Water Risk Management in the Health Service Tom Martin BSc Environmental Innovations Ltd

Introduction - Water risk management does not just concern itself with Legionnaires disease - As a widely understood risk, this presentation seeks to highlight some of the more quietly talked about risks which can be just as costly and damaging - A healthcare facility should be treated with the same regard as a conventional industrial or commercial facility when considering the nature of water on site - Generally speaking, many healthcare facilities, especially campus style hospitals have old inherited sites with ongoing or difficult to deal with water management plans - Based on the above point, this puts healthcare FM at a disadvantage to private industry

Legionella - Regulation outlining Legionella ACOP L8 - Legionella is dormant below 20oC and wont survive above 45oC. - Water tanks should be at 60oC or higher, and distribution at the coolest part should be at 50oC or higher. - Human audits should take place monthly and recorded accurately. - Insulation is flagged up at numerous times. Bear in mind a five story building with a tank at the highest point, where would you start to find the point at which the water is cooling for example? - Many facilities are increasing their water temperature at great cost, however the outcome is generally that of scalding

Scalding - Although widely addressed in America, the UK does have HSE regulation on this - Care homes, pre-schools, wards where patients who have reduced mental capacity, are vulnerable to hot water and therefore scalding. - American study shows 5 out 6 surveyed facilities had water which could scald out their ‘faucets’. - Real-time Temperature monitoring can reduce costs in the form of waste - Hot surfaces - HSE suggest that surfaces should not exceed 43degree when a 'system' is at its maximum. This must mean that a radiator should be limited via the thermostat.

Graph from Study, showing American Burn Association (ABA), and Burn Foundation of Delaware Valley (DV) having temperatures within the second and third degree burn curve

Leakage, and mismanagement of water - Leakage can lead to waste in terms of costs and down time - Leakage can cause outages in terms of repair times for major bursts - All of the above can cause ward closures, breaches in facility standards, and to the extreme, undiscovered leaks can cause building defects and structural problems. - Water costs, although relatively low in the UK, can add to a massive sum when considering the size of some health facilities. - Referring back to the scalding slide, changing the way health facilities use their radiators can go towards a cost cutting exercise

Blocked Sewers and Sewer Surcharging -Hospitals seem to be dogged with this issue more than most due to the nature of the media being disposed of - Wirelessly monitoring provides a real-time retro-fit solution which can plug straight into the building management system - As particularly sensitive areas can be affected, early warnings provide a proactive response rather than costly reactive responding

Major Spills and Oil Interceptors Incorrectly stored IBC’s on Hospital site, over surface water outlet Sensitive receptor which had a spill pollution a 5KM stretch, and killing all local fish species Remote and Automated Penstock valve for drain isolation Wireless interceptor alarm, retro-fitted for cost savings. Reduced services by 60%

Summary - Legionella - Scalding - Leakage and Mismanagement of Water Blocked Sewers and Sewer Surcharging - Major Spills and Oil Interceptors Thank you