Business & compliance advice

Legionella - Your responsibilities as an employer and everything else you need to know

26th February 2018

The Onset

On 27 July 1976, as America celebrated the bicentenary of the Declaration of Independence, five military veterans died of apparent heart attacks.

All had attended the 58th annual convention of the Pennsylvania State American Legion in Philadelphia five days earlier. All had stayed at the Bellevue-Stratford Hotel. All had experienced tiredness, chest pains, lung congestion and fever. Six more delegates died the next day. Within a week 221 of the legionnaires who had stayed at the hotel were hospitalised with the same symptoms and 34 had died. Most were men aged 39 to 82.

The Conspiracies

Information was scarce during the six-month investigation following this tragedy, so wild speculations began to spread about the cause of the deaths. At the height of the Cold War, some were convinced that enemy forces had attacked the legionnaires. Others believed it was a CIA experiment gone disastrously wrong, or a hoax tricking people into supporting mass vaccination against swine flu. Extra-terrestrials were also mentioned.

The answer was far simpler, the veterans had been struck by Legionella.

Since this first case Legionella has persisted, with 500 in England suffering from it each year. Based on the CDC’s predictions (Centre for Disease Control and Prevention), one in ten of those infected each year die from the disease.

The Symptoms

Treatment of Legionnaires’ disease is by antibiotics, and early recognition and treatment are crucial for survival. The symptoms vary, depending on whether it is mild or severe, so it is important to keep a keen eye out for their appearance.

Mild (sometimes called Pontiac fever) has a 24 to 48-hour incubation period, followed by 2 to 5 days of influenza-like illness. Severe Legionnaires’ disease usually has a 2 to 10-day incubation period, but it can be up to 20 days. It generally involves acute and rapid pneumonia with other symptoms such as:

  • Headache

  • High fever

  • Muscle pains

  • Cough

  • Breathing difficulties

  • Loss of strength

  • Confusion

  • Diarrhoea

Who's at risk?

The risk increases with age, and those with a higher risk include:

  • Over-45s

  • Smokers and heavy drinkers

  • People suffering from chronic respiratory or kidney disease

  • Diabetes, lung and heart disease

  • Anyone with an impaired immune system

  • Conditions to avoid, because Legionella loves them

People contract Legionnaires' disease by inhaling small droplets of water (aerosols) that contain the bacteria, which are suspended in the air they breathe. Certain conditions within man-made water systems can lead to the growth and spread of the bacteria including:

  • Water between 20-45°C, optimum temperatures for Legionella growth

  • The aerosol process, dispersing water into breathable water droplets

  • Stagnation of water due to storage and/or recirculation This encourages the formation of biofilm, a thin layer of microorganism slime that feeds the bacteria

Your Responsibilities as an Employer:

If you are an employer or in control of premises, you have duties to control risks from work activities related to Legionella under the Health and Safety at Work etc Act 1974 and the Management of Health and Safety at Work regulations.

More specifically, the Control of Substances Hazardous to Health Regulations 2002 (COSHH) stimulates a framework to assess, prevent or control the risk from bacteria like Legionella and take suitable precautions. The Approved Code of Practice: Legionnaires’ disease: The control of Legionella bacteria in water systems (L8) contains practical guidance on how to manage and control the risks in your system. According to it, you must understand how to:

  • Identify and assess sources of risk

  • Have a competent person to conduct a risk assessment.

  • Manage any risks

  • Conduct water treatment or other works to reduce the risk.

  • Ensure people involved with work are suitably informed, instructed and trained.

  • Prevent or control any risks

  • The use of water systems that lead to exposure must be avoided. Where this is not possible, a written scheme for controlling the risk from exposure should be properly implemented and managed, showing the layout of the water system with a description of operation, precautions and checks made, along with remedial action if the system is not effective.

  • Review of control measures: monitoring and routine inspection

  • For precautions to remain effective, the condition and performance of the system will need to be monitored.

  • Keep and maintain the correct records

  • An assessment of the risk must be carried out which records the significant findings and ensures appropriate records are kept. This should include any groups of employees identified as being particularly at risk and the steps taken to prevent or control risks. If the employer has less than five employees there is no statutory duty to write anything down, but it may be useful to keep a written record of what has been done. Doing this allows the assessment to be more easily reviewed and referred back to if employees need to refresh themselves on safety practices.

  • These records should be retained throughout the period they are current and for at least two years afterwards. Retain records of any monitoring inspection, test or check carried out, and the dates, for at least five years.

Other duties

Under the Notification of Cooling Towers and Evaporative Condensers Regulations 1992, you must notify your local authority, in writing, if you have a cooling tower or evaporative condenser on site. When doing so you must include details about where it is located.

In addition, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR), you must report any cases of legionella in an employee who has worked on cooling towers or hot and cold-water systems that are likely to be contaminated with legionella.

The Consequences

Businesses that don’t abide by their legal requirements, whether it be regarding legionella, or any other workplace hazard can often suffer significant fines. They also face more frequent employee accident and injury.

In particular with Legionella you face the risk of causing a major outbreak such as these:

  • 1985 - Stafford District Hospital

    • 175 cases and 28 confirmed deaths

    • Source of infection: rooftop air-conditioning cooling tower

  • 2002 - Forum 28 arts centre, Barrow-in-Furness

    • 172 cases and 7 confirmed deaths

    • Source of infection: contaminated cooling tower

  • 2012 - Warehouse, Stoke-on-Trent

    • 19 cases, 1 confirmed death

    • Source of infection: the warehouse hot tub

How do you protect your workplace from the threat of Legionella?

Here at Phoenix, we offer a 30-minute-long E-Learning Legionella Awareness Course, starting at £4.99. It's designed to enable employers, building owners, managers, and maintenance workers to understand the risks of exposure to legionella, prevention of infection and what control measures should be in place.

We also offer risk assessment training, which provides members of your team with the ability to conduct and record effective risk assessments, in doing so considering the potential risks of hazards such as legionella.

To explore any of our other courses, which all aid in helping your business keep its employees safe and abide by legal requirements, start here.

If you have any further questions about legionella, our services or anything else, please contact us.