Sentinel Outlets the nearest and furthestlast outlets from

Sentinel Outlets the nearest and furthest/last outlets from hot and cold water cylinders and tanks.

Dead end and dead legs need to be removed • A dead end- a redundant length of pipe, closed at one end, through which no water is flowing • A dead leg - is a pipe leading to an outlet which water flows but the outlet is un-used or infrequently used. All need to be removed by cutting them back to the main pipe run

Thermostat mixing valves • Picture TMVs these blend hot and cold water to reduce the temperature where a scald risk is present

Expansion vessels in hot or cold water systems (not central heating) • Preferably be flow through design • Have a drain valve – flush through and purge to drain (HSG 274 Pt 2 Table 2. 1) • • Minimise volume stored Should be sited – in cool areas – vertically on pipework not horizontally

Specialised Assisted Baths • Separate cleaning shower head system • • Hydro-massage function Flexible hoses Expansion vessels Filters

Other issues to address: • TMVs should be fitted as close as possible to the point of use (typically one per outlet); • Infrequently used outlets should be flushed weekly (includes short usage and no hot water flowing); • Shower heads and hoses should be dismantled, cleaned and descaled or replaced at least quarterly. • Redundant supply pipework should be cut back as far as possible to a common supply; • Replace EPDM (ethylene propylene diene monomer). rubber hoses with eg. PE (polyethylene), PEX (cross-linked polyethylene • Keep water system clean

Monitoring water temperatures legionella control for

Thermometers needed Immersion temperature probe Surface temperature probe

Measure the temperature at the hot water tanks monthly • hold the surface probe against the pipe work at the hot water tank outlet • check the temperature tallies with any fixed thermometer, if installed.

Measure the temperatures at the sentinel cold water and hot water outlets monthly Use the immersion probe to measure the temperature of the water flowing from the outlet (NB – on hot outlet where TMV is fitted, this needs to be done on TMV inlet pipe) • Hot water should measure at least 500 C within 1 minute of running water • Cold water should measure less than 200 C within 2 minutes

Measure sentinel hot water temperature at inlet to TMV monthly Measure at least 500 C within 1 minute of running water

Measure the temperatures at the cold water tanks 6 monthly Incoming water Water in tank Measure less than 200 C

Common failings 1 • No Legionella risk assessment and occupiers are ignorant of the control and monitoring requirements (lack of competence) • • Assessment findings not being implemented • Homes only measure and record hot water temps after tmv’s for scald risk • • • Tmv’s fitted too far from outlet No schematics or not comprehensive Sentinel outlets not identified Not measuring hot water temperatures at inlet to TMVs where fitted Not measuring hot water storage temperatures Hot water storage thermostats set below 50 degrees C

Common failings 2 • • • No temperature gauges fitted to hot water outlets and returns (and no one measuring with surface probe) Hot water vent pipe overflowing to cold water tank Cold water stored above 200 C (eg un-insulated cold water tanks located on roofs) Cold water tank lids not tight fitting or broken Insects screens not fitted to cold water over flows and vents Dead legs / ends present Infrequently used outlets not flushed weekly No cleaning of shower heads Evidence that some Water treatment company reports do not reflect the inadequate management, treatment and control of legionella at the homes

When is legionella sampling required? • Where storage and distribution temperatures are reduced from those required • Where an outbreak is suspected or identified • Where assessment identifies it is necessary to help monitor effectiveness of controls

Where to sample? • cold water samples -taken from the cold water tank/s and furthest outlets • hot water samples - the nearest tap to the hot water tank outlet plus the return to the hot water tank (if re-circulating) - base of hot water tank and furthest outlet from the tank

When is disinfection needed? • If required temperatures not being achieved • System has been substantially altered; or • During or following an outbreak

Other issues to consider What is an infrequently used outlet? What is the impact of green technologies or energy conservation on Legionella control? How many people are contracting Legionnaires disease from care homes? RIDDOR does not require non-worker reports of disease to HSE – but requirement to report to HPA

Frequency of Monthly Six monthly Annually Frequency of Monitoring water temperature Temperatureschecks Measure the temperature at the hot and cold water sentinel outlets and the hot water tank Check the temperature at the cold water storage tank/s (at least once in winter and once in summer during a hot period); Check a representative number of cold water outlets on a rotational basis

Frequency of other checks The Frequency of Other Checks At least weekly Flush infrequently used hot and cold water outlets At least 3 monthly Clean and de-scale or replace shower heads and hoses At least annually Visually inspect the cold water storage tank/s and clean and disinfect as required Check the schematic diagram/s of the H &CW system to ensure they are correct and up to date (eg addition or removal of water tanks and outlets) Note: All checks should be carried out using safe systems and some checks or corrective actions may need to be done by an external competent person

Further information HSE H&SC Legionella webpage: http: //www. hse. gov. uk/healthservices/legionella. htm HSE Legionella H&CWS webpage: http: //www. hse. gov. uk/legionnaires/hot-and-cold. htm HSE SIM – Control of Legionella in H&CWS http: //www. hse. gov. uk/foi/internalops/sims/pub_serv/07 -12 -07/index. htm HSE ACOP L 8: http: //books. hse. gov. uk/hse/public/saleproduct. jsf? catalogue. Code=9780 717617722 HSE ACOP HSG 274 Part 2 http: //www. hse. gov. uk/pubns/priced/hsg 274 part 2. pdf HSE Safety Notice: http: //www. hse. gov. uk/safetybulletins/legionella 2. htm