ansi/ashrae standard 188-2015 legionellosis: risk...

•Standard 188-2015 Presentation - TE

Watson

•Dec 8, 2015 •1

ANSI/ASHRAE Standard 188-2015

Thomas E Watson, P.E.

Member SSPC-188

December 8, 2015

ANSI/ASHRAE Standard 188-2015Legionellosis: Risk Management for

Building Water Systems

Published June 26, 2015


Learning Outcomes

� Understand history of Legionnaires Disease

� Know Principles of ANSI/ASHRAE Standards Development

� Basics of ANSI/ASHRAE 188-2015

� Purpose & Scope

� Framework for Legionella bacteria Control Measures

� Health Care facility Requirements

� Requirements for WMP for Specific devices such as cooling

towers, ornamental fountains, spas, etc.

� Elements of a Water Management Plan

� Designer requirements


Background

� While Legionnaire's disease has been known for many years, recent outbreaks have increased awareness of the disease, its causes and prevention strategies

� The Centers for Disease Control and Prevention (CDC):

� Estimates 8,000 - 18,000 cases of LD in the USA

� More than 10% of these cases are fatal

� ASHRAE providing information on Legionella since 1979 in response to the first Legionnaire’s disease outbreak in 1976 and the subsequent discovery by the CDC of the causative bacteria – Legionella


Watson

•Dec 8, 2015 •2


1. Legionella: the name for the genus (a major

classification) of bacteria. Legionellae is the

plural – referring to more than one Legionella

bacterium.

2. Legionellosis: any illness caused by the

exposure to Legionella. Legionnaires’ Disease

(LD) and Pontiac Fever (PF) are the two most

common types of legionellosis.


34 Deaths!221 Sick!

Legionnaires’ Disease


… that Legionnaires’ disease

is caused by (an aquatic)

BACTERIA!


Watson

•Dec 8, 2015 •3


► Mild, Flu-like illness – without pneumonia

► Appears <1 - 3 days after exposure

► Lasts up to 5 days – generally less

► Does not require hospitalization

► Susceptibility: ~95% (+/-) of those exposed


► Potentially fatal, multi-system respiratory illness, accompanied by pneumonia

► Symptoms: high fever, chills, muscle pain,

headache & dry cough; diarrhea, vomiting, confusion & delirium are also common

► Appears 2-10 days after exposure

► Recovery can be long-term & debilitating

► Susceptibility: ~5% (+/-) of those exposed


�One of 58 named Legionella Species

�The Species Responsible for ~ 90%

of Legionellosis Cases

�Has 15+ Serogroups

�The Major Infectious Lp Serogroup is Serogroup 1 (Lp1)

Legionella pneumophila


Watson

•Dec 8, 2015 •4




(2) ContainingAmplified &Virulent LB

(3) Inhaled or

Aspirated by

‘At-Risk’ Host

(1) Water/SoilAerosols


Watson

•Dec 8, 2015 •5


‘Weakened Immune Systems’

► Immune Suppressed (Transplants,

Cancer, Cardiac, Steroids)

► Sick / In Poor Health

► Elderly / Infirm

► Heavy Smokers, Lung Disease


We continue to learn about Legionella –

and have the 1st ANSI Standard to address Legionellosis – ASHRAE Standard 188!

39 Years Later (2015)


Legionnaires' outbreak widens to 12 dead in New York …

► 128 Cases Reported with 12 Deaths . . . Officials say the outbreak is

centered on the area near the Opera House Hotel in the South Bronx

August 11, 2015


Watson

•Dec 8, 2015 •6


9/30/20159/30/2015Another Outbreak in NYC


With 12 confirmed dead and more than 120 cases of infection due to legionellosis, New York City Council on Thursday adopted legislation that requires adherence to part of ASHRAE’s newly published Legionella standard.

The legislation addresses registration and inspection of cooling towers. It requires owners to create and file a plan to maintain equipment to comply with Sections 5, 6

and 7.2 of the new ANSI/ASHRAE Standard 188-2015 /

Legionellosis: Risk Management for Building Water Systems.

Standard 188 Adopted in New York City

Aug 17, 2015

Contact: Jodi Scott

ASHRAE Public Relations

678-539-1140 / [email protected]


CDC: In What Facilities Does LD Appear?


Watson

•Dec 8, 2015 •7


ASHRAE Standards Development

�Consensus through participation and public review

�Consensus = substantial agreement but not unanimity

�Balance of interest categories

�Legionella & water treatment specialists, consulting engineers,

health professionals, building owners & operators, manufacturers, government officials, and others

from around the world


Voting Professional Organizations on SSPC-188:

AWT: Association of Water Technologies

APIC: Association for Professionals in Infection Control and Epidemiology

ASHE: American Society for Healthcare Engineering

ASPE: American Society of Plumbing Engineers

CDC: Centers for Disease Control & Prevention

IAPMO: International Association of Plumbing and Mechanical Officials

NSF International


ASHRAE develops three types of voluntary consensus standards accredited by the American

National Standards Institute (ANSI):

1) Method of Measurement or Test2) Standard Design3) Standard Practice

ASHRAE Standard Development


Watson

•Dec 8, 2015 •8


ASHRAE Standards – Special Note:



*Feb 2005

SPC-188 began

meeting

October 2010

Draft 1released (+ PR/1)

June 2011


January 2013


Sept 2014


March 2015


June 4, 2015

Approved by ASHRAE

board

June 26, 2015

Finalized Standard 188-2015

*Feb 2005: 1st meeting was GPC-12 (guideline), later as SPC-188

PR = Public Reviews (required by the ANSI/ASHRAE process)

1 2 3 4 5 OK

Standard 188 Development History


Watson

•Dec 8, 2015 •9


Standard 188 ‘Evolved’ from ASHRAE

Guideline 12


The SPC188 Team …‘Legionellosis: Risk Management for Building Water Systems’



Watson

•Dec 8, 2015 •10


►►►► PURPOSE: Establish minimum Legionellosis risk management requirements for building water systems.►►►► SCOPE:

1) … for design, construction, commissioning, operation,

maintenance, repair, replacement, and expansion of new and existing buildings and their associated water systems

2) … applies to human-occupied commercial, institutional, multi-unit

residential, and industrial buildings ... does not include single-family residential buildings

3) … for use by owners & managers of human-occupied buildings, excluding single-family residential buildings ... also for those involved

in design, construction, installation, commissioning, operation,

maintenance & service of centralized building water systems and components

ANSI/ASHRAE 188-2015


Compliance with Standard 188 will

require facility owners (managers) to:

1�� Establish a Team with assignedresponsibilities & accountabilities

2�� Have, Practice, & Audit aWater Management Plan forlegionellosis risk management oftheir building water systems

Describe Water System

Access the Hazard

Establish HazardControls

Audit the Plan

In a Nutshell


ASHRAE gives a framework, but the Team must

develop specific LB control measures for:

• New Construction

• Siting

• Startup and Shutdown

• Inspections

• Maintenance

• Cleaning and Disinfection

• Monitoring (e.g., temperatures; disinfectant levels)

• Water Treatment

• Responding to Legionnaires' disease

???

ASHRAE 188-2015:Control Measures


Watson

•Dec 8, 2015 •11


SECTION PAGE

Foreword 2

1. Purpose 2

2. Scope 2

3. Definitions 2

4. Compliance 3

5. Building Survey 4

6. General Requirements 4

7. Requirements for Building Water Systems 6

8. Requirements for Designing Building Water Systems 10

9. References 11

Normative Annex A: Health Care Facilities 12

Informative Annex B: Bibliography 15

Informative Annex C:Guidance if Legionella Testing is Utilized 16

WMP �



4.1 Building Designer Requirements

(compliant survey per Sec.5; comply w/Sec.8)

4.2 Building Owner Requirements

(compliant survey per Sec.5; comply w/Sec.6 & 7)

4.3 Health Care Facility Requirements

(comply with Sec. 4.2, 6 & 7 OR with Annex A)

Section 4. Compliance

188 compliance requires Section 5 surveys be repeated (at least)

annually, fully documented & available for review at any time.



Section 4.3 Health Care Facility Requirements

188 compliance for Health Care Facilities is ultimately

one of two paths: Sections 4.2, 6 & 7 – OR – Annex A


4.3.2 Health care facilities that meet all of the following qualifications shall comply with either the requirements in Sections 4.2, 6, and 7 or the requirements in Normative Annex A, “Health Care Facilities”:

4.3.1 Health care facilities that do not meet all of the qualifications of Section 4.3.2 shall comply with the requirements in Sections 4.2, 6, and 7.


Watson

•Dec 8, 2015 •12


4.3.2 �� Qualifications for Health Care Facilities:

(a)… the health care facility is accredited by anaccrediting agency or by the authority havingjurisdiction (AHJ) over the health care IC activities.

(b)… the health care facility IC program has a certified infection preventionist … or the health care facility has an epidemiologist with a minimum master’s degree or equivalent.


Compliance for Health Care Facilities via Annex A of

the standard requires (a) and (b) above


5.1 �� Determine whether it has one or more:

(a)… cooling towers or evaporative condensers thatprovide cooling and/or refrigeration for the HVAC&Ror other systems;

(b)… whirlpools or spas either in the building or onsite;

(c)… ornamental fountains, misters, atomizers, air washers, humidifiers, or other nonpotable water systems or devices that release water aerosols in the building or on the site.

Section 5. Building Survey



Implement a “Water Management

Program” (WMP) for …

• Cooling Towers

• Whirlpool Spas

• Ornamental Fountains

• Misters, Air Washers, Atomizers, Humidifiers

• Other Devices that release water droplets



Watson

•Dec 8, 2015 •13


• Multiple housing units with a centralized hot water system,

• More than ten stories,

• Housing designated for people over 65 years of age,

• Patients staying more than 24 hours,

• An area housing or treating people with certain risk factors …


Implement a WMP for Plumbing Ssystems if a building is

characterized with any one of the following:


Implement a WMP

for plumbing systems

if a building has an

area for Housing or

Treating people …

• for burns, cancer chemotherapy, or solid organ or bone marrow transplantation

• that are immunocompromised or otherwise more susceptible than the general population because of age, health, medication, occupation, drug treatment, or smoking

• that have renal disease, diabetes, or chronic lung disease



Section 6. General Requirements

6.1 � Principles of a Water Management Program

6.1.1-6.1.7: outline of risk management principles

6.2 � Program Development

6.2.1-6.2.9: detail of management program development


Section 6 is all about the ‘Water Management Program’

(WMP)


Watson

•Dec 8, 2015 •14


Figure 1.

Elements of a Water

Management Program

(WMP)

ANSI/ASHRAE 188-2015:


1. Control Limits 2. Monitoring Method

4. Corrective Actions

3. Monitoring Frequency

for each control point

where LB control is applied

for each control point


to be undertaken when

control measurement is

Out of Limitsfor each control point


CP

Establish for Each Control Point


Water Management Plan: VALIDATION ��The process or evidence used to support that the hazard control strategies of

the plan are effective. Testing for the control of the hazard or assessment of technical, scientific, medical and other data that can be used to show that

control measures for the hazard are effective – i.e. no legionellosis;

…“Are you Doing the Right Thing – Does it Work?”

Water Management Plan: VERIFICATION ��The process and evidence used to support that compliance with the Plan is

being done – i.e. record-keeping, control monitoring, process procedures and other evaluations. It ensures that the Water Management Plan is being correctly

followed in practice;

… “Are you Doing what you Planned to Do?”



Watson

•Dec 8, 2015 •15


Section 7. Requirements for Building Water

Systems

7.1 �� Potable Water Systems

7.2 �� Cooling Towers & Evaporative Condensers

7.3 �� Whirlpool Spas

7.4 �� Ornamental Fountains & Other Water Features

7.5 �� Aerosol-Producing Misters, Atomizers, Air

Washers and Humidifiers


Section 7 is the more extensive & detailed part of the standard – that deals with the various potable & nonpotable water system requirements


Section 8. Requirements for Designing

Building Water Systems

8.1 �� General

8.2 �� Final Installation Documents

8.3 �� Balancing

8.4 �� Commissioning

Section 8 deals with Legionellosis hazard considerations and the documentation required when designing for new construction, renovations, refurbishment, replacement, or repurposing of a facility.



Designers must provide Documentation, Drawings,

and/or Instructions for …

• Filling & Draining

• Equipment Sizes

• Piping Layout

• System Materials

• Pipe Sizes

• Design Flow Rates

• Design Temperatures

• Impact of Heat Loss or Gain

• Monitoring & Control

• Code Compliance

• Operation & Maintenance

• Control System Operation

• Calibration

• Installation & Start-up

• Commissioning (including

Flushing & Disinfection)



Watson

•Dec 8, 2015 •16


Designers must note locations of:

• Equipment

• Access (or note inadequate access)

• Filling and Draining

• Flushing

• Sampling

• Temperature monitoring

• Treatment

• No flow & Low Flow areas

• Outside Air Intakes

• Possible Cross Connections



Prior to Occupancy…

• Balance the Water Systems

• Disinfect and flush no more

than 3 weeks before any part of the building is occupied for its intended

purpose



Normative ANNEX A: Health Care Facilities

A1. Supplemental Definitions for Terms used in Annex A –

legionellosis risk management plan, designated team …

A2. Designated Team – senior organizational leadership+

A3. Water System Flow Diagram

A4. Risk Management Plan – legionellosis RM plan

A5. Existing Buildings, New Construction & Renovations

A6. Building Water System Procedures (Sec. 7 elements)


A6. is the more extensive & detailed part of Annex A – that deals with the various potable & nonpotable water system requirements


Watson

•Dec 8, 2015 •17


Summary

� Legionella is everywhere

� Not simple – contributing factors:

� Environmental conditions

� Means of transmitting aerosol of water with LB

� Susceptible persons

� Cooling water & Potable Water systems important

� ANSI/ASHRAE 188-2015

� Owners & Managers

� Designers, Builders, Installers, Commissioning, O&M

� Must establish a Water Management Program


Compliance with Standard 188 will

require facility owners (managers) to:

1�� Establish a Team with assignedresponsibilities & accountabilities

2�� Have, Practice, & Audit aWater Management Plan forlegionellosis risk management oftheir building water systems

Describe Water System

Access the Hazard

Establish HazardControls

Audit the Plan

In a Nutshell


►Establish a Knowledgeable Program Team

►Assess & Address LD Risk

►Develop Water Management Program

►Manage Buildings, Facilities and Water Systems to Reduce Risk of Legionellosis


Watson

•Dec 8, 2015 •18


Slides adapted from…


► Standard 188 can be purchased from ASHRAE at:http://www.techstreet.com/ashrae/products/1897561

► Standard 188 can be read for free from ASHRAE website under the Preview ASHRAE Standards, bottom left

of page, at:www.ashrae.org/standards


More on Standard 188 & Guideline 12

• AAS ASHRAE Learning Institute (ALI) Course

• Orlando at Winter Conference Jan 25th.

• Regionally @ later dates


Questions? & Discussion!

54


Watson

•Dec 8, 2015 •19



ASHRAE Headquarters / +404.636.8400

Standards & Guidelines: Stephanie Reiniche, Senior Manager of Standards

[email protected]

+678.539.1143

Research: Mike Vaughn, Manager of Research and Technical Services

[email protected]

+678.539.1211

Technical Inquiries and Position Papers & Documents

Steve Hammerling, Assistant Manager of Research and Technical Services

[email protected]

+678.539.1158

Technology Department: Claire Ramspeck, Director

[email protected]

+678.539.1194

