Healthcare Construction Hazard: Legionella in Water Systems

Both new construction and renovation in healthcare facilities can increase the risk of Legionella. This is the case even for facilities with secondary disinfection systems that actively do Legionella testing. As hospitals, acute care facilities, surgery centers, and skilled nursing facilities modernize plumbing, modernize existing areas, or expand capacity, disruptions to water systems can create conditions that allow this Legionella to multiply. The consequences can be especially severe for high-risk patient populations found in healthcare facilities, correctional facilities, and long-term care, as the CDC reports that healthcare-associated Legionnaires’ disease and high-risk groups can carry a mortality rate as high as 25%.

Why Construction Increases Risk in Hospitals and Other Healthcare Facilities

During construction, water flow can be altered due to system shutoffs, new installations, or reconfigurations. These changes can lead to plumbing system shocks, vibrations, new areas of stagnation, and temperature fluctuations that increase the risk for Legionella growth.

Even minor healthcare construction or renovation activity can disturb biofilms inside piping, releasing trapped bacteria into the water system. If commissioning steps are skipped or rushed, these organisms can travel unnoticed into patient care areas.

Cases can also occur when new plumbing lines are introduced without proper treatment. Bacteria released during recommissioning can travel downstream and expose patients, staff, and visitors.

Gaps in Water System Commissioning of Healthcare Construction Projects

Many healthcare construction and renovation projects lack comprehensive water quality commissioning and adherence to Legionella prevention guidelines. Key tasks, such as flushing new lines, verifying temperature set points, and checking disinfectant residuals, are often overlooked or deferred.

ASHRAE 188 and the CDC’s Water Management Program guidelines stress the importance of proper system design and Legionella risk analysis. Consistent implementation of these guidelines during construction can be a challenge, not only due to schedule and budget pressures, but also because many construction companies lack Legionella mitigation expertise.

Reducing Risk with Legionella Expertise

To mitigate the risk of Legionella and other waterborne pathogens, begin by contacting an engineer who is a Legionella consultant, such as Legionella Control Systems, to lead the process of implementing a Water Management Program (WMP) early in the construction planning process. Working with the engineer, continue testing and monitoring throughout the project to track water quality. Ensure any new or modified plumbing systems are thoroughly flushed, disinfected, and validated before being brought online. Supplement these efforts with secondary disinfection such as monochloramines, mixed oxidant solution, chlorine dioxide, or copper-silver ionization.

With adequate planning and early involvement of a Legionella engineer, the risk of Legionella outbreaks during healthcare construction can be mitigated. Early intervention, strong commissioning practices, and adherence to Legionella guidelines can protect vulnerable patients as well as your staff and visitors.

If you’re preparing for construction or renovation at a healthcare, long-term care, or correctional site, it’s critical to prioritize water safety from the start. Contact the experts at Legionella Control Systems for proven solutions to help reduce the risk of Legionella growth. Legionella Control Systems can help you with Legionella risk analysis, Water Management Programs, testing, and proactive mitigation through secondary disinfection systems.