LEGIONELLA - A CURSE OR A WAKE-UP CALL?
The Way Forward, Options and Implications 

EXECUTIVE SUMMARY OF THE CONFERENCE OUTCOMES
 John Chessells and Albert Littler

The Origins and Aims of the Conference 

We decided to organize this conference under the respective banners of ‘Shades of Grey’ and ‘Building Industry 2000’ as both organisations, despite the often diametric positions of business and the unions, are committed to enhancing discussion on issues of real importance to Australian society. Containing the legionella threat, we were convinced, is one of those issues.
We believed, moreover, that the many concerns surrounding legionella could only be properly addressed in a bipartisan, multi-disciplinary forum drawing on the knowledge and expectations of a full range of interested parties. The program was developed accordingly, with an excellent range of speakers and provisions for open debate.
We were fortunate in having the Hon John Thwaites MP, Victorian Deputy Premier, Minister for Health and Minister for Planning, address us on the Government’s interim response to the recommendations of the legionella working group convened by the Department of Human Services. The conference also greatly benefited from the input of a British legionella authority, Dr John Kurtz.
The conference, held at the Hotel Sofitel, Melbourne on 22 June 2000, could not have taken place without the generous sponsorship of the Building Control Commission, Simpson Kotzman (Consulting Engineers) and Staged Developments Australia in conjunction with Salta Properties. Dunhill Madden Butler Solicitors and IT Environmental (Australia) also gave valued support. Various professional and industry bodies helped by circularising their members about the conference or placed information on their web site, as did Denis Green, a lively interlocutor from Perth.
To best serve the public interest in the wake of the Melbourne Aquarium tragedy andto contribute to the Government’s review, the conference needed to be held quickly. Despite a short lead-time we were pleased with the level and diversity of registrations, especially from local government, public health, the unions, engineers and building services regulators and practitioners including the water treatment industry. We would have hoped, however, for a greater response from builders and property owners and managers.
Overview of the Conference Debate
The favourable reaction from participants, both during and since the conference, confirmed our belief in the value of the forum. Many speakers seized on the ‘wake-up call’ analogy to protest that legionella is too often addressed with a mixture of apathy and fatalism. They sent a common message, that the health dangers of legionella bacteria are causing real community anxiety but the subject has not yet been properly aired in the public domain.
The conference considered that the Government’s review process, addressing the recommendations of the Department of Human Services working group, is very timely. But it will only effect real improvement if it fully draws on expert advice and is far-sighted and resolute in implementing change.
A measure of concern with the likely effectiveness of this review was the support expressed by many participants for an independent public enquiry (such as a Royal Commission) in parallel with the planned regulatory impact process. A coronial enquiry with broad-ranging powers was preferred by both Minister Thwaites and the Shadow Minister for Health, Robert Doyle MP.
Most conference speakers dealt principally with the dangers associated with cooling towers, which have been the main source of verified legionella infections in Victoria. Other known sources such as spas, hot water services and potting mix were, of course, acknowledged and recommendations for reform were extended to these as appropriate.
A strong consensus emerged that, despite extensive expert knowledge about the causes and dimensions of the legionella threat, the current standards and sanctions are out of step both with what is reliably known and the level of community concern.
As a consequence of the conference discussion, we believe that the existing regulatory framework is blurred by an emphasis on voluntary self-regulation, ‘lowest common denominator’ technical standards and some glaring gaps (such as the failure of building controls to cover cooling towers erected before 1990).It does not recognise the need for coordinated action nor specify responsibility for measures that could quite effectively hold the problem in check.
There was wide support for the Deputy Premier’s view that a public education program is required to inform building owners and managers of the causes of legionella in building facilities and actions by which these are best controlled.
We believe information is essential for achieving better industry practice. Education, however, must be broad-based.
It must extend to initial choices in building design (including viable alternatives to water-cooled air conditioning systems using cooling towers, which are, in Victoria, a major source of infection), to guidelines for internal maintenance, monitoring and record-keeping, to proper staff leadership, training and supervision, occupational health and safety aspects, management of subcontractors, and recognition of owners’ and employers’ legal liability.
Principal Conclusions and Recommendations
We believe that a culture needs to be instilled in which efforts and costs of risk management are regarded as a legitimate offset for owners’ and employers’ public ‘duty of care’ and potential liability for demonstrable negligence. Proactive, responsible self-regulation is a valuable driver of good practice.
Awareness of the law in this regard (notwithstanding the moot question of whether existing penalties ‘fit the crime’ or are an adequate deterrent) would encourage greater responsibility. So too, it was suggested, would action by insurance companies to tie their premiums to levels of assessed legionella risk in regard to building design and maintenance.
While the conference noted property owners and service providers’ preference for self-regulation, there was very substantial agreement that the situation would not improve unless standards are tightened and made more enforceable. The existing Australian standard, AS3666, relating to microbial control in air handling and water systems of buildings, is insufficiently prescriptive as a stand-alone guide.
Even though a consistent, Australia-wide standard would be preferred, we both believe that Victoria should take the lead in setting updated standards with enforceable clout. Standards must be comprehensive and based on expert advice from professional groups, industry and government sources.
It is our strong belief that, despite the caveats on retrospectivity, standards must apply to all cooling towers including those built before 1990 which some speakers described as a ‘disaster waiting to happen’. The standards must cover aspects such as universal fitting of drift eliminators, regular cleaning regimes, testing for bacteria infestations and protocols for remedial action.
Enforceability requires effective regulatory mechanisms backed up by appropriate sanctions. Mandatory registration of all cooling towers, administered by a competent authority with realistic registration charges to building owners and serious penalties for non-compliance, must be adopted as a matter of urgency.
Resources must be committed to enable independent audit of building owners’ maintenance programs and spot checks of the condition of facilities.
Although we absolutely believe that prevention is better than cure, the Government must be prepared to exert sanctions against non-complying owners which are concomitant with the health dangers that their negligence may cause. These dangers are intensified since discharge or drift from one poorly maintained cooling tower may ‘infect’ others in the neighbourhood.
Dr Kurtz gave the conference considerable wisdom by outlining the UK experience. Inter alia he highlighted the importance of quality assurance in the water treatment industry, having regard to the growing sub-contracting of building service operations.
Representatives of water treatment companies played a very active part in the conference discussions and are evidently concerned about ensuring high professional standards in their industry. These companies can usefully contribute to the legionella debate, both individually and through their industry associations. Their competencies and accreditation need to be part of overall regulatory reform.
The Government, in its responsibility for workplace health and safety and, most importantly, community well being, cannot stand aside from strong action in this regard. Necessary resources must be committed for this purpose. Any legislation, however, should not create ‘excessive bureaucracy’.
We believe that, in the mind of society and the electorate, the paradigm of deregulation has been seriously questioned. There are now real expectations that government will safeguard the public good. The approach, as Minister Thwaites said, must be one of partnership, but within a framework where the relevant partners are clearly and appropriately accountable. We support this view.
 

John Chessells     Albert Littler
Shades of Grey    Building Industry 2000

4 July 2000
 

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