Att 15_Bldg Mgrs and Water Maint. Staff_ Test materials

DEVELOPING A LEGIONELLA WATER MANAGEMENT PROGRAM

Elements of a Water Management
Program
Developing and maintaining a water management program is a multi-step, continuous process. The key
steps, listed here, are explained in more detail throughout the toolkit with the associated step number
appearing on the page where the specific step is discussed.

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2
Establish a water
management
program team

3
Describe the building
water systems using
text and flow diagrams

Identify areas where
Legionella could grow
and spread

4
5

Decide where control
measures should be
applied and how to
monitor them

Establish ways to
intervene when
control limits
are not met

6
Make sure the
program is running
as designed and
is effective

7
Document and
communicate all
the activities

Continuous program review (see below)

Program Review
You need to review the elements of your program at least once per year. Make sure you also review and
revise your program when any of the following events occur:

6 Data review shows control measures are persistently outside of control limits
6 A major maintenance or water service change occurs, such as:
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New construction
Equipment changes (e.g., new hot tub chlorinator pump)
Changes in treatment products (e.g., disinfectants)
Changes in water usage (e.g., high and low season for hotel)
Changes in the municipal water supply
6 One or more cases of disease are thought to be associated with your system(s)
6 Changes occur in applicable laws, regulations, standards, or guidelines
If an event triggers you to review and update your water management program, remember to:

6 Update the process flow diagram, associated control points, control limits, and
corrective actions
6 Update the written description of your building water systems
6 Train those responsible for implementing and monitoring the updated program
Reference: ASHRAE 188: Legionellosis: Risk Management for Building Water Systems June 26, 2015. ASHRAE: Atlanta. www.ashrae.org

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DEVELOPING A LEGIONELLA WATER MANAGEMENT PROGRAM

3

Control Measures & Corrective Actions:
The Basics
The diagram below shows the process of implementing and monitoring control measures. If you find that
a control limit (i.e., temperature levels, disinfectant levels) is not being met, you need to take corrective
actions to get conditions back to within an acceptable range. The right side, in yellow, illustrates the
routine process of monitoring control measures to make sure they are within limits. The left side, in
orange, shows the process of what to do if control measures are found to be outside of their limits.
Identify Control Points
(e.g., water heater, hot tub)

YES

Within
Limits?
Enhanced
Monitoring

Document
Results

Control Measures
(e.g., added disinfectant,
elevated temperatures)

NO

Routine
Monitoring

Document
Results
Document
Results

NO
Corrective
Action

Document
Results

YES
Within
Limits?

Document
Results

Remember, any time there is a suspected case of Legionnaires’ disease associated with your building
you should:

6 Contact your local and/or state health department or work with them if they contact you
6 Notify anyone who could be affected by the growth and spread of Legionella in your building if
the health department asks you to

6 Decontaminate the building water systems if necessary (you may need to get additional help
from outside experts)
6 Review the water management program and revise it, if necessary

Healthcare Facilities
In addition to the steps listed above that you would take in all buildings, if a case of healthcareassociated Legionnaires’ disease is discovered in a healthcare facility:
Make sure the person with expertise in infection prevention on your team is aware
Important: Tell clinicians so they can test patients with healthcare-associated pneumonia for
Legionnaires’ disease with both culture of lower respiratory secretions and the Legionella urinary
antigen test
Report the case to your local and/or state health department; a full investigation may be needed
For more details on identifying and investigating Legionnaires’ disease cases in healthcare
facilities, see page 24.
Reference: ASHRAE 188: Legionellosis: Risk Management for Building Water Systems June 26, 2015. ASHRAE: Atlanta. www.ashrae.org

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