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Legionella Risk Assessments

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Is it a legal requirement to carry out a Legionella Risk Assessment? 
If you are an employer or a person in control of premises, the answer is ‘yes’. 
 
You are required to comply with: 
The Health and Safety at Work etc Act 1974 (HSWA), which extends to risks from legionella bacteria, arising from work activities. The Control of Substances Hazardous to Health Regulations 2002 (COSHH) , which provides a framework of duties designed to assess, prevent or control the risk from bacteria like Legionella and take suitable precautions. 
The HSE Approved Code of Practice – Legionnaires’ disease – the control of legionella in water systems (L8) 4th edition. 
 
If I am not storing hot or cold water in my system, do I need to carry out a risk assessment? 
Yes. There may be other factors within your system that increase the risks of legionellosis, e.g. deadlegs, shower heads and/or long runs of pipe work containing warm water. A risk assessment also considers the people who could be potentially exposed to any legionella bacteria in your system, as well as any particular groups that are at a higher risk of contracting legionellosis. 
 
What is the purpose of a Legionella risk assessment? 
The purpose of carrying out a risk assessment is to identify any risks in your water system. The competent person should understand your water systems and any associated equipment, in order to conclude whether the system is likely to create a risk from exposure to legionella. 
 
What should it include? 
Your risk assessment should include: 
 
<ul>
<li>management responsibilities, including the name of competent person and a description of your system</li>
<li>potential sources of risk</li>
<li>any controls in place to control risks</li>
<li>monitoring, inspection and maintenance procedures</li>
<li>records of the monitoring results, inspections and checks carried out</li>
<li>a review date – although there is no guidance in the revised HSE ACOP on how frequently you should review the Risk Assessment, it is prudent to do so annually or earlier, if the design of the water system has changed.</li>
</ul>

 
If you decide that the risks are insignificant, your assessment is complete. 
 
Who can undertake the risk assessment? 
As an employer or a person in control of premises, you must appoint someone competent to help you manage your health and safety duties, e.g. take responsibility for managing risks. A competent person is someone with the necessary skills, knowledge and experience to manage health and safety, including the control measures. 
 
You or one of your employees could carry out the risk assessment, or if you don’t have the necessary expertise, you can appoint an external contractor. 
 
If you decide to employ an external contractor to carry out your risk assessment, remember it is still the responsibility of the competent person (you!) to ensure that the work is carried out to the required standards. Before you employ a contractor, you should be satisfied that they can do the work you want to the standard that you require. 
 
How can I ensure that your Risk Assessors are competent to carry out the Risk Assessment? 
 
<ul>
<li>They have many years’ experience in carrying out Risk Assessments in all types of buildings and they work extensively in the healthcare and commercial sectors</li>
<li>Their reports are fully compliant with the requirements of the HSE’s Code of Practice ‘Legionnaires’ Disease – the control of legionella in water systems’ and with the recommendations and guidance contained in BS8580:2010 – Risk assessments for legionella control</li>
<li>They are active members of The Legionella Control Association (LCA) and are acknowledged for their expertise and the quality of their work.</li>
<li>They provide training for personnel from other companies within the water hygiene sector in carrying out Risk Assessments to the correct standard.</li>
</ul>

Legionella Risk Assessments

Is it a legal requirement to carry out a Legionella Risk Assessment? If you are an employer or a person in control of premises, the answe...

Schools and Nurseries

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Unfortunately, increasing numbers of children attending schools and nurseries are suffering from bronchitic conditions, such as asthma, which makes them vulnerable to infections affecting the lungs. Thus, if exposed to the legionella bacteria, they are at high risk of contracting Legionnaires’ Disease, which is a pneumonia type illness. 
 
Schools, particularly those with older facilities, often have a significant amount of pipework. This can lead to ‘deadlegs’, where stagnant water can accumulate, a perfect breeding ground for bacteria. 
 
Ensure that the water system is free from the legionella bacteria by maintaining the water temperatures at the levels recommended in the HSE’s Code of Practice and flushing the taps and showers regularly, particularly during the school holidays. You should also carry out a test for the presence of the legionella bacteria in the water system and repeat this on a regular basis.

Schools and Nurseries

Unfortunately, increasing numbers of children attending schools and nurseries are suffering from bronchitic conditions, such as asthma, wh...

Nursing and Care Homes

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Why is it necessary to control the risk of exposure to the legionella bacteria? 
Legionella bacteria are associated with cases of Legionnaires’ Disease, a potentially fatal form of pneumonia, caused by breathing in water droplets or aerosol contaminated with the legionella bacteria. 
 
The bacteria are found in the environment, usually in ponds, streams and reservoirs. When water is drawn from these sources for our hot and cold supply, small, but not dangerous, numbers survive the various disinfection processes. 
 
When do legionella bacteria become dangerous? 
Poor temperature control within a water system is a common cause. However, ‘deadlegs’ in pipework and taps and showers that are infrequently used, but not regularly flushed, can also cause the bacteria to grow very quickly. 
 
At this point, there is a real risk of people contracting Legionnaires’ Disease. 
 
Who is most at risk of contracting Legionnaires’ Disease? 
Elderly people are at high risk of contracting Legionnaires’ Disease, if they are exposed to the legionella bacteria, particularly if they also have health problems. This is because our immune systems decline with age. 
 
In cases of Legionnaires’ Disease, there is a high incidence of mortalities amongst the elderly. 
 
Inspectors are becoming increasingly aware of the dangers of legionella bacteria and are now looking for evidence of testing within properties. 
 
So help fulfill your requirements under the CQC Standards, (Care Inspectorate in Scotland and CSSIW in Wales) by carrying out a legionella test.

Nursing and Care Homes

Why is it necessary to control the risk of exposure to the legionella bacteria? Legionella bacteria are associated with cases of Legionna...

Dental Surgeries and Practices

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You will almost certainly have patients visiting the practice who fall into the ‘at risk’ categories for contracting Legionnaires’ Disease. 
 
Who are ‘at risk’ ? 
Not only the elderly are at risk of contracting Legionnaires’ Disease. Anyone who has a weakened immune system, due to health problems or deliberate suppression, following organ transplantation, for example, is at high risk. Also, people suffering from heart or lung problems, such as asthma, are very vulnerable. 
 
What is the reported incidence of legionella infection from visiting a dental practice? 
It is true to say that the numbers of reported cases is very few. However, despite the fact that there seem to be few cases of infection reported from dental surgeries, there is significant evidence to cause concern with regards to the potential growth of legionella within dental practices, in particular, the presence of legionella within dental unit water lines (DUWLs). 
 
Scientific studies have shown that samples taken from over 50 dental surgeries in the south-west of England contained a wide range of bacteria including legionella; up to 25 per cent of DUWLs have been shown to be contaminated with legionella. 
 
How could the bacteria be transmitted to staff and patients? 
The main route of transmission of the legionella bacteria for dental staff and the patient is by inhalation of contaminated water droplets or aerosol, generated by dental instruments such as the high speed hand piece or ultrasonic scaler. 
 
The use of masks can provide limited protection from aerosol for members of staff, but the aerosol generated can easily be inhaled by the patient who has no barrier protection. Therefore, it is essential to ensure that the water used during dental procedures is of a quality that does not pose any threat or risk to health to either staff or the patient. 
 
How can I control the growth of legionella in dental lines? 
Currently, there is no single method or device that will completely eliminate bacterial growth in DUWLs or exclude the risk of cross-infection. In view of this, several simple procedures need to be implemented to control the risk of bacterial proliferation within DUWLs. 
 
The purging of DUWLs is one such procedure. This procedure is simple but effective, as long as it is performed diligently. However, it is very important to evidence that this has been carried out. Therefore, a checklist should be devised to record purging activity and a record kept in a Logbook (an exercise book should be sufficient for the purpose). 
 
What about the water system(s) at the practice? 
Hot and cold water systems must also undergo specific checks, which are laid down in the HSE’s Approved Code of Practice (ACOP) on the control of legionella in water systems, usually referred to by its number (L8). Particularly important are the tasks relating to flushing infrequently used outlets and monitoring the water temperatures. 
 
What are the legal requirements regarding legionella control? 
You are required to comply with the above ACOP. The Code gives practical advice on how to comply with the law but is not in itself primary law. 
 
However, unusually, the Code has a ‘special legal status’, due to the dangerous nature of Legionnaires’ Disease, and can be brought into reference, if you are prosecuted for breach of health and safety law. 
 
Failure to fully comply with the provisions of the Code of Practice, which can be a time consuming and awkward task, is regarded as a serious matter by a Court. The expectation is that the ‘responsible’ person at the practice (usually the practice manager) should be tasked with ensuring compliance. 
 
Apart from the ACOP, you are also required to comply with the requirements of the Health and Safety at Work (HSWA) and the Control of Substances Hazardous to Health (COSHH) Acts. 
Is there anything available to assist with ACOP compliance? 
Fortunately, you are permitted to use ‘alternative methods’ to ensure your compliance with the ACOP (L8) Code of Practice. Testing on a regular basis, using an accredited laboratory, for the presence of the legionella bacteria in the water system(s) is generally regarded as an acceptable ‘alternative method’. This process is currently used by many dental practices around the country, ensuring protection and peace of mind.

Dental Surgeries and Practices

You will almost certainly have patients visiting the practice who fall into the ‘at risk’ categories for contracting Legionnaires’ Disease...

GP Surgeries and Practices

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Who is most at risk of contracting Legionnaires’ Disease? 
Those people most ‘at risk’ of contracting the disease: 
<ul>
<li>Have weakened immune systems, due to age or certain medical treatments, such as chemotherapy, or are immunosupressed, following organ transplantation, for example</li>
<li>Have bronchitic or heart conditions, including asthma</li>
<li>Are smokers or have alcohol or drug dependency problems</li>
</ul>

At some time or another, you will almost certainly have patients visiting the practice who fall into the ‘at risk’ categories for contracting Legionnaires’ Disease. 
 
What checks do I need to perform on the water system(s) at the practice? 
Hot and cold water systems must undergo specific checks, which are laid down in the HSE’s Approved Code of Practice (ACOP) on the control of legionella in water systems (L8). Particularly important are the tasks relating to flushing infrequently used outlets and monitoring the water temperatures. 
 
What are the legal requirements regarding legionella control? 
You are required to comply with the above ACOP. The Code gives practical advice on how to comply with the law but is not in itself primary law. 
 
However, unusually, the Code has a ‘special legal status’, due to the dangerous nature of Legionnaires’ Disease, and can be brought into reference, if you are prosecuted for breach of health and safety law. 
 
Failure to fully comply with the provisions of the Code of Practice, which can be a time consuming and awkward task, is regarded as a serious matter by a Court. The expectation is that the ‘responsible’ person at the practice (usually the practice manager) should be tasked with ensuring compliance. 
 
Apart from the ACOP, you are also required to comply with the requirements of the Health and Safety at Work (HSWA) and the Control of Substances Hazardous to Health (COSHH) Acts. 
Is there anything available to assist with ACOP compliance? 
Fortunately, you are permitted to use ‘alternative methods’ to ensure your compliance with the ACOP (L8) Code of Practice. Testing on a regular basis, using an accredited laboratory, for the presence of the legionella bacteria in the water system(s) is generally regarded as an acceptable ‘alternative method’. This process is now being used by many GP surgeries around the country, ensuring protection and peace of mind. 
 
PRIMARY MEDICAL SERVICES (GENERAL PRACTITIONERS AND OUT OF HOURS SERVICES) MUST REGISTER WITH THE CARE QUALITY COMMISSION (CQC) AND MAY ALSO BE SUBJECT TO INSPECTION BY PUBLIC HEALTH ENGLAND (PHE). 
 
PUT YOUR LEGIONELLA TESTING IN PLACE NOW.

GP Surgeries and Practices

Who is most at risk of contracting Legionnaires’ Disease? Those people most ‘at risk’ of contracting the disease: Have weakened immune ...

Hotel and Leisure Facilities

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Most hotels and leisure facilities have showers available to the public. 
 
Showers are a danger area, particularly if they are not kept free of scale or flushed regularly. They have been associated with several outbreaks of Legionnaires’ Disease in the past; the illness is caused by inhaling the bacteria into the lungs in an aerosol and showers generate a lot of this, close to the nose and mouth. 
 
Spa baths, commonly referred to as Jacuzzis™, are also very high risk, as the temperature of the water is an ideal breeding ground for the bacteria and, again, they generate a lot of aerosol. 
 
Who are ‘at risk’? 
Not only the elderly are at risk of contracting Legionnaires’ Disease. Anyone who has a weakened immune system, due to health problems or deliberate suppression, following organ transplantation, for example, is at high risk. Also, people suffering from heart or lung problems, such as asthma, are very vulnerable. 
 
You will probably not be aware if any of the members of the public using your facilities fall in to the ‘at risk’ categories for contracting Legionnaires’ Disease. Thus, it is safer to assume that some do and test the showers and the spa baths for the presence of the legionella bacteria, on a regular basis.

Hotel and Leisure Facilities

Most hotels and leisure facilities have showers available to the public. Showers are a danger area, particularly if they are not kept f...

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