Legionnaires’ Disease – Controlling a Very Costly and Scary Hospital Acquired Infection


pic_keane_tim150x180Tim Keane

Legionella Risk Management, Inc.

For almost 20 years has provided unbiased engineering consulting services to the healthcare industry on Legionella related issues associated with all building water systems including; outbreak mitigation, risk management, training and control. Original voting member of ASHRAE 188. Coauthor of 2nd and 3rd editions of book titled, “Infection Control During Construction Manual: Policies, Procedures, and Strategies for Compliance”. Author of the monograph published by South Dakota Health Department titled, “Guidelines for Control of Legionella in Ornamental Water Features”.


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Legionnaires’ Disease – Controlling a Very Costly and Scary Hospital Acquired Infection

Today you are more likely to find information regarding Legionella that is more incorrect than correct. In May of 2017 the Wall Street Journal published an article on Legionnaires’ disease (LD) based on a CDC paper. While the chart from CDC paper in the article documented the very high risk of Legionnaires’ disease associated with potable water, the article said cooling towers were the greatest risk. Since 2014, there has been a rash of guidelines and directives for control of Legionella that are as confusing and incorrect as this Wall Street article.

Equally important, standards for water and energy savings applied to a water system without the necessary design and or operational modifications can significantly increase risk for Legionella. With all this misinformation available and conflicting guidance it is difficult for a healthcare facility to make the correct choices for control of waterborne pathogens.

Following the wrong recommendations can be costly. An LD outbreak can have a significant impact on patient safety, patient family member and employee anxiety as well as facility reputation. Also an LD outbreak in a healthcare facility frequently results litigation. It can be very scary for patients, family members, and employees to think that something coming out of the water faucet can cause serious illness.

Legionnaires’ disease is a multifaceted issue. LD requires clinical controls to identify and address the illness in a timely fashion and engineering controls to identify and address the risk in building water systems.

This presentation by consulting engineer with almost two decades of experience in legionella control in building water systems and almost 40 years of experience in areas of design, operation and maintenance will:

  1. Review lessons learned from actual healthcare Legionnaires’ disease outbreak case studies.
  2. Identify root causes of LD outbreaks and associated costs.
  3. Present cost effective steps that can be taken in building planning, design, construction, maintenance and operation that will reduce the risk of Legionnaires’ disease associated with building potable water systems.
  4. Review cost effective steps that can be taken to insure compliance with existing standards.
  5. Discuss issues in some existing standards and guidelines.
  6. Dispel many of the common myths associated with Legionella control.