Issue link: https://hi.iaq.net/i/692160
12 DEVELOPING A LEGIONELLA WATER MANAGEMENT PROGRAM 3 Control Measures & Corrective Actions: The Basics The diagram below shows the process of implementing and monitoring control measures. If you find that a control limit (i.e., temperature levels, disinfectant levels) is not being met, you need to take corrective actions to get conditions back to within an acceptable range. The right side, in yellow, illustrates the routine process of monitoring control measures to make sure they are within limits. The left side, in orange, shows the process of what to do if control measures are found to be outside of their limits. Identify Control Points (e.g., water heater, hot tub) Control Measures (e.g., added disinfectant, elevated temperatures) Routine Monitoring Within Limits? Document Results Corrective Action Enhanced Monitoring NO Within Limits? NO YES YES Document Results Document Results Document Results Document Results Remember, any time there is a suspected case of Legionnaires' disease associated with your building you should: 6 6 6 6 Contact your local and/or state health department or work with them if they contact you Notify anyone who could be affected by the growth and spread of Legionella in your building if the health department asks you to Decontaminate the building water systems if necessary (you may need to get additional help from outside experts) Review the water management program and revise it, if necessary Healthcare Facilities In addition to the steps listed above that you would take in all buildings, if a case of healthcare- associated Legionnaires' disease is discovered in a healthcare facility: • • • Make sure the person with expertise in infection prevention on your team is aware Important: Tell clinicians so they can test patients with healthcare-associated pneumonia for Legionnaires' disease with both culture of lower respiratory secretions and the Legionella urinary antigen test Report the case to your local and/or state health department; a full investigation may be needed For more details on identifying and investigating Legionnaires' disease cases in healthcare facilities, see page 24. Reference: ASHRAE 188: Legionellosis: Risk Management for Building Water Systems June 26, 2015. ASHRAE: Atlanta. www.ashrae.org