FAQ Water

1. What is Legionella?
2. What is Legionellosis?
3. Are there differnet types of Legionella bacteria?
4. What is Legionnaires’ disease?
5. What is Pneumonia?
6. How do you get Legionnaires’ disease?
7. What are the symptoms?
8. Is legionnaires’ disease contagious?
9. Do Local Authorities and Housing Association, Estate Agents and Landlords need to carry out Legionella Risk Assessments?
10. Do all work places need a legionella risk assessment?
11. What about domestic property?
12. Will I need to carry out a legionella risk assessment if I have a Health and Safety Risk Assessment?
13. How can you control Legionella?
14. What do I do if I get a legionella positive result?
15. How much does a risk assessment cost?
16. What do I need to do after the legionella risk assessment?
17. What site monitoring will I need to do?
18. Can we do the assessment or monitoring in-house?
19. How often should I carry out a legionella risk assessment?
20. Is the landlord or tenant responsible for managing legionella?
21. What are the regulations that govern legionella control?
22. Who is most at risk at work?
23. What happens when an outbreak of legionnaires disease occurs?

What is Legionella?

Legionella is a naturally occurring bacteria wide spread in nature. When the bacteria enter water systems in the built environment, conditions can often favour and encourage significant growth and reproduction to levels which can cause bacterial pneumonia and be fatal to humans. As a result legionella is considered as a biological hazard and is listed under the COSHH Regulations. This defines the need for a suitable risk assessment to cover water systems in the work place.

What is Legionellosis?

Legionellosis is the name for a group of illnesses associated with legionella bacteria. There are three main illnesses caused by the bacteria, Legionniares Desease, Pontiac Fever and Lochgoilhead Fever. All types of infection are caused by Legionella pneumophila, although Legionella micdadei is responsible for lochgoilhead ferver.

Are there differnet types of Legionella bacteria?

Yes, there are over 40 different species of legionella bacteria. However, legionella pneumophila is considered the most dangerous as it causes about 90% of the cases of infection. Around 16 different sub groups of legionella pneumophila have been reported as the cause of infection. However, Legionella Pneumophila Serogroup 1 is the most associated with Legionnaires’ disease in the UK.

What is Legionnaires’ disease?

Legionnaires’ disease is a potentially fatal, bacterial pneumonia infection that is contracted by breathing in water droplets with an incubation period of 2-10 days with an average onset of 3-6 days. An infectious dose is clearly linked to susceptibility, although it is considered to attack between 2 to 5% of those exposed. The average mortality rate is accepted to be anything between 15 and 20% of people infected.

Pontiac fever is a more common, but milder illness caused by the same bacteria. Pontiac fever is a flu like illness which usually last up to five days. No treatment is needed for pontiac fever other than paracetamol or ibuprofen for the minor fever and muscle aches. Pontiac Fever is often contracted but goes undiagnosed as the symptoms are so similar to the flu. Pontiac fever does not develop into pneumonia.

Loichgoilhead Fever is also caused by legionella bacteria. Like Pontiac fever, loichgoilhead fever is not usually fatal and will normally abate itself without treatment.

What is Pneumonia?

Pneumonia is frequently but not always due to infection that causes inflamation of the lungs. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath. Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic. Elderly people may also have few symptoms with pneumonia.

Some cases of pneumonia are contracted by breathing in small droplets that contain the organisms that can cause pneumonia. These droplets get into the air when a person infected with these germs coughs or sneezes. In other cases, pneumonia is caused when bacteria or viruses that are normally present in the mouth, throat, or nose inadvertently enter the lung.

Some types of pneumonia are known as atypical. These include infections caused by certain bacteria, such as Legionella pneumophila, Streptococcus pneumoniae, Mycoplasma pneumoniae and Chlamydophila pneumoniae (this is not an STD). Mycoplasma pneumonia is a common in children and may be associated with non-respiratory problems, such as rashes, anaemia or meningitis. If Pneumonia is diagnosed it is important to find out what form of the infection it could be.

How do you get Legionnaires’ disease?

Legionnaires’ disease is contracted by inhaling small water droplets which can be suspended in the air known as aerosols. Aerosols containing the bacteria will pose a risk to susceptible individuals. Infection however, is clearly linked to susceptibility. Highly susceptible individuals may get infected even at relatively low doses. The HSE deem a domestic water system to be under control if legionella is maintained below 100cfu/l. There are particular controls for the NHS who have particularly susceptible individuals in there premises all the time.

What are the symptoms?

The symptoms of Legionnaires’ disease, pontiac fever and loichgoilhead fever are all similar to the symptoms of very severe flu. As a result, legionellosis often goes undetected:

• High temperature, feverishness and chills
• Cough
• Sputum
• Muscle pains
• Headache
• Pneumonia
• Diarrhoea
• Signs of mental confusion

are all some of the symptoms experienced.

Is legionnaires’ disease contagious?

Legionnaires’ disease is not contagious and cannot be passed from person to person. The disease is transmitted by inhaling the aerosol of an infected water supply, not by infected persons. Legionella is different from Swine Flu and SARS which are contagious.

Do Local Authorities and Housing Association, Estate Agents and Landlords need to carry out Legionella Risk Assessments?

All local authorities are required to carry out legionella risk assessments. However the HSE accept a more pragmatic approach will be required and even suggest that a generic risk assessment may be used where large residential housing stocks are involved. However, this will require careful judgement and Organisation should appoint specialist support to risk categorise stock to create the generic assessments. Further to the risk assessments annual condition reports will be required to ensure the efficacy of the generic assessments. Various precautionary tasks should also be considered to clearly demonstrate that the risk ratings are appropriate.

Do all work places need a legionella risk assessment?

The HSC approved code of practice for legionella (L8) applies to ‘ any undertaking involving a work activity and to premises controlled in connection with a trade, business or other undertaking where water is used or stored and where there is a means of creating and transmitting water droplets which may be inhaled, thereby causing a reasonably foreseeable risk of exposure to legionella bacteria ‘. In short – if you have water on site that people can be exposed to, you need to assess and manage the risk from legionella bacteria.

What about domestic property?

The HSC approved code of practice for legionella (L8) is only relevant in circumstances where the Health and Safety at Work etc Act 1974 applies, therefore most domestic property is exempt from regulation. The risk from domestic property is viewed to be very low at this time.

Will I need to carry out a legionella risk assessment if I have a Health and Safety Risk Assessment?

A good health and safety risk assessment will normally define the requirement for a full legionella risk assessment to be conducted. The health and safety risk assessment will highlight all the likely health and safety risks in the workplace. However, the health and safety risk assessment will not normally actually assess the risks of legionella and it will not provide a site specific control scheme or schematics required to provide adequate cover for your organisation. A fully HSE L8 compliant risk assessment will still be needed in most cases.

How can you control Legionella?

There are numerous measures that can be adopted to create water systems in the built environment that are hostile to the growth of legionella. Most traditionally, temperature is used to control legionella. Wherever possible, temperature should be the initial line of defence used to control legionella growth in a system.

Temperature control

Cold Water – If we can manage the cold water temperatures throughout the system to ensure that cold water is stored below 20°C and distributed to all outlets within two minutes of opening the tap below 20°C then the cold water circuit will not encourage bacterial growth including legionella growth.
Hot Water – Hot water should be stored at 60°C and distributed and supplied to all outlets above 50°C within 1 minute of operation.
Stagnation – Stagnation can be prevented by introducing routine flushing programmes and reducing the volumes of stored water.
Chemical control – At Aqua Legion we see the use of chemicals as the last line of defence, and we will always explore the fundamental measures for control and management before embarking upon or recommending any chemical treatment programme for domestic systems.

What do I do if I get a legionella positive result?

If you get a legionella positive result you should not panic! If legionella is identified in your system there are many measures that you can take to eradicate it. Measures such as thermal disinfections, temperature management and chemical disinfections can be used to clean your system. You do not need to report a legionella positive result to the Environmental Health or your Local Authority. If you obtain a legionella positive result and need assistance or support contact us today.

How much does a risk assessment cost?

The cost of a risk assessment is entirely dependent on the amount of water services in use at the property. We offer a free consultancy meeting to assess your needs.

What do I need to do after the legionella risk assessment?

The legionella risk assessment will either find the site to be either low or negligible risk, in which case a simple review of the assessment should be made every 2 years, or it may be that a reasonably foreseeable risk is identified. In this instance, remedial work may be recommended together with a programme for continual monitoring and control (see what site monitoring will I need to do?).

What site monitoring will I need to do?

The required level of monitoring will depend on the plant and water services at the site, and Howlett Associates can tailor make programmes for the management of legionella to suit the property. Typically, a standard office with simple domestic welfare facilities would require monthly monitoring of water temperatures, annual inspections of cold water storage tanks and an annual review of the management programme. In addition, water services that are used infrequently would need to be flushed weekly. In situations where water is used in a process or a cooling tower or evaporative condenser is in operation more frequent and in-depth monitoring would be required.

Can we do the assessment or monitoring in-house?

The HSC approved code of practice for legionella (L8) states that ‘persons who carry out the assessment and who draw up and implement precautionary measures should have such ability, experience, instruction, information, training and resources to enable them to carry out their tasks competently and safely, where the expertise is not possessed (by the person on whom the statutory duty falls) it may be necessary to enlist help and support from outside the organisation.

How often should I carry out a legionella risk assessment?

According to the HSC approved code of practice for legionella (L8), the assessment should be reviewed regularly (at least every 2 years) and whenever there is reason to suspect that is no longer valid, for example:

• Where there have been changes to plant, the water system or its use
• Where there have been changes to the use of the building
• Where new information about risk or control measures has become available
• Where monitoring indicates that control measures are no longer effective

Is the landlord or tenant responsible for managing legionella?

This will ultimately be determined by the lease agreement but generally speaking tenants who have sole occupancy of a building where they are also responsible for maintenance and repairs will be the person or persons on whom the statutory duty falls. Where there are multiple occupants or where the landlord services and maintains the building, then the duty would usually fall to the landlord unless other arrangements have been documented and communicated.

What are the regulations that govern legionella control?

The two main pieces of legislation are the Health and Safety at Work Act (1974) and the Control of Substances Hazardous to Health Regulation (1994). Companies that fail to comply with government guidance may be prosecuted under either of these regulations.

Who is most at risk at work?

It is impossible to tell who is most at risk just by looking at people, as many conditions that could increase the risk are not visible. Generally speaking though, those who smoke, drink excessively, are overweight, and anyone with an underlying illness that affects their immune system may be more at risk. The elderly are the most vulnerable members of the population.

What happens when an outbreak of legionnaires disease occurs?

An outbreak is defined as two or more confirmed cases of legionellosis occurring in the same locality within a six-month period. It is the responsibility of the Proper Officer for the declaration of an outbreak. The Proper officer is usually a Consultant in Communicable Disease Control (CCDC). In Scotland, it is the Consultant in Public Health Medicine (CPHM). Local authorities will have established incident plans to investigate major outbreaks of infectious disease including legionellosis. These are activated by the Proper Officer who invokes an outbreak Committee, whose primary purpose is to protect public health, and prevent further infection. This will normally be set up to manage the incident and will involve representatives of all the agencies involved. The local authority, CCDC or EHO acting on their behalf may make a site visit and request the shutting down of any processes which are capable of generating and disseminating airborne water droplets. They may take water samples and ensure emergency disinfection is undertaken.