Legionnaires is a man-made disease that was created when humans started to store water and heating it up to a temperature that causes problems.
Legionella can appear in:
- Water systems incorporating a cooling tower.
- Water systems incorporating an evaporative condenser.
- Hot and cold-water systems.
- Spa pools.
- Natural thermal springs and their distribution systems.
- Respiratory and other therapy equipment.
- Humidifiers.
- Dental chair unit waterlines.
- Fountains/sprinklers.
- Water-cooled machine tools.
- Vehicle washes.
- Potting compost/soil in warmer climates.
Those at Risk of Legionella:
- People over 40 years of age.
- Males.
- Smokers.
- Those with excessive alcohol intake.
- Immunocompromised organ transplant patients, patients with a compromised or weak immune system, the elderly, children and those receiving systemic steroids. Patients with chronic underlying disease such as diabetes mellitus, congestive heart failure, chronic obstructive pulmonary disease and chronic liver failure are also high risk.
National Guidelines for the control of Legionellosis 2009.
Legionellosis is a disease comprising two distinct clinical entities: Pontiac Fever, a mild self-limiting influenza-like illness, and Legionnaires Disease a more serious and potentially fatal form of the illness, characterised by pneumonia.
Legionellosis is caused by Legionella bacteria which is abundant in nature and can be found naturally in environmental water sources such as rivers, lakes and reservoirs. From there the organism can pass into sites that constitute artificial reservoirs such as water distributions systems in towns and cities. Outbreaks of Legionnaires Disease have the potential to cause high levels of morbidity and mortality in those exposed.
In 2002, the Health Protection Surveillance Centre produced national guidelines for the surveillance, diagnosis, and clinical management of legionellosis. It also provided guidance on assessment and management of risks associated with Legionella in the environment.
Following the publication of the independently chaired report on legionellosis at Waterford Regional Hospital in 2003, the Department of Health and Children requested the HPSC Scientific Advisory Committee to review and update the national guidance on legionnaires’ disease. Considering this, the Legionnaires Disease Subcommittee was re-established to undertake this task.
Under the Infectious Diseases (Amendment) (No. 3) Regulations 2003 (S.I. No. 707 of 2003), which came into effect on 1 January 2004, laboratory and clinical notification of legionellosis (includes Legionnaires Disease and Pontiac Fever) is mandatory. It is also mandatory for a medical practitioner and a clinical director of a diagnostic laboratory to notify the medical officer of health of any unusual clusters/outbreaks of legionellosis.
Risk Assessment’s carried out by Aquachem:
In Ireland, under occupational health and safety legislation there is a legal obligation on employers to carry out a risk assessment in relation to Legionella prevention and control in the workplace and where a risk are identified the appropriate control measures should be put in place and a risk management plan adopted.
A risk assessment can take anywhere from 10 minutes onwards – it all depends on the size of the site.