Young, fit, and healthy people are considered at low risk of succumbing to Legionnaires’ disease, but when the elderly and patients with weakened immune systems are exposed to water contaminated with Legionella through poorly maintained hot water systems, the risk becomes considerably higher.
Roughly 400,000 seniors in the United Kingdom live in either nursing homes or residential homes for the elderly. These facilities are subject to the guidelines set forth by the World Health Organization and the Health and Safety Executive with regards to the levels of Legionella found in the water system which require immediate remedial action and intervention.
Specifically, the Health and Safety at Work etc. Act 1974 states that those who are tasked with managing these establishments have a duty to evaluate the risks of Legionella that can affect the elderly residents.
The Control of Substances Hazardous to Health Regulations 2002, on the other hand, state that care homes should assess the risks posed by Legionella to both staff and residents and, when necessary, take the necessary precautions.
Water check in care homes revolves around two key points: controlling the risk of Legionella and preventing scalding.
The first step that needs to be undertaken in order to reduce the risk of Legionella in care homes is evaluating the design of the water system.
Specifically, the water system should have a short pipework equipped with adequate insulation. Materials used in the system should not promote the growth of the bacteria and protective measures against contamination should be put into place.
In terms of operation, care home managers should be aware of the fact that Legionella can reproduce rapidly given the right conditions. This means that hot water should be stored at a temperature over 60°C and distributed at a minimum temperature of 50°C.
Apart from setting the right temperature for storage and distribution of hot water, it is essential to conduct periodic checks and inspections on the water system, preferably by a trained and experienced professional. This risk assessment should also be reviewed from time to time.
In many nursing homes, water temperature is usually kept at 60°C, not just to control the risk of Legionella but also for other purposes, including for applications like laundry and kitchen use and to take into account the length of the pipe run.
The problem here is that when the water temperature reaches 43°C or more, the residents of care homes are at risk for scalding.
With this in mind, the right question to ask is: How can you minimise the risk for both Legionella and scalding?
The simplest way to prevent both Legionella and scalding in nursing care homes is to install thermostatic mixing valves. These valves prevent the discharge of water with a temperature beyond 43°C.