[Greenbuilding] Legionnaire's in water wall features

[John Daglish]

Bonjour Jason,

just to repeat ultrafiltration or ultrasound/UV can reduce the risk
considerably... ultrafiltration at < 5 microns
is smaller than the legionella bugs (suspended solids, bacteria and
viruses in water will be removed) with recirculation and backwashing.

++
an alternative strategy to control the biofilm in
recirculating water systems :

Enwa Bin-X ultrafiltration, Side stream filtration to < 5 microns
(through sand filter and reaction pH controlling media), and air
seperator
http://www.enwa.com/systems-products/industry-buildings/chemical-free-bacterial-barrier


GENO-break-system IV  ultrasound + UV
http://www.gruenbeck.de/m2fGENO-Break_en-gb.htm


Sonooxide ultrasound cooling systems water in
recirculating system
http://www.ashland.com/products/sonoxide-ultrasonic-water-treatment-system
  

Cordialement

-- 
John DAGLISH, B.Arch,1984


4, rue des Coteaux  
F-91370 VERRIERES LE BUISSON, France
Tél / Fax: +33.(0)1.60 11 12 10



Wednesday, January 11, 2012, 4:43:26 AM, you wrote / vous ecrirez:

JH> With the off-and-on discussion on Legionnaire¹s Disease exposure, this new
JH> news is relevant:

JH> http://www.washingtonpost.com/national/health-science/hospital-fountain-link
JH> ed-to-legionnaires-outbreak/2012/01/10/gIQAyLwEpP_story.html?hpid=z5

JH> Hospital fountain linked to Legionnaires¹ outbreak
JH> By  Lena H. Sun 
JH> <http://www.washingtonpost.com/lena-h-sun/2011/03/03/ABUvPGP_page.html> ,
JH> Tuesday, January 10, 7:35 PM

JH> An outbreak of Legionnaires¹ disease in Wisconsin has been linked to a
JH> decorative water wall in a hospital lobby, according to a study published
JH> Tuesday that suggested the popular architectural feature can pose dangers in
JH> a health-care setting, especially for people with weakened immune systems.

JH> In 2010, eight people contracted the severe and potentially life-threatening
JH> form of pneumonia caused by the bacteria. None had been admitted to the
JH> Milwaukee-area hospital at the time of exposure. But they all had walked by
JH> the water wall in the main hospital lobby, researchers said.

JH> The disease is spread through inhalation contact with contaminated water
JH> sources.

JH> One person who got sick was a delivery man. Three others were picking up
JH> medication at the hospital pharmacy. Three were outpatients. And one man was
JH> waiting to pick up his wife.

JH> ³He really enjoyed sitting next to the water wall,² said Thomas Haupt, a
JH> Wisconsin  health division epidemiologist and lead author of the study.
JH> ³These water walls are indeed very beautiful, but they¹re very risky.²

JH> All eight either had underlying medical conditions or other factors that
JH> increased their risks of getting Legionnaires¹ disease. Three were
JH> hospitalized in intensive care and were on mechanical ventilators; all eight
JH> survived.  

JH> The study, published online in Infection Control and Hospital Epidemiology
JH> <http://www.jstor.org/stable/10.1086/663711> , is the second documented
JH> outbreak of Legionnaires¹ disease in a health-care setting associated with a
JH> wall-type water fountain, a design that is increasingly popular in
JH> hospitals, hotels, spas and other public settings, the study said. In 2007,
JH> two cancer patients at the National Institutes of Health in Bethesda were
JH> diagnosed with the disease after being exposed to a contaminated wall-type
JH> water fountain.

JH> Decorative water fountains and water walls can be soothing and calming, so
JH> many hospitals and clinics included those amenities as a way to be more
JH> patient-friendly, said Jan Patterson, a professor of medicine and infectious
JH> diseases at the University of Texas Health Science Center at San Antonio.

JH> But the problem is, even with regular cleaning and testing, ³it¹s possible
JH> for legionella to accumulate,² said Patterson, who is also president of the
JH> Society for Healthcare Epidemiology of America. ³I guess the takeaway here
JH> is that if you have any underlying conditions, you should avoid walking by
JH> them or stay as far away as possible.²

JH> As for hospitals and other health-care facilities, ³they should avoid having
JH> these in their facilities altogether,² she said.

JH> When the fountain was first suspected as the source of the Wisconsin
JH> outbreak, the hospital shut down the water wall and turned it into a
JH> planter.  No known additional cases of Legionnaires¹ disease occurred after
JH> that. Many other health-care facilities in Wisconsin shut down or removed
JH> their decorative fountains, the study said.

JH> Every year, the federal Centers for Disease Control and Prevention receive
JH> reports  of about 3,000 people diagnosed with Legionnaires¹ disease. But
JH> experts say that many more cases go unrecognized
JH> <http://www.cdc.gov/legionella/faq.htm> and between 8,000 to 18,000 wind up
JH> in the hospital, according to Lauri Hicks, a CDC medical epidemiologist and
JH> specialist on Legionnaires¹. More than 10 percent of cases are fatal.

JH> Some of the most common symptoms, such as shortness of breath, cough and
JH> severe fatigue, are also associated with pneumonia, she said.

JH> The Wisconsin study, she said, is a ³good reminder that in settings where
JH> you have people with increased risk of getting Legionnaires¹ disease, you
JH> should be considering carefully the management of any of your water systems
JH> that these persons could be exposed to.²

JH> CDC experts have been working with a professional organization, the American
JH> Society for Heating, Refrigerating and Air Conditioning Engineers, to come
JH> up with a standard practice for building managers and owners to prevent the
JH> disease, she said.

JH> Inpatient facilities with fountains, or any center that takes care of people
JH> with weakened immune systems, such as nursing homes, should be conducting
JH> regular assessment for Legionnaires¹ disease, she said.

JH> The water in fountains or water walls is often an ideal breeding ground for
JH> bacteria because it is warm or at room temperature and because the
JH> recirculating water can stagnate. In addition, fountains develop scum, ³and
JH> the bacteria like to live in that slime layer that forms on fountains, in
JH> whirlpools, even in your shower,² Hicks said.

JH> Fountains  can also create bacteria-bearing aerosols as water sprays or
JH> cascades down walls or rocks.

JH> The fountain at the Aurora St. Luke¹s South Shore hospital was installed in
JH> 2008. All visitors using the hospital main entrance passed by it on their
JH> way to the information desk. Water flowed down a tile wall about 8 feet wide
JH> by 5 feet high, and through a bed of decorative rocks that rested on a
JH> spongelike foam material.

JH> The water collected in a trough at the bottom of the fountain, beneath the
JH> rocks and foam, and an electric pump recirculated it to the top of the water
JH> wall.

JH> Health officials found that the water was kept warm by two heat sources: an
JH> electric fireplace on the opposite side of the same wall that housed the
JH> fountain and low-voltage flood lights in the ceiling and in the water
JH> trough.

JH>  Although hospital staff performed weekly and monthly maintenance, ³it¹s
JH> very difficult to clean those things out,² Haupt said. A sampling of a
JH> 3-inch by 4-inch piece of the foam material found it had more than 1 million
JH> bacteria, he said.