FIGHT AGAINST THE RISK OF LEGIONELLA INFECTION

Services and strategies for limiting the proliferation of Legionella and the risks of infection related to it in large and medium-sized structures.

LEGIONELLA OBJECTIVE

RISK CONTAINMENT

The purpose of our services is to offer operators of structures and work environments elements of judgment for assessing Legionella risk in buildings and defining rules of behaviour for minimising this risk.

Legionellosis is a severe form of pneumonia caused by bacteria belonging to the Legionella spp. genus. In recent times there has been a significant increase in notifications received from the Higher Health Institute.
Considering the health, judicial, economic and image implications that can derive from these episodes, the most pragmatic approach is to do everything possible to put in place all the necessary measures to prevent the disease.
Legionella, as reported in Consolidated Law 81/08, is a biological agent belonging to group 2; that is, an agent that can cause diseases in human subjects and pose a risk to workers.
At this point the employer, or the manager of the structure, must carry out a risk assessment as indicated in the Guidelines issued in May 2015 and in compliance with the provisions of Consolidated Law 81/08, taking into account all the available information concerning the characteristics of the biological agent, in particular on the disease, and its potential effects by taking all protective and preventive measures. For prevention to be effective, it is important for the employer to implement all control and predictive measures, not only in response to a case of Legionellosis, but before these occur through a risk assessment.

STRUCTURE INSPECTION

In-depth inspection of the structure, acquisition of water, sanitation and air conditioning systems, collection of information in the field in order to determine the type of frequentation of the structure

MICROBIOLOGICAL ANALYSIS OF AIR, WATER

Water and surface sampling are necessary to establish the situation of the spread of Legionella and of the bacterial load inside the sanitary/potable water distribution system and in the air conditioning system

LEGIONELLA RISK ASSESSMENT DOCUMENT

Assessment of the risk of contagion by Legionellosis is carried out by a team of qualified technicians in order to identify the critical points, providing for the operations to be carried out and the sections of the systems that may present a risk for workers or guests.

REGISTER OF MAINTENANCE INTERVENTIONS

For the recording and documentation of ordinary and extraordinary maintenance work on water-sanitary and air conditioning systems, a register of the interventions carried out exactly on the basis of the inspected structure must be established and kept up-to-date.

It is known that Legionella is a ubiquitous bacterium not only in natural aquatic environments but also in artificial habitats; this last aspect constitutes a problem of considerable importance for the spread of Legionellosis, since the disease is contracted by inhalation of contaminated aerosols.

Prevention of the risk of contracting the infection is based on a series of interventions and operations performed to contain proliferation in systems and diffusion through Legionella aerosols. In this assessment phase, analytical monitoring of contaminations is a non-containment tool, but useful for assessing the degree of risk of the structure.

Legionella infection is not transmitted from person to person, but rather is transmitted by flows of aerosols and contaminated water, as in the case of air conditioned environments or through the use of humidifiers. The bacterium, in fact, reproduces mainly in damp, warm or warmed environments, such as pipe systems, condensers and water cooling columns, on which it forms a bacterial film. Organic sediments, rusts, limescale, deposits of materials on the surfaces of water storage and distribution systems facilitate the settlement of Legionella.

Legionella risk assessment is carried out by Defensor, examining the layouts of water-sanitary systems and air conditioning systems: for each system, the critical points which represent a real risk for the users of the structure are identified and sized.

Following an inspection by expert personnel, in order to have a visual confirmation of the structure, the condition of conservation of the systems, type of equipment and all the technical characteristics useful to the case are assessed. Investigations are carried out in order to determine the type of visitors of the building and their susceptibility to infection from Legionella.

To complete the documentary picture and to have additional analytical information, microbiological sampling is carried out, aimed at establishing the situation of contamination of systems by target pathogens and thus the real level of pollution.
The assessment document indicates:

• the degree of exposure to the risk of infection by pathogens,

• the programme of immediate interventions (prescriptions) and maintenance to be implemented directly or with the aid of the Register of Interventions (“Guidelines for the prevention and control of legionellosis” of the State-Regions Conference of 7 May 2015).

Following the document, the register for the annotation of maintenance interventions to be implemented is drawn up.

At this point, the operator of the structure has indicated the way to carry out containment of the risk, which can be made only by maintenance operations or by innovative technical measures aimed at increasing the level of safety.

services available

Legionella risk assessment

Consultancy for management of the risk of Legionella contagion

Legionella awareness training and related control and containment measures

Analysis

Boiler disinfection

Disinfection of cold, hot water systems

Having operated for many years in the sector, Defensor offers a complete range of services, ranging from the initial study for establishing the plan of action, up to the supply of systems, including servicing, for extraordinary remediation operations or containment of the risk of contagion from Legionella.
It is also able to provide training and operational instruction to the internal staff of the structure.
All chemical or physical treatments recommended by the guidelines for the prevention and control of Legionellosis can be implemented by Defensor; each of them has advantages and disadvantages, merits and defects, more or less contained costs, and more less proven effectiveness. It is the competence of the technicians to understand which of these are the most efficient and the cheapest according to the multiple situations that can be found in each individual case examined. Subsequently, the highly qualified staff of Defensor will provide for the implementation of the selected methods with equipment, suitable products and/or installation of specific equipment.
The company is at your disposal for undertaking a proper assessment of the risk of each structure, for providing assistance in filling out the intervention register, for advising and/or implementing the most suitable preventive measures, and for establishing valid sampling points, sampling frequencies, sampling and transport of samples, with subsequent analyses in accredited laboratories.

results

INCREASE IN HEALTH AND SAFETY LEVELS

IMPROVEMENT OF WORK ENVIRONMENT

COMPLIANCE WITH CURRENT REGULATIONS

 

Current regulations

Legionella has been subject to a National Surveillance System for many years, and since 1990 it has been classified as an infectious and widespread class II disease for which there is an obligation of reporting.

Below we list the main legislative and regulatory references concerning Legionellosis. It should nevertheless be kept in mind that as far as safety is concerned, it falls within the competence of Legislative Decree no. 81 of 9 April 2008 (Consolidated Law on Safety), as prevention of diseases related to work environments.

  • Guidelines for the prevention and control of Legionellosis – Approved in the State-Regions Conference at the session of 7 May 2015.
  • Guidelines carrying indications for laboratories with microbiological diagnosis and environmental control of Legionellosis – Official Journal Number 29 (General Series) of 5 February 2005 (page 25-27).
  • Guidelines carrying indications on Legionellosis for operators of tourist accommodation and thermal facilities – Official Journal Number 28 (General Series) of 4 February 2005 (page 54-60).
  • Guidelines for the prevention and control of Legionellosis – Official Journal Number 103 (General Series) of 5 May 2000 (on page 12).

sanctions regime and regulatory reference

Failure to comply with the regulatory requirements for the prevention and management of the biological risk of contagion from Legionella causes the owners of affected facilities to bear criminal responsibility for injuries or death that may occur to the worker or person frequenting the facility.

Under article 2087 of the Civil Code1, the Employer, even beyond the specific provisions, is in any case established as guarantor of the physical integrity and protection of those who work in the enterprise, with the obvious consequence that where he/she does not comply with the obligation of protection, the harmful event is charged to him/her under the provisions of Article 40, paragraph 2, of the Criminal Code2.

This obligation is so far-reaching that it cannot be distinguished whether the person concerned is an employee, a person with equivalent status or a person who is not part of the business, provided that the link between the accident and the violation of the discipline on security obligations is evident.

According to the Consolidated Law no. 81/2008, and in particular on the basis of article 271, the Employer must perform the risk assessment also with reference to the biological risk and identify the protective and preventive measures deemed most appropriate.

It follows that the operator of a tourist-receptive and/or sports facility or the employer who does not comply with the provisions of articles 266 and following of Consolidated Law no. 81/2008 responds in negligence to harmful events derived to patrons who have contracted Legionellosis.

Criminal liability can derive equally from failure to adopt precautions and from adoption of entirely inadequate and insufficient precautions.

The primary normative source is undoubtedly Consolidated Law no. 81/2008 at articles 266 and following, with particular reference to art. 271.

This regulation is relatively generic, given that it does not specify the risks identified abstractly with respect to possible catching of the Legionella bacterium, nor the preventive measures that it would be advisable to adopt specifically to prevent these risks.

Indeed, there is no doubt that neither art. 271 nor art. 28 of Consolidated Law no. 81/2008 specify in detail the type and contents of the preventive measures.

Although not fully superimposable, these detailed regulations, in addition to providing for the appointment of a person responsible for the identification and assessment of Legionella risk, specify the content of the predictive and preventive measures that should be adopted to avoid this risk. Failure to comply with the aforementioned regulatory provisions may lead to serious criminal liability for the person in charge of the structures, such as those listed below:

1 Art. 2087 of the Civil Code – PROTECTION OF WORKING CONDITIONS: The entrepreneur is obliged to adopt in the company’s business the measures which, depending on the particularity of work, experience and technique, are necessary for protecting the physical integrity and moral personality of employees.

2 Art. 40 – second paragraph – Criminal Code – CAUSAL RELATIONSHIP: Not preventing an event that a person has the legal obligation of preventing is tantamount to causing it.