Cracking Down on Legionella Growth

The History of Legionella Bacteria

Legionella bacteria were first discovered in 1976 following a deadly outbreak at an American Legion convention in Philadelphia. The bacteria responsible for this outbreak, later named Legionella pneumophila, was identified as the cause of a mysterious pneumonia that affected over 200 people and resulted in 34 deaths. The outbreak prompted an extensive investigation, leading scientists to discover that the bacteria thrived in the hotel’s air conditioning system, specifically in the cooling towers. This discovery has since increased awareness of Legionella's ability to spread through water systems and its role in causing Legionnaires' disease, a severe form of pneumonia​.

Since the discovery of Legionella, reported cases of Legionnaires' disease have increased significantly. According to the Centers for Disease Control and Prevention (CDC), the number of reported cases in the United States has grown nearly ninefold since 2000. In 2018, there were nearly 10,000 confirmed cases, though the CDC estimates that this number is likely an undercount, as many cases go undiagnosed or unreported. The rise in cases is partly attributed to aging infrastructure, increased use of complex water systems, and improved diagnostic methods, which allow more cases to be detected. The growing awareness of Legionella's presence in building water systems has highlighted the need for strict water management practices to prevent further outbreaks.

Key Regulations and Guidelines

As reported cases of Legionnaires' disease continue to rise, there is growing recognition of the critical need to design legislation or create administrative rules to manage water systems effectively in order to prevent Legionella bacteria growth and protect public health. Whether mandated by federal, local, state, or industry standards, these regulations and guidelines are aimed at minimizing the growth of Legionella bacteria.

1. NJ S2188: This New Jersey state legislation requires healthcare facilities, including nursing homes and hospitals, to create and maintain a water management plan that controls the risk of Legionella and other waterborne pathogens. The law mandates regular testing and reporting of water quality to prevent outbreaks of Legionnaires' disease.

2. NYC Local Law 77: Implemented in New York City, this law requires all cooling tower systems to be registered with the city, inspected, and tested for Legionella bacteria every 90 days. It also mandates that all buildings with cooling towers implement a maintenance program and plan to prevent Legionella growth.

3. OSHA Guidelines: The Occupational Safety and Health Administration (OSHA) provides guidelines rather than strict regulations for Legionella mitigation. These guidelines recommend maintaining water systems at temperatures that inhibit Legionella growth, regularly flushing stagnant water lines, and keeping HVAC systems clean.

4. VHA Directive 1061: Issued by the Veterans Health Administration (VHA), this directive outlines procedures for controlling the growth of Legionella in the water systems of healthcare facilities. It includes requirements for routine water testing, risk assessments, and preventive maintenance practices.

5. GSA Baseline Drinking Water Testing: U.S. General Services Administration’s effort to ensure the safety of drinking water in federally owned and leased properties. This initiative requires testing for lead, copper, and bacterial contaminants like E. coli and Legionella in approximately 1,400 federally owned and 6,000 leased facilities.

6. ASHRAE Standard 188: The American Society of Heating, Refrigerating and Air-Conditioning Engineers' Standard 188 provides guidelines for establishing risk management for building water systems to prevent Legionellosis. It includes protocols for regular monitoring, maintenance, and corrective actions when risks are identified.

7. ASHRAE Standard 514: This standard focuses on minimizing the risk of infection from building water systems by addressing risk management and safety practices specifically related to water quality, including the control of Legionella bacteria and other waterborne pathogens.

8. Centers for Medicare and Medicaid Services (CMS) Memorandum QSO-17-30: initially released in 2017 and revised in 2018, this policy requires long-term care (LTC) facilities, hospitals and critical access hospitals (CAH) that receive CMS funding to have robust policies and procedures to mitigate the risk of legionellosis. These policies must focus on managing the growth and spread of Legionella bacteria and other opportunistic pathogens in building water systems.

The Future of Legionella Regulations

As awareness of Legionella growth risks increases, we can expect more regulations at both state and federal levels. Factors like aging infrastructure and increasingly complex water systems heighten the need for stronger water management strategies. Future rules and regulations will likely build on existing frameworks, adding stricter guidelines to address these challenges.

Warmer seasonal temperatures may create ideal conditions for Legionella growth, prompting rules and regulations that require more frequent testing and enhanced maintenance. Emerging technologies like smart monitoring systems and advanced filtration may also become regulatory requirements, improving the detection and treatment of water systems in real-time.

By staying proactive, organizations can ensure compliance, reduce risks, and protect public health. Adopting preventative measures and staying updated on evolving standards will be essential to preventing Legionella outbreaks and safeguarding facility occupants.

Act Now

Now is the time to take action and strengthen your water management practices. With the potential for stricter rules and regulations on the horizon, staying proactive is key to preventing Legionella outbreaks and protecting public health. Review your current protocols, invest in preventative measures, and explore emerging technologies that can improve real-time monitoring and water treatment.

Don’t wait for regulations to catch up—ensure your organization is ahead of the curve by implementing comprehensive water management strategies now. Safeguard your facility, reduce risks, and ensure compliance to keep your occupants safe and your operations running smoothly. Reach out today IWC Innovations today to learn more about how you can enhance your Legionella prevention efforts.