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Water: Friend and Foe In The Battle Against Infection. By Peter Pegden, Product Development and Engineering Manager at Sirrus by Gummers.


Why are the levels of infections contracted in British hospitals still such a cause for concern? Peter Pegden, Product Development Manager of Sirrus by Gummers, who manufactured safe water controls for hospitals, explains that water can be a friend and foe in the battle against infection.

Don't underestimate the importance of handwashing. Methicillin Resistant Staphylococcus aureus (more commonly known as MRSA) is a killer. Because it can evade commonly used antibiotics used to treat infections, for vulnerable patients, such as those in hospitals, or long-term care facilities, it represents a significant cause of mortality and morbidity in the healthcare setting.

A recent debate on BBC's Radio5 Live, however revealed some very illuminating figures. It would seem that although MRSA is a headline grabber, it is certainly not the only infection that needs to be considered in hospitals . In fact there are over 300 other infections, other than MRSA, that aren't eliminated by the alcohol gels advocated as one of the primary measures in MRSA control. therefore handwashing with water and hand scrub is still incredibly important in the overall infection control picture, as well as limiting the spread of MRSA.

One of the problems with this is that handwashing stations in many hospitals are limited. Infection control specialist recognise that no touch clinical handwash taps reduce the possibility of contamination when the taps are on, and, more importantly, prevents recontamination of the hands when the taps are turned off. Experts say that lever taps should be operated using arms and elbows but this is often easier said than done, so specifying non-touch taps should be considered a preventative measure.

Our Pulse 8 automatic spout, for example, is not operated by infra-red. It senses the users approach through a process of capacitive discharge, and cannot be activated by inanimate objects giving the hospital the added benefit of water saving measures. Whats more because of Pulse 8 is not operated with an infra-red sensor, it is more vandal proof than its infra-red counterparts.

Legionella control

Another key problem in many hospitals is the control of legionella bacteria. Water distribution systems in hospitals are often dated in design and layouts as well as being characterised by the presence of long pipe runs and an over supply of of water outlets. These systems present an ideal environment for legionella. Since hospital patients are already in poor health, they are particularly vulnerable to the effects of the legionella bacteria.

Some Key legionella facts:

At temperatures above 55*C the legionella bacteria will die.

At 55*C the time taken to die is 5 to 6 hours

At 60*C this time is reduced to 32 minuets

66*C brings the time down to 2 minuets

Legionella will multiply at temperatures between 20*C and 50*C

At temperatures below 20*C legionella will not multiply but will not die, remaining as a potential threat in the system

So how long can legionella be controlled? One of the key points is that water should be stored at above 60*C and cold water should be stored below 20*C (in fact many hospitals are now removing their stored cold water tanks in favour of a direct mains supply). Of course the system and terminal fittings should be kept clean and if the hot water outlet does not reach discharge temperature with 30 seconds, a secondary return loop should be considered.

This is all fantastic, but it does raise one critical dichotomy – reconciling the need for safe hot water and avoiding legionella. While patients are are at risk because of their reduced levels of immunity to legionella, they are also at much higher risk of scalding too, so safe bathing and showering temperatures are just as important.

So while water can be a key part of the hospital's armoury in preventing infection control through rigorous handwashing and cleaning, it is important to remember that water too can harbour some uninvited microorganisms. If controlled correctly, however, a well managed water system could help see incidences of infections plummet. Any hospital considering updating their handwashing stations, bathing or shower areas should have one thought at the forefront of their mind – safety.

Article taken from IN CONTROL MAGAZINE the Official Publication of the Association of Professionals in Infection Control.

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