Implementing an Effective Legionella Management Programme

What is the price of not implementing an effective Legionella management programme in your hospital? A loss in reputation, a loss of life, and after an April 2018 verdict, £300,000.

The HSE consider the health, social care and leisure industries as key sectors due to the nature of their water systems which often include cooling towers, air conditioning units and domestics, are high risk systems. Along with this, those most at risk of contracting Legionnaires disease, the elderly, young people and those in ill health, are more likely to occupy public sector buildings such as healthcare centres, schools and hospitals, making these sectors a high-risk environment.

Due to this high-risk environment, it is vitally important that public sector buildings such as healthcare centres, schools and hospitals have an effective Legionella management programme in place to protect the people in their care, the key word being effective. In a 2015 case at a UK

legionella testing

Biochemica Water technical expert tests temperatures

hospital, despite the risk of bacterial growth being outlined, the management programme in place was ineffective, resulting in the death of a patient who contracted Legionnaires disease whilst in the care of the hospital. The patient was being treated for cancer and was housed in an annexe which was on a separate loop of the hospitals water system to that which supplied the main ward. The hospital had been warned to update plans for its water distribution system, but the work had not been carried out and no temperature checks and tests had been taken in the annex for 6 years. In April this year the hospital was found to be liable for the patient’s death, resulting in a £300,000 fine.

It is absolutely essential that a risk assessment is carried out on a building at least every two years, if not every 12 months in a high-risk building or where there have been significant changes to the water system or its uses. This will outline which systems are at risk of bacterial growth and what actions should be taken to prevent a Legionella outbreak. Although, as in the above case, completing a risk assessment crosses another task off the to do list but if the recommendations are not carried out there is still a risk, and if there is an outbreak the duty holder can be liable for any deaths.

Legionella bacteria grows in stagnant water at an optimum temperature of 20C – 45C and can be contracted as legionnaires disease through inhalation of contaminated aerosols, in conjunction with water sprays, jets or mists. A risk assessment will uncover what systems are most likely to provide the conditions above and provide recommendations to prevent the growth of Legionella bacteria. Common recommendations to prevent Legionella growth could be physical remedial works such as changing the pipework and removing dead legs, introducing a monthly temperature monitoring regime which will make sure systems are working at their optimum temperatures and not providing a 20C – 45C breeding ground for bacterial growth and flushing rarely used outlets to get rid of the contaminated water.

If any of the above recommendations had been carried out at the aforementioned hospital, the annexe would have been a safe environment for the patient and could have saved the hospital £300,000 and more importantly saved a person’s life. This case highlights the importance of having a highly effective Legionella management programme in place to protect those in the care of the duty holder.

If you would like to review your risk assessment and discuss recommendations contact