Educational Articles

DEPARTMENT OF HEALTH &  HUMAN SERVICES  Announces Expectations for Healthcare Facilities and Surveyors DATE: June 02, 2017 TO: State Survey Agency Directors FROM: Director Survey and Certification Group.  Center for Clinical Standards and Quality/Survey & Certification Group Ref SUBJECT: Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease (LD) Memorandum Summary • Legionella Infections: The bacterium Legionella can cause a serious type of pneumonia called LD in persons at risk. Those at risk include persons who are at least 50 years old, smokers, or those with underlying medical conditions such as chronic lung disease or immunosuppression. Outbreaks have been linked to poorly maintained water systems in buildings with large or complex water systems including hospitals and long-term care facilities. Transmission can occur via aerosols from devices such as showerheads, cooling towers, hot tubs, and decorative fountains. • Facility Requirements to Prevent Legionella Infections: Facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and spread of legionella and other opportunistic pathogens in water.

The below article was published by The CDC on CDC.gov here. Legionnaires’ (LEE-juh-nares) disease is a very serious type of pneumonia (lung infection) caused by bacteria called Legionella. If you develop pneumonia symptoms and may have been exposed to Legionella, see a doctor right away. Be sure to mention if you have used a hot tub, spent any nights away from home, or stayed in a hospital in the last two weeks. Legionnaires’ Disease Can Cause Pneumonia Symptoms Signs and symptoms of Legionnaires’ disease can include: ► Cough  ► Muscle aches ► Fever ► Shortness of breath ► Headache Doctors use chest x-rays or physical exams to check for pneumonia. Your doctor may also order tests on a sample of urine and sputum (phlegm) to see if your lung infection is caused by Legionella. Legionnaires’ Disease Is Serious, but Can Be Treated with Antibiotics Legionnaires’ disease is treated with antibiotics (drugs that kill bacteria in the body). Most people who get sick need care in a hospital but make a full recovery. However, about 1 out of 10 people who get Legionnaires’ disease will die from the infection. Certain People Are at Increased Risk for Legionnaires’ Disease Most healthy people do not get Legionnaires’ disease after being exposed to Legionella. Being 50 years or older or having certain risk factors can increase your chances of getting sick. These risk factors include: ► Being a current or former smoker ► Having chronic lung disease, such as emphysema or chronic obstructive pulmonary disease (COPD) ► Having a weakened immune system from diseases like cancer, diabetes, or kidney failure ► Taking medication that weakens your immune system Legionella Are Usually Spread through Water Droplets in the Air […]

Many customers ask us about the chemical testing and treatment of glycol based closed loop systems. HVAC freeze protection is typically provided by adding either ethylene or propylene glycols. Most facilities use ethylene glycol as this provides the most efficient heat transfer. Propylene glycol is often used where toxicity is a concern. In systems that contain aluminum heat exchangers, a special pH sensitive mix is required. Each product is typically blended with special corrosion inhibitors; often dipotassium phosphate is used to help ensure long life for system metals. Many times, a secondary corrosion inhibitor such as nitrite, molybdate or an azole may be added on-site to further increase protection levels.  […]

Check out our newsletter featuring Legionnaires Disease articles and news stories. Click here to access the newsletter.

Below is part of the forward from the ANSI/ASHRAE Standard 188-2015 PDF.  For a fee, from the ASHRAE bookstore, you can download the entire PDF and Standard by clicking any of the blue buttons below.    Approved by the ASHRAE Standards Committee on May 27, 2015; by the ASHRAE Board of Directors on June 4, 2015; and by the American National Standards Institute on June 26, 2015. (This foreword is not part of this standard. It is merely informative and does not contain requirements necessary for conformance to the standard. It has not been processed according to the ANSI requirements for a standard and may contain material that has not been subject to public review or a consensus process. Unresolved objectors on informative material are not offered the right to appeal at ASHRAE or ANSI.) FOREWORD - ASHRAE Standard 188 The purpose of ASHRAE Standard 188 is to establish minimum legionellosis risk management requirements for building water systems.  “Legionellosis” refers to two distinct clinical illnesses.  When the bacterium Legionella causes pneumonia, the disease is referred to as “Legionnaires’ disease” (LD). The Centers for Disease Control and Prevention (CDC) estimates that each year there are between 8000 and 18,000 cases of LD in the United States and that more than 10% of these cases are fatal. Legionella can also cause a less-severe influenza-like illness known as “Pontiac fever.” Most cases of legionellosis are the result of exposure to Legionella associated with building water systems.  The presence of Legionella bacteria in building water systems is not in itself sufficient to cause LD. Other necessary factors include environmental conditions that promote the  growth of Legionella, a means of transmitting the bacteria to people in the building (e.g., aerosol generation), and exposure of susceptible persons to colonized water that is inhaled or aspirated into the lungs. Legionella bacteria are not transmitted person-to-person or from normal (nonaspirated) ingestion of contaminated water. Susceptible persons at high risk for legionellosis include but are not limited to the elderly, dialysis patients, persons who smoke, and persons with underlying medical conditions that weaken the immune system.  This standard is intended for use by owners and managers of human-occupied buildings and those involved in the  design, construction, installation, commissioning, operation, maintenance, and service of centralized building water systems and components.   Standard 188 consists of numbered normative sections  followed by normative and informative annexes. The normative sections and normative annex specify the requirements to  comply with this standard. The informative annexes and informative bibliography are provided for guidance that may be helpful for a given building water system. Building water systems vary substantially in their design and their capability for transmission of Legionella. Scientific evidence is either lacking or inconclusive in certain aspects of Legionella control. Therefore, the informative annexes and informative bibliography to this document provide suggestions, recommendations, and references to guidance.  ASHRAE Standing Standard Project Committee (SSPC) 188 has devoted a considerable amount of time and thought to resolving the concerns of affected and interested parties. The committee thanks everyone who participated in the development of the standard, especially those who made public review comments. Because changes to improve the [...]

Vortisand® cross-flow microsand filter shows Return On Investment of less than 12 months and keeps heat exchangers clean for district cooling center in New Orleans, LA. Click here to read the entire case study. The Project Enwave USA (formerly Entergy Thermal) located in New Orleans, LA, completed the design-build of a new District Energy Center in New Orleans to provide services to the New Orleans Regional Medical Center (NORMC) and other clients. The facility provides more than 33,000 tons of chilled water and air conditioning to more than 12 million square feet of commercial property that encompasses 15 square city blocks. Post Katrina In 2009, hurricane Katrina flooded the entire city which led to elevated Total Suspended Solids (TSS) levels in all their cooling water systems. Jeff Davis, Director Plant Operations for Enwave USA attended the IDEA Expo in Washington DC looking for solutions to improve his bulk chilled water quality in the aftermath of considerable damage caused by flooding. Mr. Davis visited the Sonitec-Vortisand booth and met with Regional Manager, Keith Karl. The Challenge Jeff discussed the challenges they were having with poor water quality negatively impacting the performance of their large thermal chilled water supply. They had tried traditional media filters and they did not succeed in reducing the level of TSS. It was determined the best solution to clean up this large volume chilled water loop, while keeping within a tight budget, would require a 300 gpm Vortisand® cross-flow microsand filter that provided submicron filtration and high quality water. The Vortisand® system replaced a traditional sand filter that claimed 5 micron capability. A standard laser particle distribution analysis illustrated that 80% of the TSS were less than 5 micron in size. The new Vortisand® unit was installed in early 2010 and after several months of operation proved to be a wise investment for them. Proof that a quality submicron filtration system coupled with a comprehensive chemical treatment program was the key to reducing TSS levels. RESULTS During a recent site visit in April 2014, Jeff Davis stated he has never seen the chilled water this clean since the start-up of the facility in 2000. The TSS issues that previously plagued the entire system never returned. Previously, their 15 heat exchangers had to be cleaned several times per year due to the increased biofilm caused by the suspended solids. “These heat exchangers have not had to be cleaned since the Vortisand® was installed in 2010”, said Davis.Maintaining their design efficiency has improved the bottom line every year with a Return On Investment of less than 12 months. To learn how Vortisand® cross-flow microsand filters kept the NORMC District Energy heat exchangers clean and reduced maintenance costs read more. Click here to read the entire case study.

Press Release from District of Columbia Water and Sewer Authority Mar 11, 2014 — From March 17 through April 28, 2014, the disinfectant in drinking water will temporarily switch from chloramine to chlorine. The annual switch in water disinfection is part of a routine program to clean and maintain drinking water systems in the District of Columbia, Arlington County and the northeastern portion of Fairfax County. During the temporary switch to chlorine, local water authorities will also conduct system-wide flushing to enhance water quality. This program is a common practice for many U.S. water systems that use chloramine during the majority of the year. The Washington Aqueduct is the organization responsible for treating and disinfecting drinking water for its wholesale customers: DC Water, Arlington County, and Fairfax Water. Local water authorities are responsible for monitoring drinking water to ensure chlorine levels continue to meet safe target levels. Individuals and business owners who take special precautions to remove chloramine from tap water, such as dialysis centers, medical facilities and […]

Most boiler systems today burn natural gas as the primary fuel.  Many systems are also set up to burn an alternate fuel if the natural gas supply is curtailed or cut off.  In most cases, the alternate fuel is No. 2 fuel oil, a light distillate that is the same as diesel fuel. Some industrial and utility boilers may use No. 6 oil as the alternate fuel.  No. 6 is a heavy residual oil that must be heated to approximately 150oF to be easily pumped.  If No. 6 oil were fed to a boiler that was set up to burn No. 2, the burner would not burn the fuel efficiently, and the unit’s combustion efficiency would decrease.  No. 6 oil is not a good “fit” for a boiler set up to burn no. 2. Just as the type and quality of the fuel affects a boiler system combustion efficiency, the type and quality of the water treatment chemical program has an impact on the overall efficiency of the boiler system.  If the chemical treatment program is not a good fit for the  system, overall efficiency can be reduced, with a corresponding increase in operational costs.  In today’s uncertain economic environment, this can put a company or facility at a competitive disadvantage, even threatening its very survival. […]