Legionella has received a good amount of airtime on television stations in recent months. For most people, this is the first time hearing the term legionella. The public wants to know what legionella is, how to handle it and that the individuals who own the buildings where legionella bacteria is found are proactively doing something about it.

Legionella is a bacterium that can cause Legionnaire’s Disease (LD), which is a form of pneumonia (legionellosis.) There are more than 45 species with more than 70 serogroups in this family of bacteria. The most notable of these bacteria is legionella pneumophila, which is responsible for more than 90 percent of LD cases. Legionella got its name from the Legionnaires who experienced the original outbreak in 1976. “Pneumo” translates into lung, and “phila” translates into loving.

Legionella is a lung-loving, microscopic bacterium less than 1 micrometer in width and 2 micrometers in length. It is found naturally in lakes, rivers, streams and ponds. It can also be found in potting soil. However, the primary source of the LD-causing bacteria is in buildings.

Many scientists have stated that LD is a first-world issue because of the massive infrastructure that promotes the growth of legionella bacteria. Naturally occurring legionella bacteria enter a building’s water system where it is permitted to grow in its ideal environment between 77-108 degrees F. When the ideal temperature and stagnation combine, it creates a perfect breeding ground for legionella bacteria.

This environment perfectly describes many modern building systems. Legionella bacteria enter the human body when contaminated water droplets are inhaled. Most people’s immune systems can fight off infection, but certain members of the population including those with a weakened immune system are much more suspectable to infection that can lead to LD.

In 2015, ASHRAE released Standard 188, which states if a building houses immune-compromised patients overnight, people of 65 years of age, has multiple housing units with a centralized hot water system and/or has more than 10 stories, the building should comply with this voluntary standard. If the building has any device that has the potential to spread contaminated water droplets, Standard 188 should be followed.

Just because the standard is voluntary does not mean FMs do not need to act. It is essential to know that eliminating legionella bacteria is impossible. However, proactive measures can be taken to ensure that LD doesn’t get into buildings. Thus, there are two reasons to act: to reduce the risk of someone contracting LD and to take negligence off the table. If someone were to become sick with LD, it would be known that Standard 188 exists and was not practiced. This could be used to prove negligence.

Just one month after ASHRAE released Standard 188, an outbreak occurred in New York. Local government responded by making parts of Standard 188 law. Also, every cooling tower within the state of New York must be registered with the health department and have a specific strategy for LD prevention. New York was forced to act. Because New York law makers only included cooling towers in the legislation, the assumption is that legionella only grows in cooling towers, and this not the case. Legionella grows naturally in water. Cooling towers are a good distribution system when it comes to spreading contaminated water droplets. Nevertheless, the Centers for Disease Control (CDC) traces more than 80 percent of LD cases back to the domestic water, not cooling towers. Many predict that New York will change the law due to this information.

There is a misconception that having a cooling tower water treatment program is compliance with Standard 188. This belief is incorrect because the two primary goals of a traditional water treatment program are to increase heat transfer efficiency and prolong the longevity of the equipment, not eliminate a specific species of bacteria. Moreover, the prime location of LD-causing bacteria is found in the domestic water, not the cooling tower. Compliance with Standard 188 covers the water systems within the building. Additionally, the only “real” way to manage legionella bacteria in any system is to test for it. Some legionella testing can cost as much as a “cheap” water treatment program. Just as a “cheap” water treatment program should not be considered, a traditional water treatment program should not be the compliance of a building to Standard 188.

Also, just having a building tested for legionella bacteria is still not the complete essence of Standard 188. It is knowing what to do when. A positive test result will eventually be found for legionella bacteria even if everything is being done correctly. Remember, the elimination of legionella bacteria is not the goal; having an action strategy to reduce the risk of someone getting LD is the goal.

When this action strategy includes the entire building’s water systems, it is called a Water Management Plan (WMP). A WMP includes a drawing of all the water systems in a building with possible legionella breeding grounds identified. Once identified, a plan is put into practice to reduce the growth of legionella bacteria in those systems and is validated with periodic legionella bacteria testing. If a positive legionella bacteria count is found in a test specimen, the WMP is followed to reduce the population of legionella bacteria. Most WMPs confirm this reduction with a follow-up legionella bacteria test. Therefore, merely testing for legionella bacteria is not enough. It is imperative to know what to do with the test results before starting to collect test specimens. The testing and subsequent action makes WMPs an essential part of the building’s operating procedures.

Another common misconception is if building operators and FMs do not test for legionella, they are not liable for someone in their building contracting LD. This cannot be further from the truth and can most likely be used against them in legal discovery. No action is the worst action when trying to understand what can be done about reducing LD in a building.

It is natural to fear something that is not understood, however, fear should not cause negligence. FMs should learn everything they can about LD. The CDC has several good documents that spell out what needs to be in a WMP. Local professionals can help anyone understand this complex topic. There is so much information out there that warns about LD, that proving negligence is not a difficult task. Professionals should work together to take negligence off the table. Dealing with LD is hard; WMPs are simple. Being proactive can not only save assets; it can save lives. Be proactive about LD and learn what can be done to prevent it.