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Legionella in Residential Care
Accomodation
Kate Brierley
Nurse Consultant in Health Protection
Cumbria and Lancashire Health Protection Unit
NW Regional Lead for HCAI
March 2012
What is legionella?
Bacteria commonly found in water systems
(both natural and artificial)
Artificial systems e.g. storage tanks, pipework,
shower heads, taps.
Often associated with larger water systems,
factories, cooling towers etc but can live in
smaller water supply systems.
Also spa and whirlpool baths, sprinkler
systems, fountains
What is Legionnaires’ disease?
Potentially fatal form of pneumonia
Can affect anybody
Higher risk – Over 45 yrs
Male
Smokers
Heavy drinkers
Chronic lung / kidney disease
Immunocompromised
Other conditions – Pontiac Fever, Lochgoilhead Fever
Approved Code of Practice
Changes to the ACOP
Removal of 300 litre limit
If you provide residential accommodation it is your
responsibility to ensure that the risk from exposure to
legionella are controlled
Assess the risk to staff, residents and others using your
premises and introduce appropriate control
measures.
Legionella does occur in smaller domestic systems
Why do have to comply?
Legionella
•
multiply on hot or cold water systems / storage tanks
• Can be spread from taps and showerheads
• ↑throughput and ↓volume of water reduces likelihood
of dangerous levels of bacteria
• Must carry out risk assessment then introduce a
course of action to prevent/control those risks
identified.
Assessing the risk
Do it yourself or seek advice from a consultant
• Conditions right for bacteria to multiply i.e. water
between 20-45ºC?
• Any deadlegs/areas of stagnant water?
• Infrequently used outlets e.g. taps/showers
• Is there debris in the system – rust, sludge, scale
• Are there thermostatic mixing valves?
• Are any employees, residents, visitors vulnerable to
infection?
Answering yes means there is an increased risk of
residents being exposed to legionella & falling ill.
Introduce proper controls
Refer to ACOP
Design, maintenance and operation of the system are
important in controlling growth of legionella.
• Remove redundant pipework, run taps & showers that
are infrequently used
• Keep water cisterns covered, insulated, clean & free
from debris.
• Insulate pipework.
• Correct temperature at hot water cistern
• Advise maintenance staff working on the system of
the risks
Word of caution
Raising temp of water is one way of controlling
legionella but may lead to increased risk of
burns/scalds – consider what control measures to
use
Further information
Legionnaires’ disease: The control of legionella bacteria
in water systems. Approved code of practice and
guidance. HSE Books
Controlling legionella in nursing and residential care
homes. Leaflet INDG253 from HSE
Local HSE office – see local directory
Environmental Health Dept at local authority
QUESTIONS?