HOSPITAL & MEDICAL – WATER SAFETY
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Wet & healthy
A ccording to Marlow-based
water treatment specialist
WCS Group, NHS Trust
Water Safety Groups have a
tough job ensuring holistic
management of water hygiene and that
their response to risk is fit for purpose.
WCS Group’s critical services marketing
director, Chris Abraham, says the risk
to health from waterborne pathogens
such as Pseudomonas aeruginosa,
Stenotrophomonas maltophilia, Mycobacteria
and Legionella is difficult to manage, as
some of these bacteria naturally occur in
water. Potable water supplied to homes,
businesses, industry and hospitals, via the
mains, is treated to remove any pathogens
that may be present at the treatment
works. A small amount of chlorine is left in
the water to maintain quality as it travels
through the network of mains and pipes
delivering water to consumers. While
healthy people’s immune system can
normally cope with low levels of bacteria,
in healthcare establishments, they pose a
real and serious threat to already-immune
compromised patients, highly susceptible to
infection.
In April 2018, Chartered Institution of
Building Services Engineers (CIBSE) held a
symposium on water safety in healthcare. It
highlighted that while hospital water safety
systems are safer now than 20 years ago,
old pipework, cold water storage tanks,
scale, mixer taps, little-used outlets, dead
legs, tap aerators, flexible hoses (now
banned for use in healthcare premises, due
to synthetic linings harbouring bacteria) and
water supply management are all threat
factors that must be regularly monitored
and assessed, to minimise risk.
The main source of official guidance on
providing safe water in healthcare premises
is published by the Department of Health
(DoH) in the form of its Health Technical
Memorandum 04-01. The latest version was
updated in 2016 following new guidance
from the Health and Safety Executive.
The latest version aims to move
healthcare providers towards a holistic
form of management of water safety by
the establishment of water safety groups
(WSG) and implementing water safety
plans (WSP). It promotes best practice and
covers the key areas WSGs must consider
when designing, installing, commissioning,
operating and maintaining water services in
healthcare premises.
The guidance highlights the need for
robust governance and management,
outlining the remit of the WSG and how this
relates to the provision of safe water.
It says key criteria and system
arrangements must be in place to
help stop the ingress of chemical and
microbial contaminants, colonisation and
proliferation. The guide includes information
By Peter Shakespeare
Who knew the humble tap could kill? OE takes a look at water safety in
healthcare and how it should be managed
Water safety plan
Its purpose is to understand what plant,
equipment, and assets are on site,
their interdependence, and the holistic
operating risk that they pose. WCS Group
advises WSGs also consider the below:
● Up-to-date and fit-for-purpose
schematics should describe all visible and
hidden assets, systems and pipework
layout. They should be reviewed regularly.
● Hazard analysis and critical control
points, designed for preventing risk and
identifying hazards, should be embedded
into management strategy.
● Physical control measures include
temperature, flushing, materials,
ultraviolet, tap design, filtration, deadlegs,
old or obsolete equipment. Chemical
measures include: chlorination, chlorine
dioxide, monochloramine, copper-silver
ionisation, hydrogen peroxide, titanium
advanced oxidisation processes.
● Operating limits for water treatment
must be put in place and recorded. They
will influence decisions about asset life
cycle, maintenance, refurbishment or
removals and secondary disinfection
decisions. Parameters include: Time,
temperature, dose, pH, water hardness,
water consumption, energy consumption,
age and complexity of equipment and site,
accuracy and frequency of data.
● Once control measures have been put
in place, system performance and KPIs
need to be monitored.
● Monitoring and consistently recorded
data will enable better decisionmaking,
more timely asset life cycle management,
and less reactive maintenance, unforced
shutdowns and less operating risk.
● According to law, records must be
retained for five years.
● System validation and verification
through analysis of performance data.
28 www.operationsengineer.org.uk June 2019
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