Preventing Legionnaires’ Disease: Testing and Risk Management
Legionnaires' disease is a severe form of pneumonia that can be life-threatening for vulnerable people such as the elderly and those with impaired immune systems.
It is caused by Legionella, a bacteria that thrives in water systems where the temperature is between 20-45°C. The amount of bacteria needed to cause an infection is believed to be very small, and it doesn’t require a long exposure time. The World Health Organization (WHO) has also found data to suggest that people can catch the disease even if they are more than three kilometres away from the infected water source.
Legionnaires’ disease: the UK laws and regulations
UK legislation requires employers and people in control of premises, e.g. landlords, to assess and manage all relevant risks in order to prevent an outbreak of Legionnaires’ disease.
The laws and regulations you need to be aware of are:
- The Health and Safety at Work etc Act (HSWA)
- The Management of Health and Safety at Work Regulations
- The Control of Substances Hazardous to Health Regulations
The Health & Safety Executive (HSE) offers detailed guidance on risk, prevention and testing.
For healthcare professionals specifically, understanding the causes of Legionnaires’ disease and having prevention and testing measures in place is paramount to safeguard the health and well-being of residents and staff alike.
What are the symptoms of Legionnaires' disease?
The infection occurs when people inhale water droplets or mist containing the bacteria – you cannot usually get it from drinking infected water or from another infected person. Of reported cases, up to 80% affect people over the age of 50, and between 60-70% of cases affect men rather than women.
Symptoms typically appear 2-14 days after exposure to the bacteria and include:
- Cough
- Chest pain, especially when breathing or coughing
- Shortness of breath
- High temperature
- Aches, pain and flu-like symptoms
- Nausea, vomiting and diarrhoea
- Confusion
The risks presented by Legionnaires’ disease increase with age, and it is also dangerous for the following groups of people:
- people with chronic respiratory or kidney disease
- smokers and heavy drinkers
- people who have diabetes, lung and heart disease
- anyone with an impaired immune system
How to prevent Legionnaires’ disease
The main method of reducing the risk of Legionella growth is water temperature control.
The bacteria are dormant at low temperatures and cannot survive in temperatures above 60°C, so it is recommended that cold water systems should be kept at temperatures below 20°C. Hot water should be stored at least at 60°C and distributed so that it reaches a temperature of 55°C in healthcare premises (50°C in other premises) within 1 minute.
Our Legionnaires’ thermometer kits are portable, battery-operated, and easy to use and store. With a waterproof surface probe, PTFE wire probe and handy zip pouch, the kits offer everything you need to test the temperature of your water supply – giving you peace of mind and enabling you to safely minimise the risk of Legionella.
In addition to regular temperature testing, you should also:
- Regularly clean and disinfect water systems – this includes draining hot water cylinders to check for debris and signs of corrosion
- Avoid water stagnation in pipes and tanks – flush out infrequently used water outlets regularly, and clean and descale items like shower heads and hoses once every three months at least
Legionnaires’ disease: prevention is better than cure
Regular testing for Legionella bacteria is vital for several reasons:
- Legal compliance: In the UK, employers and landlords have a legal obligation to ensure water systems are free from Legionella bacteria
- Prevention: Early detection allows for swift action to prevent potential outbreaks
- Protection of vulnerable people: Individuals in care homes and other medical settings tend to be at higher risk of severe complications from Legionnaires' disease
- Cost-effectiveness: Regular testing is more cost-effective than dealing with an outbreak, remedial works and potential litigation
Prevention is always better than cure. Maintaining proper water management practices and having a consistent and robust testing regime will help you significantly reduce the risk of Legionnaires' disease outbreaks in your healthcare facility, protecting the well-being of residents and staff.