Novant Health

Brian Dick

More emphasis is driving change towards safer potable (drinking) water and that is especially good news for hospitals and other patient care locations. ANSI, ASHRAE, CMS, CDC, The Joint Commission – all with standards and recommendations to make our water safer for our patients. Therefore, consider making your water quality programs more comprehensive and applicable to any business, or even homes. If we can flow water that has sufficient disinfectant (like chlorine and chloramine) from our municipalities throughout our facilities, then the likelihood of having issues related to waterborne pathogens (like Legionella species) is greatly diminished. Taking that another step further – are there other processes where potable water is used that, if not safely maintained, increases the risk of Legionella exposure? Legionella species can be transmitted through water aerosols, or even through ingestion followed by aspiration (as in food going down ‘the wrong pipe’).Risk is often difficult to calculate, but in very simplistic terms, if a person were to inhale an aerosol contaminated with Legionella species, that person’s chance of developing disease is based upon the quantity of Legionella species inhaled and that person’s ability to fight-off disease; the more co-morbidities the person has (e.g. heart disease, lung disease, etc.), the greater the risk. It’s a given that we are all different, so building a comprehensive water quality program is a benefit to your organization by creating a safer environment for all no matter their level of health.

"It’s a given that we are all different, so building a comprehensive water quality program is a benefit to your organization by creating a safer environment for all no matter their level of health"

Besides the published guidance for water quality, consider the following situations with potential risk and develop strategies to reduce or eliminate the hazard: the lawn sprinkler system is scheduled to start in the morning when staff are walking past into the building; the coffee machine in the waiting room that needs water brought to it in a pitcher that has never been sanitized;vehicles that come to your facility that have handwashing sinks in the cargo area; the dish sponge wand containing dish soap that is used over and over again in the kitchen area; drinking fountains that use a filter that removes chlorine; the water dispenser on the communal refrigerator that has an expired filter; the water cooler that has had many water bottle exchanges but the dispenser parts have never been sanitized; the drinking fountain that receives little use; safety showers that hadn’t been flushed in months; sections of the building that have not been used in months and now occupancy is planned (same for a guest bathroom that hasn’t been used in months); and fire sprinkler systems that have never been drained, to name a few.

The intent here is not to problem-solve, but rather to help recognize less thought-about hazards. Then, together with your water management team, assess and develop actions plans to correct the hazard as needed, and a verification system that is part of the prevention strategy that lists the hazard, the preventive maintenance, the frequency of preventive maintenance, and the person accountable.