While the quality of the indoor air we breathe every day has been the focus of governmental regulation and has even stimulated a huge “Green Building” initiative throughout the United States, little, if any, focus has been directed at the quality of water in those buildings, and the potentially deadly bacteria that all too often live within that same environment.
I can assure you that the words pseudomonas, acinetobacter, and/or legionella-all very common water-borne bacterial pathogens- are words that you NEVER want to hear associated with anyone that you know or care about.
Why is it then that all our focus appears to be on the air we breathe and not the water we drink, and is this all about to finally change?Just a little more than 35 years ago, an outbreak of what appeared to be a new form of pneumonia occurred during an American Legion convention at a hotel in downtown Philadelphia killing 34 people and sickening hundreds more.
Today, we know that the source of this illness was the bacteria legionella and the disease was what has come to be known as Legionnaires’ Disease and not pneumonia. Unfortunately, this bacteria, along with new and significantly more drug resistant bacteria, are now showing up with increasing frequency in our water systems and causing illness not only in healthcare and long term care facilities, but in other structures as well including some of the ritziest hotels in this country.
This increase has not gone unnoticed: the Centers for Disease Control and Prevention (CDC) reported a 217% increase in cases of just legionellosis between 2001 and 2009 and the problem is not limited to the United States, but is a worldwide issue.
Contamination of building water systems can potentially destroy not only lives, but businesses and economies as well. Liability is significant with a nearly $200 million dollar verdict having been awarded for gross negligence on a recent legionella outbreak, reported healthcare costs of approximately $34,000 to treat a single case of legionellosis, and a single publicized case of Legionella was sufficient to destroy the business of a great hotel in less than a year. So maybe people are now starting to pay attention to the water…
For the last several years, the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) has been working on a “guideline” to be released in code ready language (i.e. will have the force of law when adopted into local building codes) to finally address the “water” issue.
This guideline (known as 188) will be applicable to those buildings where historical risks have been greatest for water-borne outbreaks of illness including many types of healthcare facilities, buildings greater than 10 stories, and/or those buildings with cooling towers, whirlpool spas/baths, decorative fountains, humidifiers, and potable water systems (since much of the legionella in our water survives chlorination from municipal water treatment facilities).
While water testing is not specifically required under the guideline, the development of a hazard analysis and critical control point program (HACCP) which will monitor conditions (known to be conducive to legionella proliferation) along with response actions (to be taken if established parameters are exceeded) will be needed to comply with ASHRAE 188.
Unlike many other pathogens potentially impacting our health, including the emerging and growing group of multi-drug resistant organisms all too present particularly in healthcare facilities today, prevention and control of legionella as well as other water borne pathogens IS possible and has been successfully demonstrated with numerous prevention and response technologies currently available today.
Careful consideration should therefore be given to evaluating whether surveillance of your water supply should be performed even in the absence of the ASHRAE 188, with the goal of making the water in your building as safe or safer than the air you breathe.
