Not just a New York problem
Although New York’s continuing Legionnaires’ disease cases are thousands of miles away, Greg Rankin, CEO of Hydrosense, explains why they should serve as a critical warning for the UK – and why organisations must act now to tackle rising Legionella risks.
Last summer, New York experienced one of the worst outbreaks of Legionnaires’ disease ever seen. More than 100 individuals were hospitalised and several lives were lost.
Following an investigation, the outbreak was traced to contaminated water in 12 cooling towers across 10 buildings – an infrastructure-wide failure that allowed Legionella bacteria to become aerosolised and spread rapidly across the Harlem and Bronx communities.
A year on, the city has continued to report a slew of Legionella incidents. Most recently, Legionella bacteria were detected in the water supply of an East Village housing complex – exposing residents and serving as yet another reminder that the risk is far from over.
Our warming world
Why, you may ask, is this relevant for UK premises? Put bluntly, the reality is that this is far from an isolated incident. Legionella rates globally are rising at an alarming rate, largely attributed to our warming world and increasingly complex water systems.
In the UK alone, it’s now estimated that nearly 12 new cases of Legionnaires’ disease are reported every week. Thus, while the New York crisis may have subsided, it raises all sorts of urban public health questions – namely, how can modern cities with ageing infrastructure and rising temperatures address this growing risk within their built environments?
To answer this, it’s important to first consider the complex nature of Legionella bacteria. Unlike illnesses that spread directly from person to person, Legionnaires’ disease – a serious form of pneumonia caused by inhaling water droplets containing Legionella – can be spread from water systems and devices to people.
The bacteria thrive in warm, stagnant water, especially in systems where temperature control, flow and disinfection are inconsistent. Although cooling towers often dominate the headlines, they are far from the only source of risk. Any man-made water system that creates fine water droplets – including domestic hot and cold water systems, showers, spa pools, fountains and evaporative cooling equipment – can provide the conditions for Legionella to multiply if not properly maintained.
Yet despite Legionella’s upward trajectory, the legislative landscape around Legionella management has remained largely unchanged, even as building systems become more complex.
Clear expectations
HSG274 and ACoP L8 set out clear expectations for Legionella risk assessment, monitoring, temperature control and record-keeping, all of which premises must comply with.
However, in our experience meeting the minimum standard does not guarantee safety, particularly as conditions evolve. Traditional lab culture Legionella testing, while important and still widely used, often provides only a snapshot of the system at a single point in time.
Bacteria can proliferate between tests and results can take up to 10 days to return, delaying corrective action. Water samples can also be damaged during transport and lab culture testing is also unable to detect Viable but Non-Culturable (VBNC) Legionella – which though dormant can still be incredibly dangerous due to their ability to resuscitate and cause an infection.
The result can be a false sense of security, with the potential for lab results to state a negative outcome when repeated tests confirm non-conformance.
Arguably then, as Legionella risk evolves, best practice now demands a move beyond the lab culture status quo. Proactive rather than reactive maintenance is critical. Building operators should advocate for and implement robust maintenance schedules that include regular flushing, disinfection and temperature checks.
Safety teams and duty holders should combine active temperature management and more advanced, rapid testing Legionella testing regimes to ensure real-time alerts for contamination, allowing rapid intervention before bacteria proliferate.
Not only does this approach minimise potential exposure, but it also offers additional information during necessary reviews of risk assessment and provides peace of mind for occupants.
Guidance and solutions
Training and awareness are also key. Those who understand the latest Legionella research, emerging risk and technological solutions are better equipped to provide guidance and solutions to tenants.
Staff and occupants should also be properly informed and empowered to respond quickly to any suspected risk. Failure to do so doesn’t just risk reputational harm – it can result in loss of life.
If the recent New York outbreak has taught us anything, it’s how quickly things can go wrong when vigilance slips. In this way, we cannot afford to view this incident as a one-off issue.
Legionella is a risk that evolves with climate, building use and water system complexity, and it requires ongoing attention. With a seat at the helm of shaping the buildings we use, building operators have a lead role to play in preventing future outbreaks.
