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Managing and Controlling the Risks of Legionella in Care Homes

Legionella bacteria is commonly found in water and especially in purpose-built water systems such as cooling towers, evaporative condensers, hot and cold water systems and spa pools as well as water fountains. The bacteria can multiply where water temperatures are between 20-45°C whereas the bacteria is normally dormant below 20°C and does not usually survive above 60°C.

Legionnaires’ disease is a potentially fatal type of pneumonia, contracted by inhaling airborne water droplets containing viable Legionella bacteria. Such droplets can be created, by hot and cold water outlets, atomisers, wet air conditioning plant, and whirlpool or hydrotherapy baths.
Anyone can develop Legionnaires’ disease, but the elderly and those with cancer, diabetes or chronic respiratory or kidney disease are at more at risk.
So how can Legionella be prevented and what measures need to be undertaken by care homes to control and or eliminate the likelihood of catching this life threatening disease?.

First of all, the health and social care providers should carry out a full risk assessment of their hot and cold water systems and ensure adequate measures are in place to control the risks.
The primary control measure would be to check the water temperature from the sentinel taps and ensure:
• Hot water storage cylinders (calorifiers) should store water at 60°C or higher
• Hot water is distributed at 50°C or higher (thermostatic mixer valves are fitted as close as possible to outlets, where a scald risk is identified).
• Cold water is stored and distributed below 20°C.

It is recommended that ‘sentinel’ outlets (furthest and closest to each tank or cylinder) are checked at least monthly for the distribution temperatures. One should also check the hot water storage cylinder temperatures at least once a month and cold water tank temperatures at least every six months.
Stagnant water which can be prevalent on dead legs favours Legionella growth. To reduce the risk one should remove dead legs/dead ends in pipe-work, flush out infrequently used outlets (including showerheads and taps) at least weekly and clean and de-scale shower heads and hoses at least quarterly. Cold-water storage tanks should be cleaned periodically and water should be drained from hot water cylinders to check for debris or signs of corrosion.

It is also important to ensure that systems are designed in order to minimise Legionella growth. This can be achieved by:
• Keeping pipe work as short and direct as possible;
• Ensuring there is adequate insulation carried out in pipes and tanks;
• The use of materials that discourage growth of Legionella;
• Ensuring contamination is prevented for example by fitting tanks with lids and insect screens.

Additional recommended controls should ensure that Water samples are taken periodically and analysed by approved Laboratories to determine Legionella bacteria counts remain at an acceptable level. The testing frequency should be determined by level of risk, in accordance with the risk assessment.
Other methods to control Legionella include copper and silver ionisation and biocide treatments (eg chlorine dioxide). To ensure that they remain effective their application will need suitable assessment as part of the overall water treatment programme including proper installation, maintenance and monitoring.

How can we help:
Stansted Laboratories is independent and has been in operation for over 25 years and is accredited by the United Kingdom Accreditation Service (UKAS) to the norm ISO/IEC 17025:2005. We meet the market’s environmental analytical services and provide these to a diverse group of companies. Our services include Microbiological Analysis of Water & Air including Legionella testing and Bacteriological analysis. In addition we do chemical analysis of water and trade effluent and Legionella Risk Assessments, the latter through our trusted partners who check all water systems (plant/equipment and associated components) and test to ensure compliance with the law.
Stansted Laboratories personnel offer a high level of technical expertise and consultancy. We are differentiated by our independence and versatility, allowing us to adapt to the characteristics of every customer and respond to the demands of each specific sector. Our customers can trust in a high performing workforce which has many years of experience carrying out sample testing to meet strict legal requirements. Our Laboratories are equipped with state-of-the-art instrumentation and testing facilities to enable a speedy multi component analysis with results quickly available through our secure online portal.
Our analytical services follow very simple values:
• Service: using the latest equipment to provide accurate trustworthy results
• Competence: unparallel technical experience
• Commitment to quality
• Continuous development of services both in terms of efficiency and cost effectiveness

Contact us for any enquiries or clarification on any aspect of the above or for all your water testing requirements
Tel: 020 8594 5104
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