People Are Still At Risk
Posted on: 18/06/2015 By: Lee Rance
Brighton and Sussex University Hospitals NHS Foundation Trust has recently been fined £50,000 for failing to control legionella.
Legionella bacteria are common in natural water sources such as rivers, lakes and reservoirs, but usually in low numbers. They may also be found in purpose built water systems such as cooling towers, evaporative condensers, hot and cold water systems and spa pools. If the conditions are right, the bacteria may grow increasing the risk of Legionnaires disease.
Legionella may grow if the following conditions are present:
- The water temperature in all or some parts of the system may be between 20-45 °C, which is suitable for growth.
- It is possible for breathable water droplets to be created and dispersed e.g. aerosol created by a cooling tower, or water outlets.
- Water is stored and/or re-circulated.
- There are deposits that can support bacterial growth providing a source of nutrients for the organism e.g. rust, sludge, scale, organic matter and biofilms.
Legionnaires’ disease is a serious lung infection. It is usually caught by breathing in small droplets of contaminated water. The symptoms may initially be flu like, however once the bacteria begins to infect the lungs the symptoms of pneumonia may be experienced. These could include:
- A persistent cough – which is usually dry at first, but as the infection develops you may start coughing up phlegm or, rarely, blood.
- Shortness of breath.
- Chest pains.
Legionnaires’ disease is treatable with antibiotics however the disease can be very serious for the elderly or people with pre-existing health conditions.
Large buildings, such as hotels, hospitals, museums and office blocks, are more vulnerable to Legionella contamination because they have larger, more complex water supply systems in which the bacteria can quickly spread. Any employer, or person in control of the premises are responsible controlling the risks of exposure to legionella.
A responsible person must be appointed, with sufficient authority, competence, necessary skills, knowledge of the system, and experience. This person must carry out a risk assessment to identify any potential issues and implement a system of effective control measures. These could include:
- The system, e.g. develop a schematic diagram.
- The safe and correct operation of the system.
- What control methods and other precautions will be used.
- What checks will be carried out, and how often will they be carried out, to ensure the controls remain effective.
The Brighton and Sussex University Hospitals NHS Foundation Trust, which runs the Royal Sussex County Hospital in Brighton had failed to manage the deadly waterborne bug, according the HSE. The following inquest found that the infection, although successfully treated, may have hastened the death of 78 year old cancer patient Joan Rayment in November 2011.
The court heard that although the Trust was monitoring legionella and water temperatures across its various sites at the time of Mrs Rayment’s death, between October 2010 and November 2011 a total of 114 positive legionella tests and a further 651 records of water temperatures outside the required parameters were not adequately acted upon.
The court was told that one of the major contributors to the serious control failures was the fact that staff did not have sufficient instruction, training and supervision to be able to make informed decisions and take appropriate action.
After sentencing, HSE Inspector Michelle Canning commented:
“The legionella control failures we identified at the Royal Sussex are made all the more stark by the fact that those most at risk of contracting legionella were amongst the most vulnerable in our society – including cancer patients like Joan Rayment.”
“All organisations have a legal duty to control the risks arising from hot and cold water systems, but healthcare providers like hospital trusts must be especially vigilant and robust in terms of the systems they have in place.”
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Until next time.