Government agencies, water management professionals, healthcare facility managers, and many other stakeholders are increasingly interested to find out more about effective water management strategies to prevent Legionella Infection. Legionnaires’ disease is a severe respiratory disease caused by the bacterium Legionella pneumophila. This bacteria is found in both potable and non-potable water systems. The need for more effective water management strategies became more apparent in 2015 when the American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE) released Legionella standard, ANSI/ASHRAE 188-2015 after a consensus was reached among government agencies and industry groups concerning the general approach to preventing and controlling Legionnaires’ disease.
ANSI/ASHRAE 188-2015 identified some of the important considerations in managing water management systems to ensure proper strategies are in place to prevent and control Legionnaires’ disease. In 2015, an outbreak of Legionnaires’ disease was identified as the cause of death for 12 individuals in the South Bronx in the City of New York. This outbreak also sickened about 120 people in the same area. Several cooling towers in the affected areas tested positive for legionella. In response to this outbreak, building owners and facility managers in New York are now required to register cooling towers, evaporative condensers, and fluid containers with the Department of Buildings. After this outbreak, the Centers for Disease Control and Prevention (CDC) also reported about the increased number of Legionnaires’ disease cases and highlighted the importance of more effective building water management.
To implement effective water management strategies, potential risks associated with the water management systems need to be identified, assessed, and managed properly. Although risks are typically classified into positive and negative risks, this article focuses on negative risks or threats. Negative risks are any potential events or conditions that may adversely impact asset management objectives. A proper application of risk assessment techniques makes facilities less vulnerable to potential risks arisen from Legionella bacteria. Addressing issues after the fact usually costs significantly higher compared to the amounts paid for implementing risk response strategies. Therefore, using risk management practices are important not only to protect facilities and water management systems from detrimental risks but also to ensure that facility owners, such as commercial buildings and hospitals, do not incur costs due to unmanaged risks. Risk management consists of the key processes of planning for risk management, identification, assessment, response planning (i.e., risk treatment), and risk control. The following are some of the recommended practices to ensure risk management practices are properly used for water systems in buildings and facilities:
a) Establish water management program (WMP)
Many benefits can be gained by timely establishing a water management plan (also known as water management program [WMP]) even if an audit is not forthcoming. ANSI/ASHRAE 188-2015 can be used as a guideline and a reference but other recommended practices need to be considered to determine the best strategies that can be used to protect the occupants and users of buildings and facilities against Legionnaires’ disease because cooling towers, evaporative condensers, and fluid containers have been identified as one of the main sources of dispersing water-dispersed diseases (e.g. Legionellosis).
b) Follow your WMP and improve as needed
Property owners and facility managers protect themselves against legal and non-legal risks and expenses if they, not only prepare but also implement water management programs to demonstrate they have exercised standards of care in preventing diseases associated with water systems. Any WMP needs to be reviewed on a regular basis to identify the areas for improvements and adjust the strategies as needed.
c) Compliance with rules and regulations
In New York, compliance with portions of ANSI/ASHRAE 188-2015 is mandatory. Other states have also started to adopt more measures in this regard to protect public safety. Therefore, it is good practice for property owners and facility managers to use proactive water management measures to ensure that their facilities meet and exceed the minimum requirements established by consensus-based standards and guidelines. Examples include ANSI/ASHRAE standard 188-2015, Legionellosis: Risk Management for Building Water Systems, and NSF Standard 453-2016.
d) Use of proper liability insurance coverage
Another protective measure that property owners can adopt is to ensure that their liability insurance provides adequate coverage against the Legionella claims.
e) Use internal audits for quality assurance
Quality assurance and quality control are two aspects of quality management, and both are important to ensure proper tools, techniques, and practices are used to effectively manage water systems in buildings and facilities. Quality assurance has an important role, similar to the role of the quality control; however, it may be considered a more fundamental need because it focuses on providing confidence that requirements will be satisfied. In other words, quality assurance ensures that proper water management systems, practices, and procedures are in place and followed.
To implement effective water management strategies, potential risks associated with the water management systems need to be identified, assessed, and managed. A proper application of risk management techniques makes facilities less vulnerable to potential risks arisen from Legionella bacteria. This article identified some of the recommended practices to ensure risk management practices are properly used for water systems to prevent and control Legionnaires’ disease, especially because cooling towers, evaporative condensers, and fluid containers have been identified as one of the main sources of dispersing water-dispersed diseases (e.g. Legionellosis). These practices include establishing water management program (WMP), following WMPs and improving them as needed, compliance with rules and regulations, using proper liability insurance coverage, and using internal audits for quality assurance. Using risk management practices are important not only to protect facilities and water management systems from detrimental risks but also to ensure that facility owners, such as commercial buildings and hospitals, do not incur costs due to unmanaged risks associated with Legionnaires’ disease.
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