Water Management Design Considerations for Engineers
Water management plays a pivotal role in maintaining the safety and efficiency of our buildings. As engineers and plumbing professionals, understanding the intricacies of water management best practices can guide our designs and ensure they meet industry standards. Understanding water management programs Water management programs are designed to identify and control risks in water systems that can lead to the growth of waterborne pathogens such as Legionella. High-risk conditions like water stagnation, elevated cold-water temperatures, and sediment accumulation are often the focus of these programs. Water management programs are now an industry standard for many buildings in the United States and are necessary to meet ASHRAE Standards 188 and 514, The Joint Commission, and other regulatory agencies. Developing a water management program Water management programs are site-specific and tailored to each building’s unique risks, needs, and water quality goals, and should be developed by an ASSE 12080-Certified Legionella Water Safety Specialist. The steps to developing a water management program include: Water management design considerations for engineers When designing a building water system, there are several ways that plumbing engineers and designers can incorporate water management. Here are the seven key elements of a water management program and examples of what plumbing engineers should consider for each one. Understanding and implementing these considerations in your designs ensures optimal water management and compliance with industry standards, contributing to safer buildings. Download: Water Management Guide for Plumbing Engineers Fill out the form below to download our Water Management Guide for Plumbing Engineers that includes:
Case Study: Sediment Filtration on Cold Water System Reduces Legionella Risk
After a Northeast university achieved non-detect Legionella levels in their building’s hot water system with a LiquiTech™ Copper-Silver Ionization System, they faced a new obstacle when Legionella was detected in the cold water system due to water stagnation caused by the building’s mixed-use and fluctuating occupancy. Partnering with LiquiTech, the university implemented an innovative solution to install a LiquiTech™ Sediment Filtration System on the cold water supply. By preventing sediment from entering the building, the cold water system quickly returned to non-detect Legionella levels. The combined power of copper-silver ionization for the hot water system, sediment filtration for the cold water system, and an ongoing service partnership with LiquiTech has helped the university maintain non-detect Legionella levels and provide clean, safe water to occupants. The results: With a multi-faceted approach, this university successfully controlled Legionella and proactively reduced the risk of future outbreaks. Learn more about their journey in the full case study here.
Infection Prevention through Clean Water: How Healthcare Facilities Can Mitigate Healthcare-Associated Infections from Water
Healthcare-associated infections or HAIs are infections people get while they are receiving health care for another condition. These infections can happen in all types of healthcare settings and are a significant cause of patient illness and death. According to the Centers for Disease Control and Prevention (CDC), 1 in 31 patients experience a healthcare-associated infection on any given day, costing healthcare systems in the United States $28 billion annually. Many HAIs, including catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, ventilator-associated pneumonia, and hospital-acquired pneumonia, are caused by organisms known to spread through water and biofilms. These organisms are commonly referred to as waterborne pathogens and, according to some studies, could be the cause of 20% of healthcare-associated infections. Waterborne pathogens and healthcare-associated infections Waterborne pathogens commonly linked to healthcare-associated infections include Pseudomonas, Legionella, Burkholderia, nontuberculous Mycobacteria, and Acinetobacter. Health risks associated with these pathogens can vary from mild infections to severe illnesses, and in some cases, they can even be life-threatening, particularly for high-risk individuals with compromised immune systems. Pseudomonas, Acinetobacter, Stenotrophomonas, non-tuberculous mycobacteria, and Burkholderia are bacteria frequently associated with antibiotic resistance challenges. Legionella: This bacterium thrives in water systems including cooling towers, hot tubs, and extensive plumbing systems. It is known for causing Legionnaires’ disease, a severe type of pneumonia. Pseudomonas: Found in soil, plants, and natural water sources, these bacteria can trigger serious infections in patients with compromised immune systems. Acinetobacter: These bacteria, primarily found in soil and water, have been implicated in dangerous infections in healthcare settings, particularly in patients on ventilators. Burkholderia: This group of bacteria is widely distributed in water and soil and can result in severe lung infections. Stenotrophomonas: These bacteria, found in water, soil, and plants, can lead to infections in the respiratory tract, bloodstream, and urinary system. Nontuberculous Mycobacteria: Typically present in water and soil, these bacteria can trigger lung infections in susceptible individuals, such as those with pre-existing lung conditions or suppressed immune systems. Why water quality matters in healthcare facilities Water quality plays a crucial role in healthcare facilities for many reasons, including: Approximately 20% of HAIs are caused by water. Water is everywhere in healthcare facilities. Water serves many functions in a healthcare setting and it is estimated that 65% of HAIs are associated with wet biofilm or the presence of moisture or liquid. Water is necessary to provide patient care and is used throughout the continuum of care. Hospitals treat high-risk immunocompromised patients who are at an increased risk of infection. On average, 1 in every 10 affected patients will die from their HAI. Water is not sterile. Pathogens live and grow in building water and plumbing systems, creating risk. Factors that can increase water risk Several factors can adversely impact water quality and increase the risk of healthcare-associated infections in hospitals, including water-utilizing patient equipment, water shutdowns or disruptions, and construction activities. Water-utilizing patient care equipment, such as respiratory therapy devices and wound cleaning tools, can introduce contaminants if not properly maintained and disinfected. Regular and meticulous cleaning and disinfection protocols must be in place to ensure the safety and integrity of these essential medical devices. Water shutdowns, disruptions, or events like water main breaks or flooding can compromise the water supply, leading to potential contamination and increased transmission of pathogens. It is crucial for healthcare facilities to have contingency plans and preventative water treatment systems in place, like sediment filtration, to mitigate the impact of such events on water quality. Construction and renovation activities in healthcare facilities can disturb water systems, potentially releasing harmful microorganisms and compromising the overall water quality. Adequate precautions and monitoring should be undertaken during these activities to minimize any potential risks. What organizations can do to ensure safe water quality To ensure safe water quality, healthcare organizations and healthcare professionals must prioritize clean water as part of their strategies to prevent infections. This includes implementing comprehensive control training and water management programs, conducting regular water quality testing, and maintaining water-utilizing equipment. Systemic strategies to control and prevent biofilm in plumbing systems, such as through continuous disinfection of the entire building water system, are crucial to reducing healthcare-associated infections and ensuring patient safety. References Reynolds, D., Kollef, M. The Epidemiology and Pathogenesis and Treatment of Pseudomonas aeruginosa Infections: An Update. Drugs 81, 2117–2131 (2021). https://doi.org/10.1007/s40265-021-01635-6 CDC (2021, June 21). Health Topics – Healthcare-associated Infections (HAI). https://www.cdc.gov/policy/polaris/healthtopics/hai/index.html Perkins KM, Reddy SC, Fagan R, Arduino MJ, Perz JF. Investigation of healthcare infection risks from water-related organisms: Summary of CDC consultations, 2014-2017. Infect Control Hosp Epidemiol. 2019 Jun;40(6):621-626. doi: 10.1017/ice.2019.60. Epub 2019 Apr 3. PMID: 30942147; PMCID: PMC7883772. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883772/ World Health Organization. (2022). WHO launches first-ever global report on infection prevention and control. https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control Yiek, W.K., Coenen, O., Nillesen, M., & et al. (2021). Outbreaks of healthcare-associated infections linked to water-containing hospital equipment: A literature review. Antimicrobial Resistance & Infection Control, 10(77). https://doi.org/10.1186/s13756-021-00935-6
Legionella Risk Assessment: Essential Information for Building Owners and Managers
Legionella is a type of bacteria that can cause Legionnaires’ disease, a severe form of pneumonia. Unfortunately, Legionella can be found in any building, including hospitals, skilled nursing facilities, hotels, and office buildings. The good news is that there are steps you can take to identify and manage the risks associated with Legionella. What is a Legionella risk assessment? A Legionella risk assessment is a process that identifies the potential for Legionella bacteria to grow and spread through water systems within a building. This assessment should be conducted by an ASSE 12080 Certified Legionella Water Safety and Management Specialist and include: Fill out the form at the bottom of this page to download our Legionella Risk Assessment template for a detailed list of what an assessment should include. Who needs a Legionella risk assessment? Since Legionella can colonize any type of building, all buildings with potable water systems and aerosol-generating systems (such as cooling towers) should conduct a Legionella risk assessment to determine potential risks to building occupants and potential sources of Legionella transmission. This is especially true for hospitals, skilled nursing facilities, office buildings, hotels, and any building with a water system at risk of Legionella contamination. Landlords, building owners, and employers are responsible for protecting their occupants from Legionella exposure. How often do you need to conduct a Legionella risk assessment? Legionella risk assessments should be conducted annually or even more frequently if recommended by a water safety specialist. Additionally, any changes to the building’s water system should trigger a reassessment to address Legionella risks proactively. What are the benefits of conducting a Legionella risk assessment? Regular Legionella risk assessments provide numerous benefits: To ensure the health and well-being of occupants and minimize risk, buildings with water systems must undergo regular Legionella risk assessments. Don’t wait for a Legionella outbreak to occur – contact our ASSE 12080 Certified Legionella Water Safety and Management Specialists to schedule your Legionella risk assessment today. Download: Legionella Risk Assessment Template Fill out the form to download our Legionella Risk Assessment template for a detailed list of what an assessment should include.
Controlling Legionella Case Study: Chlorine Dioxide vs. Copper-Silver Ionization
In 2009, an outbreak of Legionnaire’s Disease hit a large Georgia hospital, affecting six wards, and resulting in the closure of 10% of their patient beds. After trying several solutions, including installation of continuous chlorine dioxide systems and plumbing infrastructure upgrades, the hospital still tested positive for Legionella. In 2023, the hospital partnered with LiquiTech to install a LiquiTech™ Copper-Silver Ionization System to control the Legionella contamination and reduce the risk of future disease outbreaks. Within just two months of installing copper-silver ionization, the Legionella positivity rate dropped from 100% to 11%, with the next round of testing showing 0% positivity. Through its ongoing service partnership with LiquiTech, the hospital has successfully maintained control of the Legionella contamination. By choosing the right technology and ensuring ongoing maintenance, the hospital’s priorities of protecting their staff and patients and controlling waterborne pathogens were achieved. To learn more, read the full case study here.
Sediment in Building Water Systems: How It Impacts Plumbing and Budget
Sediment in your building’s water system can cause damage to plumbing, increase maintenance costs, and promote bacterial growth. To ensure your building water system runs smoothly and efficiently, it’s crucial to understand what sediment is, how it enters your water system, and strategies to control it. Sediment in building water systems Sediment is a naturally occurring material that gets into source water from soil runoff or the breakdown of organic materials. It can get into a building’s water system from: Sediment’s impact on plumbing Too much sediment in a building’s water system can damage plumbing, increase operational costs, and reduce the life expectancy of equipment, including: Sediment’s impact on bacterial growth High sediment loads can encourage bacterial growth, increasing a facility’s risk of disease outbreak, like Legionnaire’s Disease. Three key ways sediment increases bacterial growth include: Benefits of controlling sediment in building water systems The benefits of controlling sediment in your building water system include: How to control sediment in building water systems There are several ways facilities can control sediment in their building water system, including: Sediment filtration case study A newly built facility in Colorado began experiencing issues with its plumbing infrastructure soon after opening its doors to patients in 2016, including: A sediment test by LiquiTech uncovered 26 times the World Health Organization-recommended sediment levels entering the building from the incoming water supply. Installing a new LiquiTech Sediment Filtration System removed 96.7% of incoming sediment, helping the facility: Installing a sediment filtration system is an effective way to control sediment, improve water quality, and extend the life of plumbing equipment. It can also result in cost savings for facilities by reducing maintenance and equipment replacement costs. For more insights on controlling sediment in your building water system, contact us today. Our team of ASSE 12080 Certified Legionella Water Safety and Management Specialists can work with you to develop a solution that’s tailored to your specific needs.
CDC Report Links Cluster of Healthcare-Associated Infections to Water System
A report published in CDC’s Morbidity and Mortality Weekly Report on August 4, 2023 linked a cluster of healthcare-associated infections to an Idaho hospital’s potable water system. According to the report, two patients who stayed in the same ICU room four months apart were found to be infected with carbapenemase-producing carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA). Carbapenem-resistant organisms, such as CRPA, are gram-negative bacteria resistant to the carbapenem class of antibiotics, a broad-spectrum antibiotic considered a “last resort.” Certain carbapenem-resistant organisms are resistant because they produce carbapenemase enzymes that make carbapenems ineffective. Infections from carbapenemase-producing organisms are difficult to treat and associated with high mortality. Pseudomonas aeruginosa can carry genes encoded with carbapenemases that can be transferred between strains and across bacterial species, leading to the spread of antibiotic resistance. CP-CRPA infections are typically transmitted from person-to-person or acquired from environmental sources, like water, sink drains, and toilets. Investigation and resultsA collaborative investigation involving the Idaho Division of Public Health, the Idaho Bureau of Laboratories, the Utah Public Health Laboratory, and the CDC was undertaken to identify the cause of the infection. The investigative team focused on the plumbing in the ICU room because Pseudomonas aeruginosa is known to persist in biofilm, a collection of microorganisms that adhere to one another and to a surface, such as a pipe. Water samples and swabs from two sinks and one toilet were collected. CP-CRPA with the same gene type isolated in the patients was found in one of the sinks, including swab samples from the drain, p-trap (a bend in a sink drain that holds water to block sewer gases), and sink counter. Water samples from the same sink’s p-trap and a toilet also tested positive for a different strain of CP-CRPA. Due to the genetic link between the patient isolate and sink isolate, the investigative team concluded that the most likely source of the outbreak was the ICU room sink. Prevention and control measuresUpon identifying the sink as the likely infection source, suggested measures for prevention and control were immediately instituted. These included the application of biofilm disinfectants, a screening regimen for future patients occupying the room, and a commitment towards forwarding any CP-CRPA isolates to public health laboratories for detailed molecular profiling, prevention, and control. On conducting a retest, no further CP-CRPA strains were detected in the environmental samples. As of December 2022, no additional CP-CRPA isolates have been reported by the hospital. These findings underpin the important relationship between biofilm, building water systems, and healthcare-associated infections. Long-term strategies to control and prevent biofilm in plumbing systems, such as through continuous disinfection of the entire building water system, are crucial to reducing healthcare-associated infections and ensuring patient safety. Read the full report. ReferencesCenters for Disease Control and Prevention. (2023). Carbapenemase-Producing Organisms (CPO). Carbapenemase-Producing Organisms (CPO) 2023 Case Definition | CDC Minnesota Department of Health. (2023). Carbapenem Resistant Pseudomonas aeruginosa (CRPA). Carbapenem Resistant Pseudomonas aeruginosa (CRPA) – MN Dept. of Health (state.mn.us) Centers for Disease Control and Prevention. (2023). Cluster of Carbapenemase-Producing Carbapenem-Resistant Pseudomonas aeruginosa Among Patients in an Adult Intensive Care Unit. Morbidity and Mortality Weekly Report | CDC
LiquiTech Joins the National Association of Manufacturers
LiquiTech, a leading chemical-free, sustainable water treatment solutions provider, proudly announces its membership with the esteemed National Association of Manufacturers (NAM). NAM, the nation’s most influential advocate for manufacturers, actively strengthens American manufacturing through policy advocacy, inspiring a new generation of talent, legal representation for manufacturers’ interests, performance-enhancing programs, and authoritative news coverage. “We are thrilled to join forces with the National Association of Manufacturers,” said Jack Berkery, President of LiquiTech. ” As a member of NAM, LiquiTech is now part of an extensive network of industry leaders, resources, and expertise, enabling us to enhance cutting-edge technologies, promote best practices, and actively shape the future of US manufacturing. This partnership reinforces our dedication to excellence and aligns perfectly with our mission of delivering sustainable and chemical-free water treatment solutions.” Through this membership, LiquiTech is poised to play an integral role in shaping the future of the water treatment industry. By leveraging their expertise and unique offerings, LiquiTech aims to spearhead initiatives that enhance water quality, prolong the lifespan of water-bearing equipment, and generate long-term value for customers, businesses, and the environment.
LiquiTech’s Loan VanAuker Chosen as Ambassador for Prestigious This is Public Health Program
LiquiTech, the leading provider of chemical-free and sustainable water treatment solutions, is pleased to announce that the Association of Schools and Programs of Public Health (ASPPH) has chosen Loan VanAuker as an ambassador for their prestigious This is Public Health program for the 2023-2024 term. VanAuker is an infection prevention and control epidemiologist at LiquiTech with more than 15 years of experience in public health, infection prevention and control, epidemiology, and investigations. ASPPH’s This is Public Health is an initiative that raises awareness about education and career options in public health through student ambassadors, graduate fairs, partnerships, interprofessional activities, and other pipeline-building events for students.As an ambassador, VanAuker will play a crucial role in leading virtual events and collaborating on projects and presentations to engage individuals and inspire them to pursue careers in public health. Her focus on water safety and copper-silver ionization education underscores the critical role these areas play in preventing waterborne illnesses and ensuring public health. VanAuker expressed her excitement about the opportunity, stating, “I am honored to be chosen as an ambassador for This is Public Health. At LiquiTech, we are committed to advancing water safety, and this platform allows me to amplify our efforts and promote the importance of public health education. I am eager to contribute to the growing interest in this field and positively impact the well-being of communities nationwide.” About LiquiTechLiquiTech partners with businesses to provide chemical-free, sustainable water treatment solutions that improve water quality, extend the life of water-bearing equipment, and deliver long-term value to their customers, their businesses, and the planet.
What is a Water Management Program?
Building water systems can create perfect conditions for Legionella and other waterborne pathogens to multiply and cause disease. Some factors in building water systems contributing to Legionella and pathogen growth include water stagnation, lack of disinfectant, water temperatures, and sediment. A water management program works to pinpoint potential hazards within the water system, so controls can be put in place to prevent pathogens from growing and spreading. Water management programs are now an industry standard for many buildings in the United States and are necessary to comply with various regulatory agencies, including The Joint Commission, ASHRAE Standard 188, Centers for Medicare & Medicaid Services, CDC, Veteran Affairs, Department of Defense, and others. Steps of a water management program Developing and maintaining a water management program is a multi-step process that requires continuous review and examination. Several components or steps are necessary to create a well-rounded water management program. Elements of successful water management programs The key elements of a successful water management program include: Customizing water management programs for each building Water management programs should be tailored to your unique building(s). Factors to consider include: For some facilities, like hospitals, hotels, and other large facilities with complex water systems, a water management program should be developed for the entire building. For smaller buildings with simple water systems, a water management program may only be necessary for specific areas or equipment, like cooling towers or decorative fountains. No two water management programs are the same, and your organization’s unique goals, needs, and buildings must play a role in how the water management program is developed and implemented. Partnering with an experienced water management company like LiquiTech can simplify the process of developing and implementing a compliant water management program. Learn more about LiquiTech’s water management programs.
