Dental Practice Legionella Management
What is Legionnaires disease?
Legionellosis is a collective term for diseases caused by legionella bacteria including the most serious legionnaires’ disease, as well as the similar but less serious conditions of Pontiac fever and Lochgoilhead fever. Legionnaires’ disease is a potentially fatal form of pneumonia and everyone is susceptible to infection.
Legionella requires certain conditions in order to survive and multiply:
Water Temperature (breeds between 20°C to 45°C)
Maximum growth at 37°C
Proliferation encouraged by water stagnation
Source of nutrition (Sludge, Slime, Scale, Corrosion and especially Biofilm)
How people contract Legionnaires disease?
By breathing in an aerosol containing an infectious dose of legionella bacteria.
“For the organism to be dangerous to man, there must be an opportunity for it to multiply and then become airborne in the form of an aerosol”
People at increased susceptibility to Legionnaires disease:
People over 45yo
Heavy Smokers
Heavy Drinkers
People suffering from chronic respiratory or kidney disease
People effected by lung heart disease
People with impaired immune system
Exposure to aerosol during the dental treatment: When the equipment is operated aerosols will be generated, which can be inhaled by the patient. Some of the patients more susceptible than the majority of people. There will also be risk of exposure to aerosols to the dentist and dental nurse.
Why do I need to control the Legionella?
Under the Health and Safety Act and associated regulations e.g. The Control of Substances Hazardous to Health (COSHH) Regulations 2002 a risk assessment must be carried out to determine if this type of system could provide favorable conditions for growth and dissemination of legionella bacteria. The assessment defines the level of the risk and what, if any, control scheme is required in order to manage the risks identified during the assessment process.
Which water systems must be included in my Legionella Risk Assessment?
As with any building, a dental surgery will have different water systems such as domestic hot and cold water covered under the HSE HSG274 Part 2 and HTM04-01, Dental Equipment including dental unit water lines (DUWLs) covered under the HTM01-05. It is important to remember that all water systems in the practice will need to be included in a risk assessment.
Who can carry out my Legionella Risk Assessment?
The assessment must be carried out by a competent person and be linked to other records, in particular, the written scheme.
A competent person is someone who has sufficient training and experience or knowledge and other qualities that allow them to assist you properly.
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