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HRMR Annual 2016-17

The CDC also concluded that the following were the most likely sources of Legionella in building-associated outbreaks: • Showers and faucets; • Cooling towers (such as large centralized air-conditioning systems); • Hot tubs; and • Decorative fountains and water features. CAUSE OF LEGIONELLA PROLIFERATION It is well known that Legionella grows best in buildings with water ���������������� ���������� �������� �������� ���������������������������������� ������������������������ ������������ �������������������������� �������������� �������� �������� ���������������������� ���������������������� �������� ������������ ������������ �������������������������� are high enough to support bacterial growth. Therefore, the key to prevention is a water system maintenance program that adheres to current industry standards. The goal of the CDC’s recent analysis was to identify gaps between the impacted organization’s building water system maintenance programs and industry prevention standards, such as the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) consensus standard published in 2015. �������� �������� �������������������� ���������� ���������������������� ���� �� ������������������������ �������������� ������ organization’s water system maintenance program that can contribute to the growth and transmission of Legionella: 1. Process failures—missing or inadequate protocols. 2. Human errors—person did not perform set protocol as expected. 3. Equipment failure. 4. Unmanaged external changes—adjustments not made to external changes (ie, nearby construction or renovation). Water System Deficiencies Causing Legionella Equipment Failure Unmanned External Changes Annual 2016 | HEALTHCARE RISK MANAGEMENT REVIEW | 17 ROYALTYSTOCKPHOTO.COM / SHUTTERSTOCK.COM 70% 60% 50% 40% 30% 20% 10% 0% Process Failure Human Error Non-Healthcare Facilities Healthcare Facilities Multiple Legionnaires’ Disease on the Rise 1.80 1.60 1.40 1.20 1.00 0.80 0.60 0.40 0.20 0.00 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Reported cases per 100,000 people “The key to prevention is a water system maintenance program that adheres to current industry standards.”


HRMR Annual 2016-17
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