Legionnaires' disease acquired its name when an outbreak of pneumonia occurred among people attending a convention of the American Legion. The causative agent was identified as a previously unknown strain of bacteria, subsequently named Legionella. Whilst Legionella can be serious, however some people can be infected with the Legionella bacteria and develop only mild symptoms or no illness at all.
Legionella can be found in most water systems and can easily colonise in most domestic water systems, whether hot or cold, since the optimum temperature range for legionella growth is between 20⁰C and 45⁰C. Legionella also prefers stagnant conditions.
The route of infection is primarily through inhalation of aerosols, fine droplets and mists, but can also be brought about by choking on contaminated water. Fifty to seventy year olds are statistically more susceptible.
As stated, the Legionella bacteria may give rise to Legionnaires Disease which is potentially a fatal form of pneumonia with a 5% to 30% fatality rate. The Incubation period is 2 to 14 days.
Typical systems at risk include cooling towers; domestic hot and cold water systems; water features such as ornamental fountains; equipment producing aerosols, mists, or droplets from stored water sources including showers and humidifiers and equipment holding or circulating water between 20⁰C to 45⁰C.
Legionella may be controlled by amongst other measures, proper temperature monitoring; avoiding temperature conditions between 20⁰C and 45⁰C; avoiding water stagnation by removing “dead legs”; maintaining satisfactory cleanliness of spray outlets and periodically flushing rarely-used outlets.
Considering the associated risks and the fact that Legionnaires' Disease can be prevented, local legislation requires that proper controls are in place through the implementation of effective management systems in order to minimise the risks.
The European Guidelines for Control and Prevention of Travel Associated Legionnaires’ Disease which were produced by the European Working Group for Legionella Infections (EWGLI) comprise the basis for the local legislation on the Control of Legionella (L.N. 5 of 2006).
The Law captures all non-domestic premises where a trade or business activity is undertaken, irrespective of whether this is done for profit or not and particularly accommodation premises, healthcare facilities and schools. The Law stipulates that management should ensure a satisfactory management regime is in place by performing risk assessments; ensuring a suitable control regime; maintaining and upgrading of water systems and reviewing control measures. The responsible person is also obliged to perform a documented risk assessment to identify the risk of exposure to legionella bacteria. Such risk assessment should be reviewed by an external auditor every two years.
The responsible person is not only obliged to implement and follow a procedural manual but arrange to have water samples taken according to the legal schedule and analysed in an accredited lab in terms of L.N. 262 of 2006, Control of Legionella (Amendment) Regulations, 2006.
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