MARS 1997

As you can see from the chart above outbreaks of Legionnaires' Disease
Seem to get larger and larger as time goes on, The cost to the community
and the devastating effects that it has on families is beyond belief, The sad part is that it is a preventable Disease.

My site contains a great deal of information concerning this Disease, it has many links that will take you to other sites that have further information about it.
I do not agree with a great deal that has been written or said on this Disease,
the links and information is here for you to make your own mind up

Legionnaires' Disease is the only Disease that has not got a Support Group, every other form of Disease has a group that is there to help the suffering of a specific Disease

Anyone willing to help form such a group would be much appreciated

LEGIONNAIRES' DISEASE

The first outbreak in 1976 caused much panic throughout the state of Philadelphia and other states in America. it turned brother against brother, father against son, neighbour against neighbour, people walked across the other side of the street from friends they had known for a life time, shops refused to handle money from customers.
It was feared that a vendetta was being waged against the Legionnaires' themselves because they was America's finest fighting men.
Many theories were put forward, but in the end if was something entirely different.

It was not till five months later that the culprit was identified, a tiny BUG which was named Legionella, though this bug was found in the Cooling Tower of the Bellevue Stratford Hotel, It was never proved that it was the Bellevue's tower that caused this outbreak.
The grand old lady of Broad Street took a great deal of shame and blame., but that's another story.

The Airconditioning industry always seems to take the blame for deaths from Legionnaires' Disease, Though the largest outbreaks have been caused by air-conditioning systems, most deaths from this Disease are from WATER SYSTEMS in Hospitals, Nursing Homes, Hotels
Two outbreaks, one in the USA and the other in Australia in 1996 was through Spa Baths (Whirlpools),
In 1994 in Queensland Australia two people died because of a Spa bath
My site contains a great deal of information regarding the dangers and places you can expect to find this SILENT KILLER.
Much has been written and spoken on the subject of Legionnaires` Disease, many ideas have been put foreward to cure the problems that face the world in trying to combat this Killer.
Many different types of devices are in use in all kinds of premises from Hospitals to Hotels
Products that are marketed extremely well , sell the most
There are many products around that dont use chemicals, Magnets that kill, UV light that kills all ,the list is endless,
There are groups that want to ban certain chemicals though some I do admit should be banned, but others will save your life.
Remember the plagues of past years thousands died because of drinking water contamination. people act without thinking because someone comes up with a idea that seems great at the time.

Yet people still die, outbreaks still happen, I wonder why

The background of this page is Mars taken from a craft that man send on a great journey, There`s three pictures of Mars at the top of this page, a great achievement by man.
These people work as a team to produce such fine results, and they get paid for it each month in salary.

The person trying to sell you something to make your Cooling Tower or Hot Water System safe from bugs is trying to sell you something to make his pay for the week, so what`s being sold is the greatest thing this side of whatever.
Armed with a great amount of testimonials, its a great product.
The 1st and 2nd Committee of Inquiry into the outbreak of Legionnaires' Disease at the Stafford General Hospital England in 1986 in my opinion a few errors in their submissions that I would have liked clarified.
The Expert Advisory Committee on Biocide's in the same year dealt with the best chemicals to use for Cooling Towers and alike, and again in my opinion made many errors concerning the issue`s involved.
You may wonder why I raise the issue of these Committees,
The Medical Profession is like the Legal System, It will pull a book out and say..................
so thats you shot down in flames.

The world must change its way of thinking, with Diseases coming back that was thought to be no more, these tiny bugs are telling us, You kill us we kill you.
With the world population increasing so fast and Cities getting larger, people living closer together more outbreaks of all Disease will occur.
The (CDC) Control Disease Centre in Atlanta are working on new guide lines for Whirlpool Spas and Hot Tubs in commercial applications.
You will see that it is said that your test kits for checking your chemicals are only between 40 and 60% accurate, so your behind the eight ball to start with.
The World must change it way of thinking when it comes to killing (controlling) bacteria in all forms of water systems.
The method of Parts Per Million (PPM) has never been the right way to check
the chemical levels in your water systems, using this type of method means that any influx of bacteria in your Spa ,Tower, Swimming Pool, Hot Water System your chemical can not cope with it.
You jump in a swimming pool , your eyes sting, chlorine takes the blame again, to much chlorine... the reason for this is your Ph is wrong, but chemicals like chlorine take the blame.
Know matter what you do you can never dose your Cooling Tower or Swimming Pool, Whirlpool Spa in safety while using the method of PPM
(Parts Per Million)
The World must change its ways the next victim could be you.
The Federal Government of America recently where made to pay a large amount of money in damages to the people involved in the outbreak of Legionnaires' Disease in the Social Security Building in 1991, I understand it was ruled that the Disease is preventable, so the Government was to blame for the outbreak.
In my opinion the outbreak in England in 1985 was because of a mans blind faith in his employer and the product they sold.
The only way to be 100% safe and sure is the world must change to the method of (ORP)

OXIDISING REDUCTION POTENTIAL

In recent years, the existence of many previously unrecognized bacteria and viruses in recirculated liquids have come to the public’s attention. The 1976
outbreak of Legionnaires’ disease led to the recognition that Legionella exists in most municipal water supplies. Today, over 43 different strains of Legionella have been identified and increasing numbers of buildings test their water specifically for this bacteria.
There are now more than nine major studies in which Legionella ranks among the three microbial agents of sporadic community-acquired pneumonia. The threat of hospital-acquired infection is intensified due to the high percentage of immune-suppressed patients receiving care. It is estimated that 10,000 to 100,000 cases of sporadic legionellosis occur each year.

Hospital-acquired Legionnaires' disease is emerging as a major problem. Studies indicate potable hot water distribution systems to be the primary source of patient exposure to the Legionella organisms.

Legionella is found in virtually all natural aquatic environments, such as lakes, rivers and streams, and man-made habitats including cooling towers, evaporative condensers, therapy pools, and domestic water distribution systems. The colonization of water systems by Legionella depends on a combination of several factors: sediment and scale accumulation, commensal water bacteria, and temperature. In the past, hospital engineering and infection control personnel were usually concerned about acquiring Legionella from cooling towers of air distribution systems. Although these are a potential threat, current research indicates potable water distribution systems are the most likely to contain Legionella and pose the greatest threat. Virtually all hospital outbreaks of Legionnaires' disease occurring since 1982 have implicated water distribution systems rather than cooling towers. The most current research indicates Legionella is transmitted through aspiration, aerosolisation (i.e., through steam generated from showers or faucets), or direct exposure to Legionella during respiratory tract manipulation. Solid organ or bone marrow transplant patients, elderly, tobacco smokers, chronic lung disease patients, and other immuno-suppressed patients appear to be at higher risk.

Precautions against Legionnaires' Disease

The advice given is not claimed to be exhaustive. It is intended as a short summary of current guidelines and Codes of Practice and if followed carefully by an appropriately qualified person should reduce the risk of an outbreak.

1.INTRODUCTION

1.1 Legionnaires' Disease is the name commonly given to the pneumonia caused by the organism Legionella pneumophilia Other illnesses commonly attributable to the Legionella bacteria include Pontiac Fever and Lochgoilhead Fever.
1.2 The organism exists in building water services in most parts of the world including the British Isles. Particularly it colonises water systems incorporating cooling towers or evaporative condensers and hot and cold water services.
1.3 It gains nutrients from various sources such as sludges in the bottom of calorifiers and cooling tower ponds. (These consist of rusting iron particles, dead algae, bacterial slime etc).

Hot water services also pose a risk and Legionella will multiply at water temperatures in the range of 20-46 C. 1.4 Susceptible persons contract the disease by inhalation of contaminated water droplets or spray-mists. It is not contracted through drinking contaminated water.

2.LEGAL IMPLICATIONS FOR EMPLOYERS

2.1 The Health and Safety At Work Act 1974 places an obligation upon employers to ensure, so far as is reasonably practicable, the health, safety and welfare of their employees and that persons not in employment (ie. guests, contractors etc) are not exposed to risks to their health and safety.
2.2 It is the responsibility of senior management to carry out a full risk assessment of all Legionella susceptible plant within their premises and to instigate, monitor and keep under constant review a scheme for the control of legionellosis which will include a plant maintenance and water hygiene programme.
A person should be appointed to be responsible for the scheme.

3.NEW INSTALLATIONS

3.1 All newly-installed pipe work for hot or cold water services should be sterilised before being brought into use in accordance with British Standard 6700 ( 1987). It is important when chlorinating to check water pH and if it exceeds 7 then higher chlorine levels will be needed. All aspects of the sterilisation procedure should be clearly recorded including free chlorine levels. Care on type of product used is essential to avoid damage to some internal working parts of catering equipment. This is a one-off treatment on commissioning new plant and should be written into the contractors specification.
3.3 Do not undertake chlorination unless you are suitably trained and equiped to do so, if in doubt seek advice.

4.COLDWATER TANKS AND SYSTEMS

4.1 Ensure that all services supplying water conform to BS: 6700 ( 1987) where applicable.
4.2 If so advised by local water companies install on site proportional chlorine dosage systems to the water supply. Where water softeners are in use chlorination should be on the outlet side. The proportional chlorine dosage system units should be checked and serviced on a monthly basis with the free chlorine level being checked on a daily basis. For ease of cleaning and maintenance, it is advisable to install more than one tank, so that tanks can be drained and sludge deposits removed, without disrupting water supplies.
4.3 Connect multiple or divided tanks so that all are in continuous service ie. in series and not stagnant, alternatively reduce system capacity. 4.4 Monitor the whole system via periodic inspections/temperature checks and take samples for potable water quaky.
4.5 Eliminate dead legs from the pipe system. 4.6 Non-metallic tanks such as fibreglass are recommended. Metallic tanks should be lined internally with a paint of potable water quaky, alternatively rubber liners may be fitted.
4.7 All tanks must conform to Water Byelaw requirements for the prevention of contamination of stored water.
4.8 Sterilise tanks and associated down services once a year in accordance with MS(G) 70 (NB BS 6700 requires 16 hours standing time). Care with product used see note 3:1.
4.9 Maintain the temperature of cold water storage tanks below 20 C at all times. Lagging, cladding, shading and re-routing of pipework may assist. 4.10 All fixtures and fittings used in water systems must be approved for potable water.
Make sure all water tanks are covered

5 HOT WATER SYSTEMS

5.1 All systems should conform to BS: 6700 ( 1987) where applicable.
5.2Hot water should be stored at 60 C - 65 C and distributed at > 50 C. Where these temperatures are unobtainable or impracticable the reason should be clearly noted in the on-site log book and other appropriate measures taken.
5.3 Insulated hot-water pipes to ensure that these temperatures are achieved and maintained. Also cold pipes in kitchens and laundries to keep cool as temperatures can rise in standing water.
5.4 Eliminate dead legs from the pipe system.
5.5 If parts of the system remain unused for 5 days or more, or if they are newly installed, disinfection or pasteurization to the appropriate standard is required.
5.6 Disinfection or pasteurization of all hot water services to Health and Safety Executive requirements should take place on commissioning and there after.
5.7 Fixed shower pipes are preferable to flexible pipes. Shower heads should be descaled and disinfected routinely to the appropriate standard (it is useful to hold a stock of these items so that maintenance can be carried out routinely on a 'clean for dirty' basis).
5.8 If solar heating panels are used in any part of the system seek specialist advice.
5.9 Monitor the whole system by periodic inspections and temperature checks.

6.CALORIFIERS

6.1 Quarterly - blowdown each calorifier for at least 3 minutes or until stored water runs clear. This operation should only be carried out by a competent person.
6.2 Six monthly - check storage temperatures and re-set as necessary.
6.3 Annually - drain, de-scale and clean, ensuring that all sludge is removed from base, including the area below the drainpipe exit Allow to dry. Refill and either chlorinate or pasteurise the vessel. This is achieved by raising the temperature to 70 C over the entire surface of the calorifier for 6-12 hours, with the flow valves closed to obtain pasteurisation of the interior of the installation. 6.4 When returning the calorifier to service, open the header valve very slowly to reduce any risk of turbulence.

7.COOLING TOWERS

7.1 Ensure that a suitable water treatment programme controlling scale, corrosion and microbial growth is in place and that k is being suitably monitored and logged.
7.2 Ensure that all effluent runs to foul sewer and that a "Consent to Discharge" is sought from the local Water Company
7.3 Test for Legionella bacteria on a six monthly basis.
7.4 At least twice a year the tower should undergo a deep cleaning/stripdown and sterilisation programme. It should be ensured that the disinfection process complies with HSE requirements.
7.5 Ensure that the water treatment programme is immediately re-instated after the cleaning process is complete.
7.6 All cooling towers should be constructed in such a very as to facilitate cleaning and maintenance and with materials that do not promote bacterial growth. High efficiency drift eliminators must be fitted.
7.7 If the plant is shut down for any period of time, it should be drained and left dry.

8.SWIMMING POOLS, SPA BATHS AND WHIRLPOOL BATHS

8.1 Ensure that treatment plant is operating at all times.
8.2 Ensure that chlorine and pH readings are within manufacturers' recommended limits.
A minimum of two readings per day must be taken.
8.3 Clean skimmers, strainers etc. daily or weekly, as appropriate to size and use of the pool.
8.4 Back-wash filters frequently to remove any build-up of debris/slime etc
8.5 Clean in accordance with the recommendations of S.P.A.TA.

9. SAFETY PRECAUTIONS FOR MAINTENANCE PERSONNEL

9.1 When cleaning cooling towers, calorifiers etc. wear a suitable positive pressure respirator fitted with a hood or blouse. In addition other appropriate safety equipment should be worn ie. gloves, boots, waterproof overalls etc.
9.2 Run-off (neutralised) contents by hose into a foul sewer. Do not allow contents to fall and splash outside the equipment. A "Consent to Discharge" must be sought from the local water company to authorise this process.
9.3 Ensure that a first aid station, including eye wash, is immediately available.
9.4 Never work alone - always make sure there are at least 2 operatives on site at any one time.
9.5 Water treatment activities should only be performed by those suitably trained and equipped. If in doubt seek specialist advice. Where chemicals are to be added tanks must be clearly labelled.

ENERGY CONSERVATION LEGIONELLA

Maintaining hot water storage tanks at 120°F while often recommended for energy conservation, may not be the best for your facility.

Over the past several years, studies have indicated that warm or tepid water systems may be breeding grounds for the bacteria Legionella Pneumophila, otherwise known as Legionnaires' Disease. One way to combat this potentially deadly disease is to maintain hot water storage tanks at or above 140 degrees Fahrenheit.

The bacteria which causes Legionnaires' disease is often present in many natural freshwater sources including lakes, ponds, streams, and rivers--ultimately finding its way into domestic water systems.

Many of the outbreaks are occurring in hospitals, office buildings, hotels, and other settings.
A person can get the disease by either inhaling airborne water droplets containing Legionella or drinking Legionella-contaminated water. The risk can be high with humidifiers, showers, sinks, fountains, or whirlpool baths, for example.

While Legionella is everywhere, the mere presence of it in the water is not a cause for concern. Rapid growth, resulting in high concentrations, is essential before the water can be considered hazardous.

The key ingredients--a wet environment, the presence of oxygen and carbon dioxide, high microbial concentrations, scale and corrosion products--as well as a favorable temperature range (68 to 120 degrees Fahrenheit) must be present in order for the bacteria to reduce rapidly.

"Unfortunately, many hot water storage tanks provide an opportunity for accelerated reproduction or bio-amplification. You have to keep the water conditions at temperatures where the environment is not favorable for growth to Legionella out of the water, "Hot water should be stored at temperatures no lower than 140 degrees Fahrenheit and deliver hot water at a minimum of 122 degrees to the outlets."

While there is little chance of scalding at that temperature, an anti-scald valve can be installed at the outlet of the water heater. "An anti-scald (not a tempering valve) helps reduce the minimal risk of scalding for children or individuals with disabilities.

Keeping your facility out of risk is key to avoiding outbreaks, he added. Establishing engineering and management policies regarding the selection, installation, cleaning maintenance, inspection and sampling is a good way to keep Legionnaires' Disease out of your facility.