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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 contents
 What 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 deaths
 Spain-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 40Males
People who smoke
People who drink to excess
People with suppressed immune systems. For example
HIV sufferers or organ transplant recipients
 People with underlying health problems such as
diabetes, heart complaints and respiratory problems.
 People with impaired choking reflex such as stroke
sufferers
Legionella related legislation
 The 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 Studies
St Patrick’s University Hospital
Basildon University Hospital
 I work there
 In a neighbouring Country so
relevant to Ireland
 Directly involved with
legionella prevention
programme
 Access and permission to
publish data-test results etc-
 Has suffered recent outbreaks
of legionellosis
 Has been fined for legionella
related deaths in the past
Lessons learned
 Independent 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
Infection
Control
Committee
Outside
Agencies
Building
Services
Engineer
Household
& Catering
Staff
Nursing
Staff