Healthy Indoors Magazine - USA Edition

HI May 2014

Healthy Indoors Magazine

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Page 34 of 57

AirWays Environmental Services Legionella Continued from previous page Healthy Indoors 35 favorable to Legionella amplification. Flushing water through a building's water supply helps to refresh chlorine disinfectant levels and can be protective against bacterial amplification. Reducing water usage is not a guarantee that Legionella will colonize a plumbing system, but before implementing such changes the overall impact on residual chlorine levels and biofilm development should be considered. The proliferation of electronic eye faucets in bathroom sinks has had an unforeseen impact in that they have created a breeding ground for Legionella and other waterborne bacteria. Many of these electronic eye faucets were installed for two purposes. First they were sup- posed to save water by shutting off automatical- ly, bypassing the discourteous patron who left the sink flowing. Second, they were supposed to reduce the spread of germs by eliminating the need for contact with the faucet handles. Unfortunately, the mechanics of making water flow without touching a faucet handle involves a system of solenoids, mixing devices, and a metal mesh screen to catch debris. The inner workings of such a mechanical wonder creates a great habitat for Legionella and Pseudomo- nas. Several studies in hospitals have found high levels of bacteria growing in these strain- ers and mixing valves, resulting in high levels in the water. While no outbreaks of Legionnaires disease have been publicly attributed to these automatic faucets, the data clearly shows ampli- fication and an increased risk of exposure. (5) Dismantled Public Health Agencies & De-regu- lation Two additional factors may be influencing how we perceive risks associated with Legionella and what can be done when illness occurs. Budgets for public health agencies at the fed- eral, state and local level have steadily been reduced and cut by significant amounts over the past 20 years. Fewer people are now respon- sible for providing the same services as before, and shifting political priorities have redirected funding to preparedness and high profile issues. The mundane task of ensuring that clean and safe water is delivered to the public is left to fewer public health professionals who are given less authority to enforce standards. The staff necessary to manage surveillance programs is now spread over several programs and has fewer resources to respond outbreaks when they occur. Efforts to dismantle public health agencies at the federal and state levels have resulted in fewer seasoned professionals who have the education, training, and experience to protect public health when crises arise. The Occupational Safety and Health Adminis- tration (OSHA), the federal agency that pos- sesses "right of entry" to perform the investiga- tions in work places that would be necessary to fully assess these claims, has not yet stepped into the arena. However, OSHA has been reportedly in the process of revising Technical Manual 7, which provides guidance on Legion- naires' disease; whatever revisions are made could potentially reduce risks to employees and the public. In the absence of effective regulations or com- petent public health professionals who have the authority and resources to investigate outbreaks and correct problems when they arise, the public is left with the option of litigation when they believe they have been impacted by Le- gionnaires' disease. The driving factors behind civil litigation are probably varied and unique to each situation, but the frequency of claims against hospitals, hotels, cruise lines, nursing homes, and businesses appears to be on the rise. Often these plaintiffs possess little or no data to prove their case, usually because the public health investigation is too late and incom- plete for the purposes of litigation. Several law firms have begun specializing in Legionnaires' disease cases on both the plaintiff and defense sides. This disturbing sign might be the best indicator of an impending storm of Legionnaires' disease. What's over the horizon? No one can be certain of what the field of Le- gionnaires' disease will look like in one year or

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