School of Civil and Building Services Engineering

Department of Building Services Engineering

“An engineering approach to legionella control in Health care Facilities”

By Paul Cleary

Table of contentsWhat is legionella

How it affects people

Legislation dealing with legionella

Case studies

Lessons learned

The role of the Building Services Engineer

What is legionella ?Human Hair: 10ˉ⁶ m Legionella Bacteria:

10ˉ⁹m

Legionella related deathsSpain-Costa Blanca-January 2012-2 deaths

Basildon Hospital-Essex- August 2011-1 death

Spain-Murcia-July 2001-6 deaths

Ireland-67 reported cases between 2001 and 2007 resulting in 5 deaths

Optimum growth conditions for legionella

Who is at risk ?Older people –over age 40-MalesPeople who smokePeople who drink to excessPeople with suppressed immune systems. For

example HIV sufferers or organ transplant recipientsPeople with underlying health problems such as

diabetes, heart complaints and respiratory problems.People with impaired choking reflex such as stroke

sufferers

Legionella related legislationThe Safety, Health and Welfare at Work Act

2005

The Safety, Health and Welfare at Work ( General Application ) Regulations 2007

The Health Protection Surveillance Centre (HPSC) - The Management of legionnaires’ disease in Ireland (Endorsing HSC Approved Code of Practice);

Case StudiesSt Patrick’s University Hospital

Basildon University Hospital

I work there

Directly involved with legionella prevention programme

Access and permission to publish data-test results etc-

In a neighbouring Country so relevant to Ireland

Has suffered recent outbreaks of legionellosis

Has been fined for legionella related deaths in the past

Lessons learnedIndependent risk assessment essential

Design and build of hot and cold water storage and supply systems critical

The role of chlorine dioxide

Regular independent water sample testing

Interaction with stakeholders

Cold water storage

Chlorine dioxide plant

Building Services Engineer

Infection Control

Committee

Nursing Staff

Household & Catering

Staff

Outside Agencies