29 de jul. de 2012

SETRI - Legionella HACCP - ASHRAE 188P

A SETRI Brasil, já vem trabalhando no processo HACCP para avaliação de Risco da bactéria Legionella.
Com a chegada da ASHRAE 188P, o processo fica ainda mais importante.
O tema é tratado no artigo abaixo:

How to Protect Against Legionella

Is your water safe? A new standard can help safeguard against a Legionella outbreak.
It can lurk in your cooling towers, piping systems, showerheads, hot tubs, sauna rooms, and decorative fountains. It causes flu-like symptoms, hospitalizations, lingering neurological issues, and death. Legionella bacteria begin as a microscopic presence in your water systems and can balloon into a tarnished business image, a CDC investigation, and lengthy lawsuits.
“Though some facilities are proactive with water management, many building teams struggle with documentation or do not have a clearly identified team responsible for the water system,” observe ASHRAE members Bill McCoy of Phigenics and William Pearson of Southeastern Labs. The forthcoming ASHRAE Standard 188, Prevention of Legionellosis Associated with Building Water Systems, is a significant step toward formalized Legionella prevention.
The standard will require a new process to document proactive measures against Legionella with a Hazard Analysis and Critical Control Point (HACCP) risk management plan. The goal is to establish which control and monitoring measures your building has in place.
“We know how to analyze and control this hazard. But we need a standardized practice to specify for facility managers and owners exactly what to do in their facilities to control the hazard in a systematic and scientifically defensible way,” McCoy and Pearson explain. “ASHRAE Standard 188P is intended to fulfill this need.”
Whether you choose to adhere to the standard or not, preventing Legionella from breeding in your water system requires a proactive stance. Remember that building water safety and quality are not within the jurisdiction of the public water utility – the responsibility is yours. Use these three components of the standard to fulfill your General Duty Clause.
KNOW THY ENEMY Legionella is a type of bacteria that causes two forms of pneumonia – Legionnaires’ disease and Pontiac Fever (collectively referred to as Legionellosis). Both conditions develop when the bacteria is inhaled through water droplets or vapor. The disease is not communicable and does not occur if Legionella is ingested.
According the Center for Disease Control (CDC), anywhere from 8,000 to 18,000 cases are reported in the U.S. each year. Because the disease is hard to distinguish from community-acquired pneumonia and the onset of symptoms occurs several days after contact, many more incidences may go unnoticed. The bacteria are most likely to affect those with weakened immune systems, including children, those with diminished lung capacity, the elderly, and people with autoimmune disorders.
The CDC estimates that 5-30% of Legionnaires’ victims perish. Many patients recover with the aid of antibiotics, but some require hospitalization for days. A growing number of reports also show that victims can have lasting neurological damage, largely affecting memory and muscle control.
Along with other waterborne diseases such as giardiasis and cryptosporidiosis, Legionella costs the healthcare system up to $539 million annually, according to CDC research. By using insurance claims, the CDC calculated that Legionnaires’ disease places a $101-321 million burden on patients, insurers, and taxpayers. For example, a single hospitalization for Legionnaires’ averages more than $34,000.

Are You At Risk?

While all commercial buildings are vulnerable to Legionella, the following risk factors can increase the likelihood of contamination
Unlike a slip and fall incident, there’s no specific statute of limitations for Legionella. Time is of the essence for a victim to medically document the disease and connect the source of contamination to a specific location.
But once an incidence has been traced back to your building, many more reports can follow in its wake. It is the likelihood of a severe reaction to Legionella that requires the proactive attention of building managers.
UNDERSTAND THE ROLE OF YOUR WATER SYSTEMSBeyond obvious places like cooling towers and hot tubs, there are many areas in a building vulnerable to Legionella, cautions Simon Turner, president of Healthy Buildings, a consulting firm that specializes in indoor environments. These include drinking water systems, hot water tanks, showers, misters, ice machines, fire sprinklers, and water features such as decorative fountains and water walls. Even respiratory devices and humidifiers in healthcare settings have been called into question.
The likelihood of Legionella doesn’t necessarily depend on the type of water system in question, but the conditions within that water supply. Miniscule amounts of the bacteria won’t make anyone sick, but certain environments will promote Legionella to breed at dangerous levels.
“Legionella will flourish under three conditions,” says Turner. “It needs an optimum growth temperature between 95-115 degrees F., the presence of biofilm to provide a source of nutrients, and an accumulation of sediment or scale that will shield it from chlorination.”
A major source can be dead legs in plumbing lines, which are common in older buildings with renovations or restrooms with waterless urinals. “Water becomes stagnant in these abandoned pipes and can’t be properly sanitized or flushed out, yet it will constantly seed the rest of the plumbing system with Legionella,” Turner explains.
“Owners may not be aware that they need to be prepared to respond to specific events that can push the bacteria into the rest of the water supply or cause it to grow rapidly, like water main breaks or shutdowns,” says Matt Frejie, ASHRAE member and president of HC Info, a consulting firm for Legionella prevention.
DEVELOP A RISK MANAGEMENT PLAN One of the greatest impacts of Standard 188P is the recommendation of a HACCP risk management plan. The HACCP approach was first developed by NASA and then adapted to industries such as food safety, munitions, and automotive manufacturing. Its purpose isn’t to prevent Legionella, but to verify that the control measures to address the bacteria are in place and effective.

Famous Cases of Legionellosis Outbreaks (USA)

Las Vegas (2011-2012) – Over the course of a year, two MGM properties (the ARIA and Luxor resorts) were linked to Legionella cases with one fatality. Both sites had water management programs in place prior to the incidences.
Playboy Mansion (2011) – Close to 200 conference-goers who attended an evening soiree at the Mansion developed Legionnaires’ or Pontiac Fever. Bacteria in the hot tubs were identified as the culprit and a fog machine was also suspected, though never confirmed.
Unidentified Wisconsin Hospital (2010) – Eight people, none of whom were inpatients, became ill from a decorative water feature in the hospital’s lobby. The bacteria were contracted by delivery personnel and visiting family.
Stadium Place (2009) – Legionella struck eight residents at this Baltimore retirement community with one fatality. To remedy the outbreak, the water temperatures were elevated above 130 degrees F.
Bellevue-Stratford Hotel (1976) – First documented outbreak of the disease. Guests at an American Legion convention at the hotel contracted the bacteria – over 200 attendees became ill and 34 perished. The exact source of the contamination was never identified, though the air conditioning system and the cooling tower were likely sites.

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