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Engineering Keys for Legionella Control Jeff Boldt, PE, LEED ® AP, HBDP Principal – KJWW Engineering Member ASHRAE SSPC-90.1 Chair 90.1 Hydronic & Elevator WGs Member ASHRAE SSPC-90.1 Consultant to 62.1 Something to Standard 55 Member GPC-36 PE - M and FP [email protected] “Jeff Boldt Nerd”

Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

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Page 1: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

Engineering Keys for Legionella Control

Jeff Boldt, PE, LEED® AP, HBDP

Principal – KJWW Engineering

• Member ASHRAE SSPC-90.1–Chair 90.1 Hydronic & Elevator WGs

• Member ASHRAE SSPC-90.1

• Consultant to 62.1

• Something to Standard 55

• Member GPC-36

• PE - M and FP

[email protected]

• “Jeff Boldt Nerd”

Page 2: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

Learning Objectives

• Understand the challenges of Legionnaires’ disease prevention and control of Legionella in water systems

• Know current trends in epidemiology (disease transmission), diagnosis and treatment of Legionaries’ disease

• Distinguish and be familiar with Legionella disinfection and control methods, including chemical and non-chemical methods

• Apply the information from this seminar to write specifications for water treatment in cooling water systems

ASHRAE is a Registered Provider with The American Institute of Architects Continuing Education Systems. Credit earned on completion of this program will be reported to ASHRAE Records for

AIA members. Certificates of Completion for non-AIA members are available on request.

This program is registered with the AIA/ASHRAE for continuing professional education. As such, it does not include content that may be deemed or construed to be an approval or endorsement

by the AIA of any material of construction or any method or manner of handling, using, distributing, or dealing in any material or product. Questions related to specific materials,

methods, and services will be addressed at the conclusion of this presentation.

Page 3: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• What’s Legionellosis

• Existing Standards– ASHRAE Guideline 12

– CTI Guideline 208

– ASHRAE Standard 188

• What About My Designs?

• What’s My Risk?– Minimal plumbing discussion – this is ASHRAE

OUTLINE

Page 4: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

What’s Legionella?It’s Pneumonia

Page 5: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Most cases not diagnosed as LD

• Legionellosis cases >3X in 10 years

• Outbreaks create publicity and outcry

• ~4% of pneumonia cases

• 8-18,000 cases per year in USA (CDC)

• Usually develops 2-14 days after exposure

• >10% of cases are fatal (CDC)

LEGIONELLOSIS = PHNEMONIA

Page 6: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Elderly

• Smokers

• Immunocompromised

• ~25% of cases have no risk factors

WHO IS SUSCEPTIBLE?

Page 7: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Legionella is a bacteria

• Legionella Pnemophilia, serogroup 1

– Some antibiotics are effective

– Levofloxacin

– Not Penicillin

WHAT IF I HAVE LD?

Page 8: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Must be inhaled

• Potable water (#1 risk)– Is CW a significant risk?

• Pittsburgh VA deaths

• Warm water (cooling towers)– Less total risk, but often more publicity

– 13 deaths in Quebec (180 cases)

– NYC deaths

SOURCES

Page 9: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control
Page 10: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

ASHRAE Guideline 12

Page 11: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Available free from some tower manufacturers’ sites

• Minimizing the Risk of Legionellosis Associated With Building Water Systems

• Standard of Care

• Most cases are not outbreaks

ASHRAE GUIDELINE 12

Page 12: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Legionellae are bacteria – not viruses• Antibiotics are effective• Risk is higher for elderly, smokers, immune

suppressed• Amplification factors• Water 77F-108F, stagnation, scale, sediment,

biofilms• Must be inhaled

ASHRAE GUIDELINE 12

Page 13: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Copper inhibits growth somewhat

• Controlling other microorganisms may be the best strategy

• HVAC Sources:

– Cooling Towers

– Humidifiers

GUIDELINE 12

Page 14: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Hard to keep temps outside of 77-108F

• Many or most have detectable Legionellae levels

• Maintain, clean, treat water with biocides

• Employ (specify) qualified water treatment specialist

• Clean cold water basin when dirt, organic, or debris is visible or sampled

COOLING TOWERS (ETC.)

Page 15: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Require MSDS for chemicals (specify)

• Specify water treatment to minimize scaling (phosphonates, phosphates, polymers, etc.)

• Minimize corrosion (phosphate, azoles, molybdenum, zinc, etc.)

• Alternate biocides

COOLING TOWERS (ETC.)

Page 16: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• If system is shut down over 3 days, drain entire system– Consider corrosion (my note)

– Possibly bypass and circulate biocide periodically

• Prior to starting fan, treat system with biocide (4-5 ppm free chlorine for >6 hours suggested at 7.0-7.6 pH) and circulate prior to starting tower fans

TOWER START-UP / SHUT-DOWN

Page 17: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Turn off pumps before fans to dry media

SHUTDOWN

Page 18: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Remove debris from tower and sump(s)

• Circulate and verify biocide concentrations without starting fans for >6 hours

TOWER START-UP OF UN-DRAINED SYSTEMS

Page 19: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Locate as far as possible from air intakes & operable windows

– 62.1 has minimums also

• Avoid organic sources (kitchen exhaust, truck bays)

• Consider prevailing winds and public entrances

SITING

Page 20: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Steam humidifiers are not a concern, unless water stagnates during off times

• Wetted media humidifiers tend to be below 77°F because they are used in low wet-bulb areas

HUMIDIFIERS

Page 21: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Consider ozone generators

– Controversial

• Clean and Flush entire cooling loop monthly

– I’ve never heard of any owner doing this

• No confirmed cases related to air washers, evaporative coolers/humidifiers, or steam humidifiers

CHEMICAL TREATMENT – EVAP. COOLERS, ETC.

Page 22: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• May be useful – or not

• Be careful with sampling, culturing, sample handling, shipping, lab methods, etc. so results are consistent.

MONITORING

Page 23: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

CTI Guideline 208

Best Practices for Control of Legionella

Page 24: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• 68-113°F favors growth (vs. 77-108°F)

• 99°F is optimum

• Does not survive above 140°F

– For how long???

CTI - ECOLOGY

Page 25: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Halogen oxidizers are recommended

• Ozone, peroxides, UV, ultrasonic, and non-oxidizing biocides work in limited circumstances

• Most recommendations are for periodic cleaning and testing – not design

• Most agencies’ guidelines do not recommend routine testing

CTI RECOMMENDATIONS

Page 26: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Feed chlorine or bromine and maintain 0.5-1.0 ppm as Cl2

• Effectiveness is reduced at higher pH– Chlorine is effective to 8.0– Bromine is effective to 8.5-9.0

• Discharge halogens legally – often to sanitary sewer

• Biodispersant/biodetergent may aid in penetration and increase efficacy

• Periodically use non-oxidizing biocides

CTI – ROUTINE TREATMENT

Page 27: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Eliminate Stagnant areas

• State-of-the-art, high-efficiency, nested drift eliminators, are suggested

• System design engineers should provide discharge piping and equalizers to move water with no dead flow locations. Special attention should be paid to equalizer piping to ensure these areas are not stagnant.

CTI – DESIGN ISSUES

Page 28: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

ASHRAE Standard 188

Page 29: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• The Purpose of this standard is to establish minimum Legionellosis risk management requirements for building water systems

PURPOSE

Page 30: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Potable water systems

• Non-potable water systems

• Whirlpools and spas

• Ornamental fountains

• Humidifiers

SCOPE

Page 31: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• NY City adopted sections 5, 6, and 7.2

• Written in mandatory language

• Will be the standard of care

• 5 Public Reviews

• Sections 4.1 and 8 include “Designer Requirements”

– IMO some are Owners’ responsibilities

NOT A CODE, BUT…

Page 32: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• A Program utilizing the risk management principles in the following subsection shall be used to reduce the risk of legionellosis…

• Identify the persons on the Program Team responsible for developing and implementing the Program and the tasks for which they are responsible. – When???

PROGRAM & PROGRAM TEAM

Page 33: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control
Page 34: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

POSSIBLE ISSUES

• Implies prohibition of fill valves below the basin overflow level

• Daily shock disinfection of whirlpool/spas

• Program documents shall include cleaning procedures when commissioning misters, atomizers, air washers, humidifiers

Page 35: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Drawing of distribution system including monitoring points for temperature, sampling points, and treatment points

• Detailed instructions for commissioning of all building water systems shall be provided by the designer… Including…

INSTALLATION DRAWINGS

Page 36: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Must be within 3 weeks of beneficial occupancy

DISINFECTION

Page 37: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Primary responsibility

• Plans for regular activities

• Emergency plans

• Program Team decides about water testing– If

– How much

– Criteria

OWNERS

Page 38: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control
Page 39: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Flush outlets before sampling?– Study – Janet Stout et al

• Recommends not flushing– Represents what user does

– Flushing reduces counts

• Sample size– 100-200 ml is enough

– Bottles from lab have neutralizer to remove Cl

– Less shipping/handling than 1L

– Ship in insulated containers

TESTING

Page 40: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Does shipping time affect results?

– 2014 study by Dana Flanders et al

• Tested samples immediately and after 24 hours

• Minimal difference in results

– Study by Janet Stout et al

• Multiple sites

• 0, 1, 24, 48 hours

• No change at 24 hours – 2% at 48 hours

SAMPLE SHIPPING

Page 41: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Quick Methods

– DFA – Direct Fluorescent Antibody Staining –sometimes false positives

– ICT – Immuno-chromatographic test

• Got negative test at >3,000 CFU/ml

– PCR – Polymerase Chain Reaction – tells species type, but not counts – hospitals have

• CDC doesn’t recommend for routine testing

– Dip slide – Total count only

PICKING A TEST METHOD

Page 42: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• CDC

– “Use of PCR for identification of Legionella is not recommended until more data regarding sensitivity and specificity of procedures are available”

• Progressing – Nested Enzymes

MOLECULAR METHODS - PCR

Page 43: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

DIP SLIDE

Page 44: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Culture Methods - Proficiency Standards– ISO 11731 (parts 1 &2)

– ASTM D 5952

– International – HSE L8 ACP 2013

• Labs use different methods– Pretreatment, filtration, culture media

– Presumptive agglutination or definitive sequencing?

• CDC Elite labs is a minimum – Not all equal– Variations in duplicate samples

PICKING A LAB

Page 45: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• No requirement

• Maybe if going into CT known to have LD

• Maybe power washing CT

PPE FOR PEOPLE TESTING?

Page 46: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• From the basin is most representative

WHERE TO TAKE CT SAMPLES

Page 47: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Zero is good, but generally not considered necessary

• 58 named species

• Half implicated in human disease

• Worry about pneumophila, serogroup 1

• 65% of studied hospitals tested

• >1,000 CFU is probably trouble

• Program Team decides

HOW MUCH LEGIONELLA IS ACCEPTABLE?

Page 48: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control
Page 49: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control
Page 50: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Alternating Dual biocide– Oxidizing + Non-oxidizing

– Bromine +Quaternary Amine

– Probably Chlorine + Quat (not in test)

– ASHRAE RP-1361• All non-chemical methods were ineffective

– Magnetic

– Electric pulsed, Electric static

– Ultrasonic

– Cavitation

CHEMICAL TREATMENT

Page 51: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Establish baseline during maint period

• Test for Legionella Pneumophila, Serogroup 1

• Periodic testing

– Best = send cultures to CDC Elite lab

– Dipslide or pen gives total count – non-specific to Legionella

TEST WATER

Page 52: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Minimize time inside towers

– Direct drive to eliminate belt/gear maintenance

– Fans/Motors with external maintenance

MAINTENANCE STAFF

Page 53: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Distance as much as possible

• Minimize droplets

– High performance drift eliminators

• Hybrid Towers??

– Just my theory

PASSERS BY

Page 54: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• My Suggestion to the Tower Industry

– Think of how you handle fume exhaust

DISCHARGE THROW

Page 55: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Maximize distance to OA intakes

– Consider prevailing wind (odds)

BUILDING OCCUPANTS

Page 56: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Circulate water and treat with biocides >6 hours before fans start

• Nested “high efficiency” drift eliminators

• Run fans slowly after water flow stops

• Include sidestream filters

SPEC ITEMS – COOLING TOWERS

Page 57: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

Open Systems . . . . . .expose system

components to

airborne

contaminants

Fouled Plate Exchanger

Fouled Tube Exchanger

Page 58: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• 77°F minimum CW temperature?

– Guideline 12 mentions this, but not 188

– VA has requirements

DOMESTIC WATER

Page 59: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

ASHRAE Standard 188

What’s My Risk?Higher? �Lower? ☺

Page 60: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• No A/E LD losses prior to 2015

• What should we expect in the future?

WHAT’S XL CATLIN SAY?

Page 61: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• If you address 188 – Risk goes down ☺

• If you don’t – Risk goes up – A LOT �

JEFF’S OPINION

Page 62: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Sidestream filters

• Avoid dead legs

– Level equalizing

DRAWING ITEMS – COOLING TOWERS

Page 63: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

• Drawings & Specs

– Plumbing

– HVAC

– Commissioning

• Contracts

TEAM TO ADDRESS

Page 64: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

WHAT WE DID

Page 65: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

YOU CAN INFLUENCE ASHRAE STANDARDS!

• Have a suggestion?

– Email me or any ASHRAE committee member

• Lowest Overhead method

– Submit a CMP

• More OH, but formal response is required

– Call and discuss

• ASHRAE involvement has benefits!!!

– Connections – Knowledge

Page 66: Engineering Keys for Legionella Control - Madison ASHRAE...diagnosis and treatment of Legionaries’ disease • Distinguish and be familiar with Legionella disinfection and control

Q & A

• Jeff Boldt

[email protected]