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Legionnaire’s Disease; The Top 10 Things You Need to Know The outbreak of Legionnaire’s Disease in Edinburgh has caught media headlines; one fatality, 88 in hospital (14 in Intensive Care), three Improvement Notices from HSE. It’s been 10 years since something similar has happened (Barrow-in-Furness; 180 cases, 7 fatalities, one manslaughter conviction). As it can be a work-related health and safety hazard, we thought it about time to dust off the key facts for you.

1. What is it? The illness is caused by a bacterium, Legionella pneumophila, which is very common in the environment.

2. How Do I Catch It? The germ likes water systems. Once inside these systems, in the right conditions, it will multiply. The contaminated water then needs to be sprayed into a mist, vapour or aerosol. The victim breathes in the contaminated aerosol, introducing the germ to the nice, warm, moist lungs. It then causes illness.

3. How Bad Is It? As it’s in the lungs, it causes a form of pneumonia. At one end of the scale, it can be a mild respiratory illness (normally called Pontiac Fever), up to fatal. Fatality rate varies, maximum 30% in extreme cases

4. How Bad Is It (2)? As always there are more vulnerable groups; infants, the elderly, people already ill, and (interestingly but not surprisingly) smokers.

5. Which organisations need to take heed? “At risk” water systems are (no surprise) those that produce water vapour or mist. Examples we’ve looked at include;

• Showers are the most common we come across; hotels, sports clubs, etc but don’t forget emergency showers.
• Spa baths. Those in swimming pools tend to be well managed, but in hotels things like “Jacuzzi” baths a can be overlooked (think of all that dirty water sitting in the bottom of the pump systems….)
• Fire sprinkler and wet riser systems
• Lathe and machine tools, where a cooling liquid is jetted onto work-pieces or cutting blades
• Horticultural misting systems
• Car washes
• Indoor fountains/water features
• Large air conditioning or industrial cooling systems (such as the three in Edinburgh that have so far been served with Improvement Notices). These are larger systems that include an “evaporative condenser” like power station cooling towers. These are actually notifiable to the HSE or Local Council, as they give off large clouds of water vapour from systems that can readily be colonised by the bacterium.

6. What Do I Need To Do If I Have An “At Risk” System Under My Control? A risk assessment (no surprise there), and, if controls need to be put into place, then these need to be part of a management system. These both need to be recorded if you have 5 or more employees (management arrangements usually in your Safety Policy).

7. What goes into a risk assessment? a. How likely is the contamination of the system? Have a guess from the picture below…) b. How likely is it that the bacteria will multiply to dangerous levels? This in turn includes looking at water temperatures (highly important; the bacteria prefer water at 20-45OC), flow rates (stagnant water or little used outlets), shelter for the bacteria (scale, rust, poor materials used in plumbing, etc) and food for the bacteria (things like slime inside water tanks) c. Likelihood of a mist/vapour being formed (a certainty with all of the systems mentioned above) d. Likelihood on someone breathing the vapour, and if any of those people are more vulnerable. How many people, how often, distance from the source of vapour, etc. What do you mean by “management arrangements”? There are some specifics in HSE Codes of Practice, including; nominating someone to take responsibility for putting control measures into place having a schematic (diagram) of the water system the water system’s operating settings, etc (a “Normal Operating Procedure”). This might include thermostat settings, for example. Staff awareness training, especially for anyone managing the water systems, but could also include cleaners. Precautions might include things like how to make sure little used water outlets are managed (e.g. hotel showers that haven’t been used over winter). These arrangements will also include monitoring, as one of the most important control measures is temperature control. Who is going to measure water temperatures, where, how often and how? Where and how should this be recorded? What should they do if water is found to be between 20 and 45OC?

8. Are there any local examples of Legionnaire’s Disease? In my former life as a H&S inspector I investigated one fatal outbreak in King’s Lynn. As a consultant, one tourism client was implicated in a fatality (as the victim had stayed with them), but having a decent risk assessment (plus clearly implemented improvements) and management plan eliminated this business from the investigation. The business could show that the water system had been properly assessed, and that controls/monitoring were in place (through documented procedures) and robust.

9. What Should I Do Now? Decide if you have an “at risk” water system. Make sure you have a decent risk assessment that looks at the factors in 7 above. If you have an assessment, has it been reviewed regularly (e.g. have water systems been changed)? Does your safety policy include the necessary management arrangements?

10. Some examples of how not to do it….

https://www.flickr.com/photos/65011205@N07/sets/72157630133748822/

Health and Safety often gets blamed by people for stopping things happening; people can receive bad advice from their Employer, their Insurance Company or indeed from a Health and Safety Consultant. They can also use Health and Safety as an excuse for not doing something or for people who can’t be bothered or have a ‘killjoy’ attitude.

The Health and Safety Executive have responded to concerns by setting up a Myth Buster panel; this is chaired by Judith Hackett- a formidable character – she has 11 co panellists who are drawn from all walks of life.

So far this year they have commented on 47 cases; the first about a swing on an allotment that a Parish Council wanted removing; the swing was provided for use by the hirer’s children to keep them occupied. The latest that a landlord of a block of flats was asked to replace metal framed windows; that fitted & opened safely.

There is a form on the HSE’s website for anyone to report any ‘Health and Safety gone mad’ occurrences.

Health and Safety as I have said is all about Common Sense; but Common Sense is not always that common- it is about awareness, knowledge, attitude & perception.

Health and Safety is about protecting people with sensible controls; not about blanketly saying people cannot do things

I have chosen some ‘favourite’ myths to highlight that Health and Safety has not gone mad – but some peoples interpretation of it has:

1. Bonkers Conkers- in reality the risk of playing conkers is low; a head teacher did ask for children to wear goggles; but there is no blanket need; in schools it is often discipline that’s the issue not H&S.
2. Bunting (well we have had the Jubilee & now the Olympics)- The myth is that Bunting is not allowed due to H&S – this is just plan nonsense; H&S is about protecting people not about stopping celebrations! People need to plan – where to hang bunting and how to get it up their safely- again not a blanket ban.
3. Restaurant based myths; yes you can issue tooth picks, yes you can heat up baby foods & no dogs in restaurants is not a Health and Safety Issue.
4. Topical one of Mortar Boards- like conkers there is a v v small risk of injury from a flying Mortar Board- the issue can be that the hats are hired and need to be returned in pristine condition?
5. Trapeze artists need to wear Hard Hats! Hard hats are only required when there is a risk of falling debris.
6. PAT testing of electrical items is an yearly requirement; this is simply not true; the Electricity at Work Regulations require businesses to maintain their electrical appliances- this needs to be risk based; some items can be visual checked (low risk static office equipment) others such as portable hand tools that are used in dusty/wet environments will need more frequent thorough checks.
7. Lastly there is nothing you can do about Slips & trips- there’s lots of cheap effective solutions – there were 4 fatalities last year, and about 100, 000 injuries – the estimated cost to UK PLC is £800 million per year; Good Housekeeping, cable management, correct well maintained clean flooring, foot wear and staff attitude will all reduce the risk

Health and Safety is siimply about protecting people; unfortunately 173 people were killed at work last year- this fiqure does not include those who are killed whilst driving on our roads; or ask the 300 000 plus people who are injured at work

It is about sensible Risk Management – about putting in place some proportionate controls.

We all need to accept personal responsibility- whether we are an Employer, an Employee or a member of the public

Provisional Met Office figures show that 2012 has seen the UK’s wettest April and June, since records began in 1910. Over a months worth of rain fell in the North West and North East within 24 hours, after flood warnings were issued to more than 7,000 homes and businesses.

Although some of the UK remained unaffected, flash flooding and unpredictable weather conditions are becoming more and more common, leading the more proactive businesses to ask the question:

Would my business be prepared in the event of a disaster?

A disaster or crisis can strike a business at any time and failing to plan for such an event can undo years of good work and hard trading in an instant. This can be the difference between your business recovering or failing; a return to full normal trading can often take a business more than a year. According to a report undertaken by AXA in 2007, 80% of businesses affected by a major incident either never re-open or close within 18 months. Imagine for example you had a fire which resulted in your premises closing for a re-build. Such a disaster could result in obtaining planning permission/building warrants, allocating building contractors, allowing for delays on the build caused by holidays, poor weather conditions and availability of materials required.

Assess the threats

Think of the threats in terms of the operations which are key to your business, such as:

• Fire, flood or storm damage to your premises or stock
• Explosion
• Loss of power or other services
• Threat of vital equipment or stock
• Unavailability or loss of key personnel
• Staff sickness levels (Swine Flu Pandemic)
• Loss of customer or other records
• Theft of delivery vehicles

Make a plan

Once you have assessed the threats, consider any potential actions you can take to reduce the risk of these occurring, or even prevent them altogether. Are there steps you could take to reduce the scale of loss, or speed up your return to normality?

We recommend all businesses are supported by some form of Continuity Plan, regardless of their size

Think about things such as:

• Organise suitable alternative premises
• Keep an updated list of staff contact details off site
• Arrange for an off-site storage solution for backed up files
• Making sure fire extinguishers are regularly inspected, maintained and appropriately located
• Train staff in emergency procedures including the use of fire extinguishers
• Invest in a fire resistant safe for important paper records
• Carry out back up procedures for important computer records
• Fit fire alarms, burglar alarms, CCTV and any other relevant security systems
• Ensure germ killing hand foam is available for staff and visitors

Peter Fosterof Hugh JBoswell states; “we recommend all businesses are supported by some form of Continuity Plan, regardless of their size. Many businesses underestimate the sheer quantity of time and effort required to get their business back up and running following a substantial loss. By being prepared, you can reduce the time required to return your business to pre-loss trading levels, and help minimise the impact on your business.”

To encourage businesses to make the investment in monitoring technology and energy saving, Enhanced Capital Allowances (ECAs) are available meaning that 100% of the qualifying capital expenditure may be claimed back against taxable profits in the first year.

There are three schemes for ECA’s which are energy saving plant and machinery, water conservation plant and machinery, and low carbon dioxide emission cars and natural gas and hydrogen refuelling infrastructure. Focussing on water conservation, did you know if you fit efficient showers, taps, toilets, washing machines, detection and monitoring equipment and the product is suitable you can use the ECA Scheme.

Taking it further, installing rainwater harvesting equipment, smaller scale sludge dewatering equipment, water efficient industrial cleaning equipment amongst many others, you can again use the scheme.

The general rate of capital allowances is 18% a year on a reducing balance basis up to a limit of £25k. Some technologies supported by the ECA Scheme (e.g. boilers, lighting) are included in a special capital allowances pool where the general rate of capital allowances is 8%. Additional benefits of purchasing ECA qualifying energy efficient technologies could include: improved cash flow, lower energy bills, reduction in Climate Change Levy or CRC payment.

We will look into all of these options as part of any project we work on and to the Clients needs and specifications.