Healthy Indoors Magazine - USA Edition

Legionella Continued from previous page Healthy Indoors 43 time we must rely upon professional judgment and familiarity with each facility and its poten- tial sources to establish site specific monitoring programs. Because we must rely so heavily upon the professional judgment and expertise of an individual some effort is needed to determine who should be considered a competent profes- sional. Because Legionella is a challenging microorganism to control and the water systems it tends to colonize are complex by their very nature, individuals charged with establishing and implementing a proactive monitoring plan should have both a sound foundation of knowl- edge and specific training on Legionella, its ecology, control and measurement. Only specially trained and qualified individuals should perform assessments of Legionella bac- teria in building water systems, design remedia- tion protocols and conduct post-remediation verification. Such individuals include, but would not be limited to, Certified Industrial Hygienists (CIHs) with specialized education, training and experience specific to Legionella bacteria and building water systems. Individuals with lesser amounts of training and education can perform much of the sample collection and measure- ment of water source parameters under the direction of a Competent Professional. Teams conducting assessments of amplifica- tion sources suspected to have caused either a single case of Legionnaires' disease, or an out- break, should be multi-disciplinary and be com- prised of appropriate subject matter experts, including occupational or respiratory physicians and building engineers. Interpretation of sampling and measurement re- sults should be left to competent professionals with general and specific knowledge of building water systems (both potable and utility), micro- biology, sampling methodologies, personal pro- tective equipment and exposure assessment. • Institute an active surveillance system for Legionnaires' disease with adequate resources at the Centers for Disease Control and Prevention (CDC). • Shift the responsibility of environmental investigations for Legionella sources and oversight of remediation efforts associ- ated with LD outbreaks to Industrial Hy- gienists at the National Institutes for Oc- cupational Safety and Health (NIOSH). • Commission and fund research needed to validate interpretive guidance for Le- gionella concentrations in water sources under various conditions. • Conduct research to determine risk factors that could help to predict the virulence of Legionella and its infectious dose. • Develop and pilot test procedures to pro- actively monitor and prevent Legionella in building water systems. • Adopt an Industrial Hygiene approach to the anticipation, recognition, evalua- tion, control, and prevention of Legionella hazards. • Provide adequate funding to federal and local agencies to research, investigate, and enforce Legionella activities. • With input from stakeholders in the hospitality, healthcare, and other work- places, develop an implementation plan for proactive monitoring and prevention of Legionella with the goals of reducing risks to the general public and workers, early detection of amplification sites, establishing criteria for proactive monitor- ing, and defining validation metrics for control efforts. WHAT CAN BE DONE DIFFERENTLY?

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