In February 2017, the Queensland Government amended both the Public Health Act 2005, to improve water risk management practices in health facilities across the state.
All hospitals with inpatients, residential aged care facilities and any licenced private health facility in QLD are required to:
Develop a Water Risk Management Plan
Ensure Water Risk Management Plans are complied with
Notify the Chief Executive of the Department of Health (within 1 business day) when it is confirmed that Legionella has been detected in water used by a prescribed facility
Submit periodic reports summarising the results of Legionella tests for a prescribed facility.
On a national scale this legislation is not mandatory, however each state recommends implementing a Water Risk Management Plan to manage the risk of legionella. While most healthy individuals will not develop an illness from legionella, newborn babies or very old people with compromised immune systems are at risk of legionella infection, causing either serious illness or fatalities.
In health and aged care settings, the mortality rate from Legionnaires’ disease is as high as 40 per cent.
– Queensland Health
Implementing a Water Risk Management Plan will not only improve the management and control of health risks associated with the supply and use of water, but also provide a greater public transparency of water testing activities being undertaken by your facility.
A Water Risk Management Team is responsible for developing and enforcing written procedures for legionella risk management. It is essential the Water Risk Management Team provides all staff access to the Water Risk Management Plan.
A Water Risk Management Team can be made up of both internal and external resources.
2. Describe the facility’s water distribution system
When undertaking a proper system analysis, it is essential that accurate plans of the water distribution system are held, along with any modifications to the original system.
In older or larger buildings, obtaining an accurate plan may be difficult. To ensure accuracy, conduct physical inspections to identify and highlight where components of the water distribution system may increase the risk of Legionella growth.
3. Identify Hazards
Identifying all potential hazards, hazard sources and hazardous events will allow for a better understanding of the risks and how to control them in an appropriate manner.
4. Undertake a risk assessment
Undertaking a risk assessment will take into account any the water system risks or health risks.
More specifically, the process will ‘consider the likelihood of Legionella colonisation and infection, and the consequence of the colonisation or infection.’¹
Find out more information on undertaking a risk assessment, here.
5. Identify control points
Control points are the ‘locations within a water distribution facility at which a hazard may be reduced or prevented (e.g. point-of-entry into a facility or water leaving a storage tank within the facility).’²
Where possible, proactive control measures should be developed and implemented at these points to reduce the risk of legionella growth within your water distribution system and minimise exposure.
6. Set Critical Limits
Set a maximum or minimum value set (critical limit) for a particular parameter being monitored at each control point. This process will indicate whether set controls are effective or not.
7. Develop and implement
A Monitoring Program
Monitoring a facility’s water distribution system provides the ability to assess the effectiveness of maintenance and controls, as well as detecting the presence of Legionella before cases of Legionnaire’s disease occurs.
Sampling and analysing of the water is vital to ‘ensure that the risk control measures instituted are effective’ (operational monitoring) and to ‘determine the presence and extent of legionella colonisation, both generally and following the implementation of control or remediation measures’ (verification monitoring).¹
Corrective procedure actions for the monitoring program
If Legionella is detected, or a case of Legionnaires’ disease is shown or suspected to be linked to a colonisation of a facilities water distribution system, one or more of the following control measures or an alternative suitable decontamination procedure should be undertaken as a matter of priority:
Chlorination and hyper chlorination
Cleaning of fittings or replacement with new or cleaned fitting
Implementation of appropriate exposure controls
For more information on these methods, click here.
Management of incidents and emergency procedures
Sampling, swabbing and testing should be conducted as soon as possible. This will help to determine the extent of potential Legionella colonisation within the water distribution system, before commencing appropriate precautionary control measures as a matter of priority.
Record keeping procedures
Record keeping procedures are important to ensure accurate documentation of all results and actions. The documentation should include:
A schedule for updating and reviewing the Water Risk Management Plan
Your Water Risk Management Plan should be a living document that is reviewed regularly by the Water Risk Management Team. It is essential that this document is reviewed following incidents or cases, to assess the effectiveness of the response.
Full reviews should be conducted annually (or more frequently), based on the risk assessment after a detection of Legionella in the water distribution system or a case of Legionnaires’ disease, or after significant system modifications or change of use.
Frequency, triggers and plans for review should be outlined in this plan.
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