put an alternative measure or system in place.

Your water treatment contractor should be able to advise you of the steps to take in the interim between the 1st February and the essential use appeal.

The main thing will be to ensure if necessary alternative measures are put in place that doesn’t compromise the control regime. Good luck to all those 1000’s who may need to think about an alternative for the cooper and silver ionisation systems they installed.

Silver survives!

It’s important to highlight that the use of silver ions in water as a disinfectant is still allowed.

Current cooper and silver ionisation systems could become compliant by simply removing the copper ionisation element/ process of the water treatment regime leaving the silver ions to provide the biocide effect.

Whilst this is likely to reduce the biocidal and particularly the biofilm prevention/ penetration element of the product it should still offer a level of protection.

However, it will be important that silver levels do not exceed those acceptable in drinking water. Products such as silver hydrogen peroxide can and will still be used on domestic water services and in drinking water services so long as the system is flushed so silver levels are less than 0.1mg/l.

 

London at risk of ‘catastrophic’ legionnaires’ outbreak, report says

Leaked HSE report by inspectors before 2012 Olympics highlights danger of poor management of cooling towers

London could experience an outbreak of legionnaires’ disease with potentially “catastrophic consequences” for people’s health because of poor management of cooling towers and evaporative condensers near busy transport hubs and Olympic venues, according to a leaked Health and Safety Executive (HSE) report.

The stark warning is contained in a report by the HSE detailing the results of inspections for the presence of the legionella bacteria, which causes the disease, at 62 sites around the capital, carried out by its inspectors as part of the safety preparations for this summer’s Olympic Games.

Inspectors visited sites “within two kilometres of London-based Olympic venues and certain major travel hubs, namely Heathrow airport, London City airport, London Bridge station and St Pancras train station”, as well as all sites under the HSE’s remit in the central London borough of Westminster, according to the report entitled Olympic Legionella Project, dated “spring/summer 2012″.

It reveals that compliance with health and safety requirements was inadequate at almost three-quarters of the sites. “The headline to arise from this project is the poor level of compliance. In percentage terms 73% of sites were in receipt of enforcement notices or written/verbal advice,” it says.

Noting that “there appears to be no logical reason why compliance is poor”, it then refers to the previous outbreaks of legionella and the relevance of the Corporate Manslaughter and Corporate Homicide Act for management of risk. It then states: “The potential of any outbreak in terms of numbers of people infected and potential for prosecution on both an individual or corporate basis is well known.”

Then, noting the problems inspectors uncovered and potentially poor management of cooling towers and evaporative condensers by facilities management companies, it adds: “Taken together with the increased turnover of FM companies leading to management responsibilities changing, it could be speculated that scenarios are occuring where an outbreak could happen [in London]. This will have catastrophic consequences compared to Edinburgh given it is the area with the most footfall within the country.”

Three people died and almost 100 others fell ill, with several ending up in intensive care in hospital, in the Scottish capital in June this year in an outbreak of legionnaires’ disease linked to cooling towers in the south-west of the city.

The HSE’s report, obtained by Environmental Health News (EHN) magazine, appears to be warning that London could experience a much greater loss of life than Edinburgh because of the large number of people who use the transport hubs inspected in the capital.

An outbreak of legionnaires’ disease in Stoke-on-Trent in July, which was linked to a hot tub display, led to 21 people becoming infected and two deaths. The disease is an uncommon but severe form of pneumonia. Smokers and anyone with a weakened immune system is at higher risk.

Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen, told EHN that the still unpublished HSE report showed that urgent action was needed to minimise the risk to Londoners.

“A great pity that the HSE Olympic Project Report has not yet been published. It is a powerful wake-up call for action to rectify the long list of deficiencies found regarding the management of the legionella risk from cooling towers, particularly in the public sector. But for the grace of God there hasn’t been an outbreak in London – yet. Urgent action is needed. Legionella kills – but it is preventable,” Pennington said.

The HSE initially identified 106 sites for inspection. Of those, 62 were HSE-enforced sites which had active wet cooling towers and evaporative condensers, 31 were decommisisoned or not in use, four were embassies “where enforcement was a grey area” and the other nine were due to be inspected by local council officials.

Of the 62 sites its staff visited, 11 were issued with improvement notices over issues such as access problems, insufficient risk assessment and poor monitoring or management. It issued written advice in relation to another 30 sites and verbal advice to eight others. But only one site was being considered for prosecution, the report says.

Compliance was “poorer” among the 43 sites it visited that were owned by the public sector than among the 19 private sector sites, the report notes.

The HSE told EHN that the warning of a catastrophic outbreak was unfounded. “This was a comment made by the inspector who drafted the report, based on speculation and personal opinion. It is not one that is backed up by research or evidence,” a spokesperson said.

Formal enforcement action in the form of notices was needed at fewer than 10% of the sites visited, the HSE added.

“Most of this enforcement related to the provision of safe means of access for staff and contractors involved in the monitoring and maintenance of the cooling towers and evaporative condensers, rather than being related directly to legionella management. Verbal and written advice is generally given where it has been identified that improvements can be made and standards raised, but where people are not being put at serious risk,” said the spokesperson.

A “final version” of the report would be published, the HSE said.

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London at risk of ‘catastrophic’ legionnaires’ outbreak, report says

Leaked HSE report by inspectors before 2012 Olympics highlights danger of poor management of cooling towers

London could experience an outbreak of legionnaires’ disease with potentially “catastrophic consequences” for people’s health because of poor management of cooling towers and evaporative condensers near busy transport hubs and Olympic venues, according to a leaked Health and Safety Executive (HSE) report.

The stark warning is contained in a report by the HSE detailing the results of inspections for the presence of the legionella bacteria, which causes the disease, at 62 sites around the capital, carried out by its inspectors as part of the safety preparations for this summer’s Olympic Games.

Inspectors visited sites “within two kilometres of London-based Olympic venues and certain major travel hubs, namely Heathrow airport, London City airport, London Bridge station and St Pancras train station”, as well as all sites under the HSE’s remit in the central London borough of Westminster, according to the report entitled Olympic Legionella Project, dated “spring/summer 2012″.

It reveals that compliance with health and safety requirements was inadequate at almost three-quarters of the sites. “The headline to arise from this project is the poor level of compliance. In percentage terms 73% of sites were in receipt of enforcement notices or written/verbal advice,” it says.

Noting that “there appears to be no logical reason why compliance is poor”, it then refers to the previous outbreaks of legionella and the relevance of the Corporate Manslaughter and Corporate Homicide Act for management of risk. It then states: “The potential of any outbreak in terms of numbers of people infected and potential for prosecution on both an individual or corporate basis is well known.”

Then, noting the problems inspectors uncovered and potentially poor management of cooling towers and evaporative condensers by facilities management companies, it adds: “Taken together with the increased turnover of FM companies leading to management responsibilities changing, it could be speculated that scenarios are occuring where an outbreak could happen [in London]. This will have catastrophic consequences compared to Edinburgh given it is the area with the most footfall within the country.”

Three people died and almost 100 others fell ill, with several ending up in intensive care in hospital, in the Scottish capital in June this year in an outbreak of legionnaires’ disease linked to cooling towers in the south-west of the city.

The HSE’s report, obtained by Environmental Health News (EHN) magazine, appears to be warning that London could experience a much greater loss of life than Edinburgh because of the large number of people who use the transport hubs inspected in the capital.

An outbreak of legionnaires’ disease in Stoke-on-Trent in July, which was linked to a hot tub display, led to 21 people becoming infected and two deaths. The disease is an uncommon but severe form of pneumonia. Smokers and anyone with a weakened immune system is at higher risk.

Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen, told EHN that the still unpublished HSE report showed that urgent action was needed to minimise the risk to Londoners.

“A great pity that the HSE Olympic Project Report has not yet been published. It is a powerful wake-up call for action to rectify the long list of deficiencies found regarding the management of the legionella risk from cooling towers, particularly in the public sector. But for the grace of God there hasn’t been an outbreak in London – yet. Urgent action is needed. Legionella kills – but it is preventable,” Pennington said.

The HSE initially identified 106 sites for inspection. Of those, 62 were HSE-enforced sites which had active wet cooling towers and evaporative condensers, 31 were decommisisoned or not in use, four were embassies “where enforcement was a grey area” and the other nine were due to be inspected by local council officials.

Of the 62 sites its staff visited, 11 were issued with improvement notices over issues such as access problems, insufficient risk assessment and poor monitoring or management. It issued written advice in relation to another 30 sites and verbal advice to eight others. But only one site was being considered for prosecution, the report says.

Compliance was “poorer” among the 43 sites it visited that were owned by the public sector than among the 19 private sector sites, the report notes.

The HSE told EHN that the warning of a catastrophic outbreak was unfounded. “This was a comment made by the inspector who drafted the report, based on speculation and personal opinion. It is not one that is backed up by research or evidence,” a spokesperson said.

Formal enforcement action in the form of notices was needed at fewer than 10% of the sites visited, the HSE added.

“Most of this enforcement related to the provision of safe means of access for staff and contractors involved in the monitoring and maintenance of the cooling towers and evaporative condensers, rather than being related directly to legionella management. Verbal and written advice is generally given where it has been identified that improvements can be made and standards raised, but where people are not being put at serious risk,” said the spokesperson.

A “final version” of the report would be published, the HSE said.


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Inspection cutbacks could lead to deadly legionnaire’s outbreaks

Proactive checks on potential legionella breeding grounds have halved in three years, says UK health and safety watchdog

Inspections of sites identified as potential breeding grounds for legionnaires’ disease have almost halved over the last three years.

The sharp decline has resulted in warnings that cutbacks are having a damaging effect on public health and comes as officials continue to investigate several outbreaks of the disease, including one last month in Stoke-on-Trent in which two people died.

There has been a 44% fall in the number of inspections into legionella – the bacterium that causes the disease – carried out by the Health and Safety Executive since 2009. The total level of proactive inspections fell from 833 in 2009 to 464 in 2011.

Proactive inspections are carried out at sites that are considered to be at high risk of causing an outbreak of the disease, which is spread through infected water sources, particularly industrial cooling towers and air-conditioning systems. According to the HSE, 90% of outbreaks in the past 10 years were caused by businesses failing to identify risks and implement effective control measures.

There are around 5,800 cooling sites in the UK, of which 2,900 undergo inspections by the HSE. The number of legionella inspections at cooling towers carried out by the HSE fell from 237 in 2010 to 134 in 2011, according to the figures released to Environmental Health News.

Graham Jukes, chief executive of the Chartered Institute of Environmental Health, warned of a “ticking time bomb”. He said: “My concern is that, over time, we will see increases in the number of accidental deaths or outbreaks of disease that could be prevented from proactive actions.”

In June more than 100 people in Edinburgh contracted legionnaires’ disease in an outbreak believed to have stemmed from a cooling tower. Three people died. A leading bacteriologist, Professor Hugh Pennington, has called for a public inquiry into the outbreak and a “root-and-branch” review of regulatory policy.

He described the fall in inspections as “highly unsatisfactory”. He added: “The great majority of cooling towers can only be having inspections once every 10 years, some probably less.”

The number of deaths from legionnaires’ disease has halved over the past three years but Pennington said this had been achieved through improvements in intensive care.

A spokeswoman for the HSE said it was the responsibility of operators of cooling sites to ensure they did not pose a risk to public health and that inspections were only one of a number of measures deployed in combating disease. She said the figures related only to legionella-focused inspections and did not include general inspections that might also reveal the bacteria.

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Inspection cutbacks could lead to deadly legionnaire’s outbreaks

Proactive checks on potential legionella breeding grounds have halved in three years, says UK health and safety watchdog

Inspections of sites identified as potential breeding grounds for legionnaires’ disease have almost halved over the last three years.

The sharp decline has resulted in warnings that cutbacks are having a damaging effect on public health and comes as officials continue to investigate several outbreaks of the disease, including one last month in Stoke-on-Trent in which two people died.

There has been a 44% fall in the number of inspections into legionella – the bacterium that causes the disease – carried out by the Health and Safety Executive since 2009. The total level of proactive inspections fell from 833 in 2009 to 464 in 2011.

Proactive inspections are carried out at sites that are considered to be at high risk of causing an outbreak of the disease, which is spread through infected water sources, particularly industrial cooling towers and air-conditioning systems. According to the HSE, 90% of outbreaks in the past 10 years were caused by businesses failing to identify risks and implement effective control measures.

There are around 5,800 cooling sites in the UK, of which 2,900 undergo inspections by the HSE. The number of legionella inspections at cooling towers carried out by the HSE fell from 237 in 2010 to 134 in 2011, according to the figures released to Environmental Health News.

Graham Jukes, chief executive of the Chartered Institute of Environmental Health, warned of a “ticking time bomb”. He said: “My concern is that, over time, we will see increases in the number of accidental deaths or outbreaks of disease that could be prevented from proactive actions.”

In June more than 100 people in Edinburgh contracted legionnaires’ disease in an outbreak believed to have stemmed from a cooling tower. Three people died. A leading bacteriologist, Professor Hugh Pennington, has called for a public inquiry into the outbreak and a “root-and-branch” review of regulatory policy.

He described the fall in inspections as “highly unsatisfactory”. He added: “The great majority of cooling towers can only be having inspections once every 10 years, some probably less.”

The number of deaths from legionnaires’ disease has halved over the past three years but Pennington said this had been achieved through improvements in intensive care.

A spokeswoman for the HSE said it was the responsibility of operators of cooling sites to ensure they did not pose a risk to public health and that inspections were only one of a number of measures deployed in combating disease. She said the figures related only to legionella-focused inspections and did not include general inspections that might also reveal the bacteria.


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Legionnaires’ disease outbreak in Staffordshire blamed on hot tub

Samples taken from tub at JTF Mega Discount Warehouse in Stoke-on-Trent match those from patients

Health authorities say a hot tub is the “probable” source of an outbreak of legionnaires’ disease in Staffordshire.

Samples taken from a tub at the Stoke-on-Trent branch of the JTF Mega Discount Warehouse match those taken from patients with an unusual strain of the bacteria responsible for the disease. There have been 18 cases linked to the outbreak. One person has died.

A statement from the firm, which has 11 branches across the Midlands and north of England, said it was “extremely concerned by this incident”, and had worked closely with authorities to eliminate any further risk. The product has been withdrawn from all stores.

Seven people are in hospital in Stoke-on-Trent and another is in a stable condition in hospital in Leicester, health agencies said on Monday. The tub was “decommissioned” on Tuesday as investigations were launched across the city to identify the possible source of the outbreak. Cooling towers, air conditioning systems and other potential sites of infection have also been checked.

Specialists from the Health and Safety Executive and Stoke-on-Trent council are continuing to take samples from sites across the city.

The probable link with the spa tub was established by the specialist laboratory of the Health Protection Agency (HPA), the NHS’s main public health body, late on Sunday. Sue Ibbotson, the agency’s regional director, said: “We have the evidence from DNA fingerprinting of samples from the hot tub and the patients being caused by the same previously unseen strain of legionella.

“The HPA also took detailed histories from the confirmed cases and we know that 17 of the 18 confirmed cases visited this warehouse in the two weeks before they fell ill. Added to that we know that spa pools are known to be effective mechanisms for spreading legionella infection.

“We may still expect to see new cases of legionnaires’ disease related to this outbreak. JTF Warehouse decommissioned the hot tub on 24 July. It can take up to two weeks following exposure for people to develop symptoms of legionnaires’ disease and a further few days before they go to see their GP.”

Zafar Iqbal, director of public health for the NHS in Stoke, said: “It’s good news that we have a probable source, especially as we know that it has been dealt with through precautionary measures last week.”

Those in hospital are all said to be in a “stable and improving” condition.

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