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RHP Risk Management’s certified industrial hygienists, public health scientists and certified safety professionals have extensive knowledge and expertise in assessing, testing and analyzing water systems for Legionella, a bacterium known to be dangerous to public health. As recognized industry leaders, we partner with clients to match their needs with our application of our comprehensive Legionella water management services including development of custom, facility specific, water management programs; inspections of buildings and water storage containers for suspected sources of Legionella bacteria; investigations of suspected or confirmed cases of Legionnaires’ disease; and collection of routine or investigatory water samples to determine the presence of Legionella bacteria. Development and implementation of a water management program (WMP) and program validation through water sampling to determine the presences of Legionella can ensure the safety of those on your property, build confidence in water sources and protect your business from liability and business interruption.

What is Legionella and What Harm Can It Cause?

Legionella pneumophila is a bacterium found naturally in freshwater environments. When ideal conditions for bacteria proliferation occur, such as warm, standing or stagnant water, bacteria can multiply to levels of concern. Bacterial growth can occur in water storage vessels, delivery piping and fixtures at end-point uses, or in standalone devices such as cooling towers, hot tubs and decorative fountains.

When Legionella bacteria in a water system multiplies and becomes aerosolized, a person in proximity to the source may inhale the bacteria contained within the airborne water droplets. This inhalation or aspiration of water droplets can lead to the development of diseases such as Legionnaires’ disease, or legionellosis, a serious and fatal form of bacterial pneumonia, or a milder infection known as Pontiac Fever, an acute, nonfatal respiratory disease. Legionnaires’ disease is waterborne and is not transmitted from person to person. According to the Centers for Disease Control (CDC), Legionella is the number one cause of waterborne disease outbreaks in the United States as well as the most expensive. The CDC estimates that inpatient hospitalization for Legionnaires’ disease averaged more than $34,000 per case, totaling $101 to $321 million per year in the US for direct healthcare costs alone.

Legionnaires’ Disease Cases and Outbreak Investigations

Specific building water systems that can harbor and transmit Legionella include showerheads and sink faucets, cooling towers, whirlpool spas, hot tubs, decorative fountains, and hot water tanks/heaters. Most healthy individuals exposed to Legionella do not get sick. However, individuals with an increased risk of developing illness include those who are 50 years or older, current or former smokers, already are experiencing a chronic lung condition or disease, have a weak immune system, or have a history of cancer or underlying illness such as diabetes, kidney failure or liver failure. When Legionnaires’ disease is suspected and reported, the implications to businesses and facilities such as health care facilities, nursing homes, VA hospitals, cruise ships, casino, lodgings (hotels, motels, resorts), and multi-residential properties, as well as municipal water systems business interruption, brand/reputational damage and panic can be an expensive and irreversible outcome. When presented with a suspected case or outbreak—defined by the CDC as two or more people— working with experienced, knowledgeable and credentialed professionals can guide building owners and operators through an outbreak investigation and provide understandable and reliable analytical results.

We understand that a rapid response can be critical, RHP works closely and confidentially with clients to evaluate commercial, public and residential properties in response to Legionnaires’ disease allegations and suspected outbreaks. Our industry leading experts follow recognized methodology to:

  • Conduct a hazard analysis of building water systems (plumbing systems, cooling towers, whirlpool spas, ornamental fountains, misters, air washers, humidifiers).
  • Develop a site and case specific sampling strategy.
  • Collect water and/or swap samples for Legionella.
  • Understand the Legionnaires’ disease diagnosis.
  • Associate the laboratory analytical results with the identified disease.
  • Provide recommendations for any necessary remediation or mitigations actions.
  • Document control measures.
Case Study: Commercial Day Cares(Lead in Water)RHP Risk Management performed lead in water testing at
commercial day care buildings. RHP collected initial samples,
provided results and assisted mitigation strategies.
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Case Study: Healthcare Building(Legionella / Water Management Plan)RHP Risk Management developed a site-specific water
management plan (WMP) to reduce the growth and spread
of building related legionella & other waterborne opportunistic
pathogens for a healthcare facility.
Read Case Study

Water Management Program (WMP) Development

Our WMP development and validation services for public buildings, commercial buildings, residential facilities, lodging and resorts, and industrial facilities include the development and validation of a site-specific WMP to reduce the growth and spread of building-related Legionella following best-practice guidance as noted by the American National Standards Institute (ANSI) / American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE®) under Standard 188. RHP professionals work with onsite staff, management and owners to review WMP requirements and evaluate the current building water system design; develop a redesigned water system flow diagram; and assist with the development of a custom WMP. Following implementation of a site-specific WMP, RHP experts proficient and trained in providing Legionella water testing services, can assist with WMP validation plan either on a quarterly, bi-annually, annually or one-time sampling, by the collection of water samples analyzed by a CDC-elite Legionella laboratory testing facility. RHP is also a Legionella Assessment and Management Plan Support (LAMPS) partner.

RHP experts have decades of experience and knowledge in providing Legionella consulting services for commercial, public and industrial buildings, including:

  • Hospitals
  • Retirement communities
  • Long-term care facilities
  • Nursing homes
  • Hotels
  • Schools and dormitories
  • Factories
  • Resorts

In addition, RHP has assisted numerous hospitals and long-term care facilities with fulfillment of the Centers for Medicare and Medicaid Services (CMS) Memo # 17-30-Hospitals/CAHs/NHs requirements to develop water-management programs aimed at reducing the risk of legionellosis attributable to health care facility water systems.

The key to preventing Legionnaires’ disease is to develop a proactive preventative strategy and proper maintenance of building water systems. Water management programs developed by RHP professionals, follow guidance from the ANSI/ASHRAE Standard 188-2018 and CMS regulations and standards to manage Legionella related risks, provide clients with evidenced based, defensible, current, comprehensive, and effective controls for reducing the risk of Legionnaires’ disease, and instill confidence in their management. In addition, through WMP validation services including Legionella water testing, RHP professionals provide direct feedback on program effectiveness.

ANSI / ASHRAE Standard 188-2018

This nationally recognized standard provides guidance in developing a WMP to reduce Legionella growth and spread in buildings. The standard as published by ASHRAE, approved by ANSI in 2015 and updated in 2018 (Standard 188), “Legionellosis: Risk Management for Building Water Systems.”

Following this standard has been shown to provide building and facility managers tools to prevent cases of legionellosis through correct management of building water systems decreasing the risk of Legionella bacteria growth. Online guidance such as the CDC WMP toolkit, provides a simplified process based on key elements of the ASHRAE Standard 188 but may not be appropriate for all sources.

Centers for Medicare and Medicaid Services (CMS)

Created in June 2017 and revised in July 2018, the CMS issued a memorandum (Memo # 17-30-Hospitals/CAHs/NHs) that requires hospitals, long-term care facilities and critical access hospitals to develop and implement water-management programs aimed at reducing the risk of legionellosis attributable to water systems. The CMS memo references ASHRAE Standard 188 and the CDC toolkit as a tool towards achieving compliance.

Contact RHP for Legionella Water Management

RHP professionals guides with expert knowledge and expertise; works closely with clients when investigating buildings and suspected sources for the presence of Legionella bacteria; and develops need based and site-specific methodology and plans that use scientific risk-based guidance and solutions you and your company can trust. Our team of experts work to address pressing concerns, helping clients understand their risks and solutions moving forward. Our team consists of professionals who are recognized experts in their fields including risk management, industrial hygiene, safety, dose estimation and analysis, the built environment, exposure simulation and indoor air quality (IAQ).

The RHP team includes: 

  • Public health scientists
  • Risk assessors
  • Certified Industrial Hygienists
  • Certified Safety Professionals
  • Occupational Health and Safety (OHS) Science Professionals
  • Engineers
  • Anthropologists
  • Field technicians

With our Legionella testing and management services, our clients can expect to:

  • Recognize and manage the risks to their business.
  • Comply with industry and federal/state regulations.
  • Respond to liability claims and concerns.
  • Identify areas to target and control.

Contact us today to learn more about our Legionella water management program services.

For further references and RHP White Papers on the topic, see: rhprisk.com/white-papers