Fighting Legionella: Lessons from more than 100 hospitals and healthcare facilities

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Information about Fighting Legionella: Lessons from more than 100 hospitals and healthcare...

Published on September 4, 2015

Author: Hydrochem

Source: slideshare.net

1. ‘x FIGHTING LEGIONELLA LessmLs-front more than 100 hospìlalxs and henllhcarefmrililies "' ' ' r " "24’ - _ , ‘— f - _ ' » ' / .f— ‘i ’ ‘ " C / s a f «Q: ‘k ’ ù- . .. ‘ — Jr J’ wwìîfib 3,0 c I-I-EeÌÌ-rcnllufi u. ‘ il? ’ ' "' g} _ î’ , - N ag ‘ h» , '_r _ ì _ , _*o / - '503” -1 . o I "9", J. “

2. Healthcare facilities are recognised worldwide as high-risk Iocations for Legionnaires disease outbreaks.

3. L: 5:5, a . ... i _ _, :.— . . _ I , . . . .3 N . .. .8. .11111.. _u111<1.a))42JJ)J/ J// )/. /./ /// É/nr uV. m. .. _ i3 2E a . 55.. ... . . .. _ _ .5 van: 5.2.5555 5.55.55 îz5i/ fiuwuozfiywfi 5 M É F5,. 5. 5 k . J" f, x1. . , . ,, g .0 4 a: _ . . ÎΑ . . _ è

4. THE USUAL SUSPECTS WARM WATER SYSTEMS COOLING TOWERS HEATED POOLS

5. AND THE NOT SO USUAL WINDSHIELD TREATED WASHER WATER pLUgD SUPPLIES THE PLAYBOY MANSION WATER FOUNTAINS flHydroC/ gem Wcrspcodss

6. THIS IS BECAUSE: The same risk factors that made cooling towers ideal breeding grounds for the bacteria were also found in warm water systems.

7. [N FA CT: Data captured from hospitals and many thousands of samples conclude that the Legionella bacteria is present in various water systems.

8. This means the follozving water sources associated wilh hospitals may be al risk of contaminalion with Legionella bacteria: FOUNTAINS AND DECORATIVE PONDS POTABLE (NON-WARM) WATER IRRIGATÌON RECYCLED OR HARVESTED WATER QHydmChem Waterspoodsxs

9. Initial contamination may come from the surrounding environment such as airborne dust or soil from gardens, or even the incoming mains water supply.

10. T'—"“——1 _ ——. ___. A "C'e ” Q. How da the compliance requirelnents A work to minimise eri) risk?

11. sta? !‘ Irmmnuant Itenujt ciiluolnmlim: :_= edsrwtiàlìelln ‘Inlinîîomeu tini: slflslvmîtait ‘îmîv Illîziflslilîîl‘ aiiaem. ; "@“A"= ‘Ylut ciiwanmltm attua‘; îrîîllntàxuîì ‘lr lit: tratta; sii lit; 2.312€‘: - tn-«aas asma: - t= .v. vp: u.n: al’ Pfltztîftc Cm: fluo)" Eîlucìlflr, Îzlinlîuglîalnàd’ ÎI. " EÌWI îileizliîalvflclì. ‘van: taii l'un: nflctnolbfnl. NCIÌIÌVBI DIÎ ttvaucllluut imvtasr: nuuflug u: in: un: «sui ztitamramu; emcreexèfuenn ìniflìmenr: Mflìlîzlì gutmiaaaud’ ala : ,u| ÎIÎn: _|-: 'liar’f: ,|‘ aîîacìì‘ lineari-mutanti.

12. After the media frenzy surrounding the outbreak at the Melbourne Aquarium, microbial monitoring and bacterial control was given much greater focus. Standards and regulations were amended to include specific guidance on effective forms of disinfection. ‘Q gin '/ " I firzm

13. ‘mm; .1 i 1L! i i ' d Although the potential for Legionella contamination within warm water systems has been known for many years, the degree of regulation in Australia and in turn, maintenance of warm water systems has been ad-hoc at best, and non-existent at worst.

14. Traditionally, the management of water systems has been test first, react second. Most observers have been surprised by the high frequency of positive results returned from these tests. ce The hurdle posed to risk management by this “testing first” approach is the inevitable, “What do I do now? ” flHydrocw/ flggflqg

15. 7/“ Ce)“ A li "T ’T""‘ 5 lit trîfiie ÙLÉQjÎÈHÉÌIÈUÙÉM-ÌÎÈ Ìèîfltîîtîtîìîmîtî-‘ìîlîtîîaîtîiîjfiilîàfitf i IÌJÎÎÎÎ-ÎÎÎ ‘tttîttra . "ÎÌÙ@lIÎÈ@É4ÌÎÈJMÌÌDÙ%ÙÎH fio tîtîtîrîmfieetîîtonsk.

16. “Rules are for the obedience offools and the guidance 9 0 f w ise men. ’ - Douglrts Bader ‘-’ r_r 1,, p L: I 4/a: oro;

17. al’ i’ f, l’ I, Il. l, v’ , r. 1. D. ..‘ . i 1 V . ' ‘ix/ AI x — s. ;/ r/', ’/. //’ a '“=9-"—-*J'= t-‘t'"“' «z. « . — -: z‘. ._rai—‘-. . H

18. Without an effective control mechanism in place, the frequency and degree of contamination by Legionella can be expected to be high. This has been supported by our findings: I’1:'RC1;-"7 ' l'05] T1 VIS LEGIQ-‘VLLL/ l‘ 012711.’! ‘IONS - ALv’. S'1'IL4LIzL'H1-. ‘zlL7'H(. '.-lltl5 FACILITIES- 1696 1496 v 12% 8,, 75;] I 6% T fi k 4% Î fi { a 2% _ E . ' E 5-5 E , ,,5J-J__Î__Ì_J, _ÌT. _ sovra OL’ELLSL4:’I) VICIOIUA . -"l: 'W'(. '.-lS1'Ll: ' sruvzr rr'A'I'IO: VAL AUSTRALIA [T usum www srsmus (5.010 0,11;: 101x13) cooum; ‘m WEB srsmus (2.656 01m tot-vis) Total number of samples tested for Legionella from healthcare facilities and detected over a 12 month period. ti: i-‘voîo Ch em . . . - J w r spoa.

19. Some striking observations from this data include: Warm water systems AII cooling towers Victoria (where a Risk return positive tested in this sample Management detections at a higher are fitted with a approach to cooling rate than cooling method of disinfection tower maintenance is towers in all regions; as a minimum. regulated) has the between 4 to 15 Iowest positive times, 6 times detection rate for nationally. cooling towers by 3 to 10 times. {i} HydroChem Water S000805

20. 8% It is clear that warm water systems pose significant risk in terms of the presence of Legionella in close proximity to large numbers of people who are at “high-risk".

21. Preventing growth of Legionella in COOZÎÌÎ/ g ÎOUJGÎS ì; g_ ‘i i‘ "fiî 547.1‘ 7 J’ , 45_13 . fllfu E, i ”C"‘ÉÌÈ’; ‘LÎEÌT; Î . E li iilllllil «Il

22. These are some factors you should be taking into consideration to ensure that your cooling towers are being effectively managed to Eliminating stagnancy and ensuring a suitable system design. E HydroChem Vvulcr Spoodsts prevent bacterial growth: 9 G) Locating cooling 0 Reducing t Using proven, sources of °YV°f d effective nutrition and appmpm e y a" methods of considering the susceptibility of persons potentially exposed. fouling through the use of filtration. water treatment and disinfection.

23. Preventative maintenance and methods of disinfection for warm water systems {è î‘ __- _ L - ‘ _ _ e __ ì 7 ì . v- t. lau‘ îi ‘x "1 ' ‘it- 7 z

24. E AII jurisdictions in Australia recommend that a Risk Management Plan be developed around warm water systems. Testing for Legionella, and corrective actions if Legionella is detected, are mandatory or recommended, with a focus on high-risk facilities such as hospitals and aged care.

25. DETERMINE THE POTENTIAL FOR PEOPLE TO BE EXPOSED TO RESPIRABLE SIZED x DROPLETS. , -. *' '_ x DEVELOP A CLEAR PLAN ON WHAT YOU WILL DO IF LEGIONELLA IS DETECTED IDENTIFY DEAD LEGS AND STAGNANCY CREATED BY UNUSED OUTLETS DEVELOP A PREVENTATIVE MAINTENANCE REGIME

26. I l ‘m’ a ‘I l Preventalive maintenance methods of disinfection include: ‘grc-‘io Chem w — Sposa

27. The performance of continuous chemical disinfection: WAILV WATER S YSTEMS POSITIVE LEIOXELLA DEI’ 1'127‘ 10.'S 16% 14% 12% 10% 6% 2” z C OATINUOLS DISINFECTIQN’ . -'0 TREATMENT (611 DATA POIATS) (1.121 DATA POLWS} {i} HydroChem Water Spoddsts

28. Based on the graph, HydroChem recommends the installation of equipment to monitor and control disinfection parameters, such as: Compact ORP Controller and Industrial ORP probe {i} HydroChem Vhlerspeoafias Diaphragm metering pump (up to 16 bar) Weekly maintenance regime to calibrate pumps and probes and refill chemical suppfles

29. The disinfection package provides oplimum control of: porse FREQUENCY ÙGNALFOR PUMP CONTROL OUTPUT ALARM pELAy SIGNAL FOR system OUTPUTS FOR REPORTING reducves the needfor LHV" T COIÌIPIÈÎC CÎÎCUÎÎ AN” MA DEVICES flushing. (GHydroChem Walerspcodsts

30. O ‘tu’ ‘/ " I , "{: .,' With a portfolio of more than 100 hospitals and healthcare facilities as happy clients across Australia. it's safe to say that HydroChem understancls and caters t0 hospitail-specific water treatment needs better than anyone else. Infavct. our clients tell us that the support and service ‘we offer them is unsurpassed.

31. THANK YOU Tofind out more about how HydroChem can help you drive down the Legionella risk dssociated urith your toater treatment call 02 9792 1444 or email nsw@hydrochem. com. .au. ‘ j J - _ ’ -' / .—- "1 T ‘Lv f‘ o‘ - - e, «un: - ' ‘T’ ’ ‘r ‘Cîrfi T ‘ r‘ w , _ DR 7 . COM. ÀU flfîì 5 = l‘- nana-À! a -r_ ‘g: '- 2m. ‘ T ‘ ‘t; -- _, f———_«amîgj ‘"

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