Risk Management

This section is about risk managment plans and inspections that are continuously reviewed at the site of the water system. This is different to the operational dynamic risk assessments performed on arrival at the site during an outbreak to protect the outbreak control team staff.

Risk assessment is a method of identifying hazards and risks associated with the environmental exposure to Legionella and subsequent potential infection with Legionnaires' disease during activities, and then implementing control measures. A risk assessment should document and describe an existing system, then assess hazards and prioritise the risks. These risks and controls can then be collated in a risk management plan that should be reviewed by suitably trained and briefed people with accountability for control measures clearly stated. A general risk assessment is not necessarily about health and safety of staff but about control and maintenance of water systems and Legionella levels within. Each site should have a risk management plan, which takes the risk assessment and creates a process for monitoring and validating the risks identified. Further guidance, from a UK perspective, is available from the L8 Health and Safety Executive paper [HSE (2000) Legionnaires' disease HSE, UK http pdf], but other member states might have their own versions of such codes of practice. Similarly the British Standard BS 8580:2010 (Water Quality. Risk Assessments for Legionella. Code of Practice) gives recommendations and guidance on the assessment of the risk of legionellosis presented by artificial water systems.

Four phases exist in creating a risk management plan, which will be site specific:

Assessment: risk based, prioritising hazards and risks in the system, what is a safe or acceptable level of contamination in a system, where might aerosolisation occur

Monitoring: observe systems and check levels periodically, review installation of new equipment

Management: maintain system, communicate issues, know responsibility/accountability

Review: revise plan at suitable periods, check updates of national and international guidance