How to Improve Hospital Water Safety Standards
In this article the healthcare specialists at Legionella Control International look at some of the key challenges facing hospital estates and facilities teams in the management of hospital water safety systems.
The article explains why healthcare facilities often present an increased water safety risk, why the size and complexity of facilities really does matter, and how improved design practices can help to reduce water related risks in new buildings and refurbishments. It also reviews a number of common waterborne pathogens that can contaminate hospital water systems, and concludes by highlighting the importance of the Water Safety Group and intelligent risk planning practices.
A version of this story dealing with improvements to water safety standards in hospitals first appeared in Legionella Control International’s newsletter. To get it in your inbox, sign up for free here.
How to improve water safety in hospitals?
Every man-made water system could potentially be the site of an outbreak of waterborne bacteria – perhaps most notably, the potentially deadly Legionella bacteria. However, it’s worth noting that some water systems present a greater risk than others of developing this type of problem.
The more complex a water system is, the more likely it is that risk factors could be missed or mishandled. Many hospitals and other healthcare facilities are likely to have several water related risk factors present, all of which could lead to an increased chance of legionella and other waterborne bacteria and pathogens causing significant issues.
Does water system size and complexity increase water safety risk?
The size and complexity of a water system can be an issue in many plumbing systems. The larger a system is, the more places there are for bacteria to develop.
Both old and new hospital buildings are at risk too. Older buildings are more likely to have been expanded and redeveloped over the years. Additionally, changes of use may have also occurred.
Designing-out legionella and other water safety problems
With new hospital buildings, there is an excellent opportunity from the initial planning and design stage onward for the water systems to be designed with good water safety in mind. However, there is always a risk that the right people, those with the right knowledge and understanding of how to maintain water safety standards are not present during this process.
Proper planning and an understanding of water usage, legislation and guidance, people at greater risk of disease and illness, and other crucial factors must all be considered prior to the construction stage. This can help make sure the hospital water systems are safe, and fit for purpose from the start.
Even then, future expansion and changes of use to existing hospital buildings could lead to issues developing. In all cases, it is vital that a Water Safety Plan should be created by those people making up the hospitals Water Safety Group (WSG), those responsible for continuing to maintain safety in this area.
What are the two main waterborne pathogens to be aware of?
Any water system could contain one or more of the following pathogens. However, as we have seen, hospital systems could be at particular risk given their unique setting and demands.
Research has shown that the following pathogens do appear in hospital water systems. Risk assessments should therefore be created to consider and manage the presence of these waterborne pathogens, so they remain under control and at acceptable and safe levels at all times.
Legionella bacteria
Legionella bacteria is the cause of Legionnaires’ disease and the lesser-known and milder Pontiac fever. Some people are at greater risk from this respiratory disease than others, namely those aged over 50 and who already have underlying health conditions. People with respiratory conditions or who have certain chronic conditions would be at greater risk. Therefore, those in hospital and other healthcare settings may represent some of the higher risk groups.
Pseudomonas aeruginosa
Much like Legionella bacteria, pseudomonas can make anyone ill, but certain age groups and those with suppressed immune systems and/or illnesses can be at greater risk. Water that is already contaminated with P.aeruginosa can cause illness through transferring to people via hand washing, and via its presence on contaminated hospital equipment or surfaces.
There are other pathogens that may be present in hospitals as well, including:
- Stenotrophomonas maltophilia
- Certain species of Fusarium solani
- Nosocomial aspergillosis
Many pathogens present risk via aerosols, as legionella does. The risk of spray from shower heads or even water coming out of taps could mean that people nearby may inhale that spray and any legionella or other bacteria or pathogens in the water.
How can a Water Safety Group help combat the dangers of a hospital water system?
All water systems could harbour one or more types of waterborne pathogens. Keeping such pathogens at the lowest level, and certainly within safe limits, is vital for the continued safe running of a hospital.
One of the most important factors in achieving this is making sure that the right people have a role in the Water Safety Group. In a hospital it would not be enough for just a handful of people to have these roles. No one knows everything necessary to create a safety plan for risk assessing, checking, and maintaining a hospital water system.
To this end, those working in specific departments may be able to identify specific risks in their areas of work. These may include identifying whether their patients could be at higher risk of exposure to legionella and other bacteria and pathogens. They could also point out risk areas others without specialist knowledge could miss.
The aim of a Water Safety Group is to create an approach to water safety that begins with a comprehensive risk assessment of the water systems throughout the hospital. Each area should be separately reviewed, as one department may have risk factors that are not present elsewhere in the hospital.
By having the right people in the Water Safety Group, a comprehensive approach to water safety and reducing or eliminating risk factors, and an eye to changes in the hospital, water safety can be improved and made far more robust.
Hospitals are among the most complex and challenging buildings when looking at the control of legionella and general water safety. Yet with the right approach, there is no reason why they should see an increased risk of illness with these pathogens.
Healthcare water safety specialists
Our healthcare water safety specialists support those responsible for the control of waterborne pathogens including legionella and pseudomonas in hospitals and healthcare environments, helping them to protect people and so meet their health and safety obligations in this specialist area.
We are experienced in the role of Authorising Engineer (Water) and deliver professional water safety risk assessments for legionella, pseudomonas and other waterborne pathogens. We also offer water quality testing, independent compliance auditing, City & Guilds training and other risk management services that help keep staff and others safe.
If you would like to speak with one of our healthcare specialists about managing your water safety risks call us today on 0330 223 36 86 or contact us here …
