· 6 min read
ANN ARBOR, Mich. – Environmental and public health experts agree that proactive water management plans, stronger policies, collaboration, communication and regulation are needed to stop the rapidly increasing number of Legionnaires’ disease cases and outbreaks.
Representatives from public health agencies, water utilities, water industry organizations, regulatory bodies and academia were among 360 international attendees at Legionella Conference 2019, Building Water Systems: The Sustainability and Public Health Nexus, co-hosted by NSF and the National Environmental Health Association Sept. 11-13 in Los Angeles.
The conference emphasized the importance of building water management plans and served as an important driver in thought leadership about surveillance and response to outbreaks.
“We are humbled by the enormity of the public health issue before us. Together, we can rise to the challenges and shape the approach to protect human health for decades to come,” said Chris Boyd, General Manager of Building Water Health at NSF Health Sciences, LLC.
In his keynote address, Dr. Patrick Breysse of the U.S. Centers for Disease Control and Prevention (CDC) said policies need attention. Dr. Breysse, who is Director of the CDC’s National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, presented grim statistics.
Legionnaires’ disease, a severe form of pneumonia caused by inhaling aerosolized water containing Legionella bacteria, is fatal for 25% of people who contract it in a health care setting and deadly to 10% of the general population, according to CDC data. About nine out of 10 outbreaks are caused by problems that could be prevented with more effective water management, Dr. Breysse said, adding that outbreaks are often due to environmental deficiencies related to process failure, human error, equipment repairs or unmanaged external events—such as a power outage.
“It will take a diverse set of stakeholders to truly move the needle. Everyone wins in the end when the outcome is preventing Legionnaires’ disease,” Dr. Breysse told a packed ballroom at the Westin Bonaventure Hotel in Los Angeles.
The first documented Legionella outbreak and name for the disease came after the 1976 American Legion convention in Philadelphia, when 221 people attending fell ill and 34 died. Since then outbreaks have continued to rise, and there has been a six-fold increase in reported cases between 2000 and 2018, according to the CDC.
Safe water is a strategic priority, and Legionella is one of the CDC’s main focus areas, Dr. Breysse said.
The CDC has published a Legionella toolkit based on ANSI/ASHRAE Standard 188-2015 detailing seven steps for a water management program. Other interagency efforts between the CDC, the Department of Veteran Affairs and the U.S. Environmental Protection Agency also address Legionnaires’ disease.
Nationally, water management programs are being implemented but aren’t yet widespread, according to Dr. Breysse, who added promising developments include the:
Deterrents in the long road to achieving widespread use of water management programs include cost and the lack of resources and expertise, as well as required policies still in their infancy, Dr. Breysse said.
The CDC co-sponsored a study conducted by the National Academies of Sciences, Engineering, and Medicine (NASEM) that examined evidence and best practices to control Legionella in water systems.
Dr. Michèle Prévost, a NASEM Management of Legionella in Water Systems study committee member, presented the report in depth to Legionella Conference attendees. Dr. Prévost is Professor and Industrial Chair for Drinking Water of the Natural Sciences and Engineering Council of Canada and Civil Engineering Industrial Chair for Polytechnique Montréal.
The NASEM report, published Aug. 14, 2019, conservatively estimates 52,000 to 70,000 people contract Legionnaires’ disease annually in the United States. The study made a number of recommendations and findings. Among them:
Additionally, the NASEM report says:
“This is a significant report,” Dr. Prévost said. “Where are we 40 years after Philadelphia? Much has been learned, but much less progress has been made in preventing Legionnaires’ disease.”
Environmental health professionals are the backbone of public health, and local practitioners should be considered a foundational resource, Dr. David Dyjack, Executive Director of the National Environmental Health Association, emphasized. “Each state needs, as it manages its water resources, to align administrative, technical and political capital to nurture the relationships that make Legionella outbreaks much less likely. This begins with professional relationships grounded in trust and a common mission,” Dr. Dyjack said.
Water is a national security issue, Dr. Dyjack said, citing $1 trillion in water distribution infrastructure investments needed to ensure a healthy, sustainable and efficient supply. “We’ve entered an era where water management will present complexities sobering in scale … it is high time our nation gets our arms around this.”
View the Legionella Conference 2019 photo gallery at www.legionellaconference.org.
Editor’s Note: For media interviews, please contact Fran LeFort, at +1.734.773.4353 or email@example.com.
NSF is celebrating 75 years of protecting and improving human health. The global public health organization facilitates standards development, and tests and certifies products for the food, water, health sciences and consumer goods industries to minimize adverse health effects and protect the environment. Founded in 1944, NSF is committed to protecting human health and safety worldwide. With operations in 180 countries, NSF is a Pan American Health Organization/World Health Organization (WHO) Collaborating Center on Food Safety, Water Quality and Indoor Environment.
The National Environmental Health Association (NEHA) currently serves over 5,500 members to advance the environmental health and protection professional for the purpose of providing a healthful environment for all. Professionals who earn a Registered Environmental Health Specialist/Registered Sanitarian credential from NEHA are recognized as having achieved an established standard of excellence. These environmental health professionals master a body of knowledge (which is verified by examination) and acquire sufficient experience to satisfactorily perform work responsibilities in the environmental health field.
NSF Strengthens Commitment to Germany and Europe Through figawa Membership
NSF's Water Division Strengthens Commitment to Germany and Europe by joining leading industry association.
CDC to Address COVID-19 Impact on Legionnaires’ Disease, Present New Prevention Tools at Legionella Conference
Special Session of Legionella Conference to Address Emergent Health Crisis