The following transcript is provided by YouTube. Mistakes are present. To hear the podcast episode, click HERE.
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Scaling UP! Nation I am so excited that
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welcome to Scaling UP! the podcast for
water treaters by water treaters where
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1:30.8
we’re Scaling UP! on knowledge so we do
not Scale UP! our systems nation Trace
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1:36.8
Blackmore here and we are in a series
about Legionella we had Janet Stout on
1:36.8
1:44.9
last week and she is back today to tell
us even more about the complex topic of
1:44.9
1:49.2
Legionella so ladies and gentlemen if
you will please help me welcome once
1:49.2
1:54.2
again dr. Janet Stout
I did want to ask you so if we go
1:54.2
2:00.0
through ASHRAE 188 and go through the
different areas and have you explained
2:00.0
2:05.1
to the nation what the section is
looking for why it’s there so the first
2:05.1
2:11.0
section starts with establishing a water
management team what does that mean well
2:11.0
2:17.4
you have expertise in Scaling UP! Nation
has expertise in water treatment and
2:17.4
2:22.5
that’s microbial control corrosion
control and many other things but in
2:22.5
2:28.7
order to control Legionella you have to
have many people multidisciplinary team
2:28.7
2:33.1
and we’ll just give you an example of
health care so you need the infection
2:33.1
2:38.3
control prevent or the confection
Preventionist and you need someone from
2:38.3
2:42.0
engineering because you need to have
knowledge of the water distribution
2:42.0
2:46.1
system you know it’d be nice if you
could have an infectious disease
2:46.1
2:50.9
physician on there and the importance of
the multidisciplinary team really goes
2:50.9
2:56.7
to there’s a sentence in standard 188
that says the program team shall have
2:56.7
3:01.7
knowledge of the building water system
design and water management as it
3:01.7
3:07.4
relates to Legionella so the first part
you know design of the building how the
3:07.4
3:14.6
water flows managing water treatment got
that but the latter part of that is how
3:14.6
3:20.4
it relates to legionellosis and the risk
of transmission and who’s at risk where
3:20.4
3:24.1
are they at risk what parts of the
building pose the greatest risk and
3:24.1
3:29.4
devices and things like that that really
requires that multidisciplinary team so
3:29.4
3:35.9
whenever I see a plan and it has one
person listed as the team I get worried
3:35.9
3:41.2
yeah I think so many customers think
that it can just be the water treater
3:41.2
3:46.0
or it can just be the building engineer
so thank you so much for shedding some
3:46.0
3:50.7
light on that to people in the
Scaling UP! nation so the next area says
3:50.7
3:57.3
describe the building water system using
text and flow diagrams so the concept
3:57.3
4:03.8
here is that as water goes into the
building or the device a cooling tower
4:03.8
4:07.1
it is
impacted the water quality is impacted
4:07.1
4:12.2
as it flows through that water system or
device so the idea is to do a
4:12.2
4:17.6
walk-through document where water
quality is impacted throughout the
4:17.6
4:22.6
building and what you want to do is
address where that water quality is
4:22.6
4:27.4
impacted those are like decision points
and so you have to do a flow diagram
4:27.4
4:34.1
it’s either a drawing or it can be a
description and words as you said but
4:34.1
4:38.6
more typically it’s a drawing and it’s
not a it’s not an engineering drawing
4:38.6
4:43.7
it’s sort of boxes and lines that show
the flow of the water as it comes into
4:43.7
4:47.4
the building and flows you know the cold
water goes over to the hot water
4:47.4
4:52.4
distribution system it might go through
a water softener goes to the hot water
4:52.4
4:56.9
and the cold water goes to an ice
machine goes to a cooling tower other
4:56.9
5:04.6
devices where we know Legionella has
been linked to exposure of patients or
5:04.6
5:10.2
building occupants and caused infection
you know one one example is a decorative
5:10.2
5:14.4
water feature what I always say to
people is you know if you’re in that
5:14.4
5:17.8
hotel and you’re sitting in the lobby
and as this decorative water feature
5:17.8
5:20.9
right there by the bar
you know don’t stay there too long
5:20.9
5:25.4
because you don’t know how well that
water feature is being managed and so
5:25.4
5:30.3
you want to know where water quality can
be impacted and the purpose of the flow
5:30.3
5:36.0
diagram is to document that all right
and now decide control measures and how
5:36.0
5:40.4
they should be applied and how to
monitor them so at each one of these
5:40.4
5:45.7
locations where water quality could be
impacted meaning that Legionella could
5:45.7
5:50.2
grow and amplify you don’t want to
ignore that right you want to control
5:50.2
5:57.6
that so the simplest example is a hot
water tank and in healthcare by code
5:57.6
6:01.6
they’re required to keep the temperature
as it distributes through the building
6:01.6
6:05.9
and out the faucets and showers have a
temperature range that Legionella likes
6:05.9
6:13.5
somewhere around body temperature around
100 to 105 degrees well some people will
6:13.5
6:18.6
put thermostatic mixing valves just
after the hot water tank
6:18.6
6:23.8
and raise the hot-water tank temperature
to a hundred and fifty degrees or so and
6:23.8
6:28.6
then temper it back down as it goes out
through the distribution system thereby
6:28.6
6:34.5
controlling the ability of Legionella to
grow within the hot water tank so that’s
6:34.5
6:40.8
one example of a place where water
quality can be impacted with temperature
6:40.8
6:45.0
and nutrients where Legionella could
grow and multiply applying a control
6:45.0
6:50.6
which is temperature in this example to
prevent that from impacting the building
6:50.6
6:55.4
occupants so that’s an example of
control measures another one that you
6:55.4
7:00.6
all relate to very well is the cooling
tower right so cooling towers are air
7:00.6
7:05.6
scrubbers full of nutrients the water
treatment is there as the control
7:05.6
7:11.1
measure to control the janela growth and
spread and when you test that cooling
7:11.1
7:15.4
tower for Legionella you know whether or
not that control is working so that’s an
7:15.4
7:20.1
important element as well next is
established ways to intervene when
7:20.1
7:26.5
control limits are not met so it’s it’s
an imperfect world right so let’s let’s
7:26.5
7:30.4
stick with our cooling tower example
because I’ve seen this happen before
7:30.4
7:35.3
it’s a cooling tower that’s not
state-of-the-art in terms of its water
7:35.3
7:40.8
treatment and what I mean by that is
there’s a guy and he’s manually adding
7:40.8
7:47.5
the biocide every day and then he goes
on vacation and nobody is adding the
7:47.5
7:54.2
biocide so your control measure the
biocide is no longer adequately applied
7:54.2
7:59.2
and so is no longer controlling so you
have some with an automated system you
7:59.2
8:04.3
have some ways to to document that but
if they were checking it periodically
8:04.3
8:08.8
manually then they would know whether or
not they were out of specification so
8:08.8
8:12.6
the way that I describe this for myself
is that it’s like you’re a car on the
8:12.6
8:17.8
highway and the lines on the highway are
your control limits you want to stay
8:17.8
8:22.8
within those limits and in the controls
that you’re using water treatment or
8:22.8
8:27.9
temperature or whatever to keep you
within those controls are what you’re
8:27.9
8:32.2
measuring in terms of success so you
need the control measure you need to
8:32.2
8:36.4
document whether you’re within those
lines within those limits and then if
8:36.4
8:40.2
you’re outside those limits what’s the
beauty of having a water safety and
8:40.2
8:45.4
management plan is that you have written
into the plan what to do when you’re
8:45.4
8:50.4
outside of those limits it’s spelled out
there and so you know with a cooling
8:50.4
8:55.3
tower if you’re Legionella counts are at
a thousand per milliliter well you’re
8:55.3
9:01.2
gonna do a shock treatment probably an
online not a 50 ppm free chlorine but
9:01.2
9:06.9
raise it up to 5 ppm and so all of these
things are described in the plan and
9:06.9
9:11.4
that’s why it’s important to have a
water safety and management plan so that
9:11.4
9:15.4
you’re you have an organized way to
manage this risk and then we have to
9:15.4
9:20.3
make sure the program is running as
designed and it is effective right so
9:20.3
9:26.3
yeah have you ever gone into somebody’s
office and seen those binders on the
9:26.3
9:30.4
shelf and they’re always sort of covered
with dust and no one’s ever looked at
9:30.4
9:35.0
them well you don’t want your Legionella
water management plan to be one of those
9:35.0
9:40.3
binders on the shelf that no one ever
looks at because the success of any of
9:40.3
9:45.6
these Legionella water safety plans is
not in having the plan its
9:45.6
9:51.3
implementation of the plan right so you
have to make sure and document that what
9:51.3
9:56.3
you’ve written in the plan is actually
being executed there’s documentation of
9:56.3
10:01.5
quarterly meetings of the water safety
team the the monitoring results whether
10:01.5
10:05.5
it’s temperature or biocide
concentration and that all of that is
10:05.5
10:10.6
recorded and in the binder or in the
electronic file so you have to have
10:10.6
10:17.1
evidence that the plan is being executed
and then you have to show that the risk
10:17.1
10:23.4
is being controlled and that means show
that Legionella is under control and the
10:23.4
10:28.9
only way to do that is to test for
Legionella there is no surrogate and
10:28.9
10:33.1
those that have heard me speak on you
know what’s the value of heterotrophic
10:33.1
10:38.4
pipe count and predicting whether we
Janelle is there or not they they do not
10:38.4
10:43.8
predict HPC results don’t predict the
presence or absence of Legionella they
10:43.8
10:46.3
have
for growth requirements so the way you
10:46.3
10:51.2
measure HPC doesn’t detect Legionella
and doesn’t tell you anything about
10:51.2
10:55.1
whether lead to know is present or not
and the same is true for temperature and
10:55.1
11:00.9
other measures you may be making in your
water distribution system you don’t know
11:00.9
11:04.9
whether Legionella is present or not and
the risk is being controlled unless you
11:04.9
11:10.3
test really janela so that’s how you
validate your plan well Jenna correct me
11:10.3
11:17.0
if I’m wrong but we’ve just gone through
what ashtrays 188 is you got it I can’t
11:17.0
11:20.8
help but think there’s some people
listening out there thinking oh wait a
11:20.8
11:24.7
second you didn’t tell me what to do
that’s not specific to my building
11:24.7
11:29.9
that’s not a plan at all how do we help
explain that to them so that’s a great
11:29.9
11:35.7
point trace because as I said earlier if
you follow what’s in the standard you
11:35.7
11:39.3
could still have an outbreak of
Legionnaires disease and the reason for
11:39.3
11:46.1
that is when I talk about a Surrey
stander 188 I say the good news is you
11:46.1
11:52.2
get to bake lots of decisions the bad
news is you get to make lots of
11:52.2
11:58.6
decisions and so this is where having
some expertise in this area is helpful
11:58.6
12:03.8
because what ASHRAE says is you fill in
the blanks you have to have it’s really
12:03.8
12:09.7
a very high level architecture of what
the plan should include but there are no
12:09.7
12:14.7
details there they’re a little bit more
details in the section on cooling tower
12:14.7
12:20.9
management but the rest is you decide
and you even decide whether or not to
12:20.9
12:27.3
test for Legionella where to test what
method to use for testing and people are
12:27.3
12:30.5
not equipped to make those
determinations they just don’t have the
12:30.5
12:37.1
knowledge base right and so ASHRAE to
the rescue okay so what’s missing out of
12:37.1
12:44.2
standard 188 the gaps are to be filled
by the guideline and in 2000 it was
12:44.2
12:51.4
published as a guideline 12 from ASHRAE
and I can tell you coming attractions I
12:51.4
12:56.6
was just at the June meeting of ASHRAE
and the group has been working on the
12:56.6
13:01.2
guidance document for
to a company really and to inform
13:01.2
13:07.5
standard 188 for a number of years now
and it will go out I think for its last
13:07.5
13:13.1
public review shortly and it’s a limited
public review only the changes that were
13:13.1
13:19.2
made we’ll go out for public review so I
think your audience will soon see more
13:19.2
13:25.9
detail on how to implement standard 188
in the form of the ASHRAE guideline well
13:25.9
13:30.2
Janet there’s no doubt about it I am
sure you have seen many many water
13:30.2
13:34.9
management plans in your career what do
some of the best plans have and what do
13:34.9
13:41.4
some of the worst plans have so let’s
start with the worst plans so real real
13:41.4
13:47.9
life example so there’s an outbreak or
case investigation at a hospital and the
13:47.9
13:52.1
logical question from the health
department is do you have a Legionella
13:52.1
13:57.4
water management plan and they say sure
I got it right here and so we were
13:57.4
14:02.8
working with the hospital we said you
know please send it over and it was two
14:02.8
14:09.6
pages and one page was definitions so
I’ll let you be the judge of whether
14:09.6
14:14.2
that’s a good plan or a bad plan but we
as well as the health department had
14:14.2
14:20.6
some suggestions for beefing that up
another worst plan is if you go to the
14:20.6
14:25.9
trouble of writing a plan and it might
even be a good plan if it doesn’t have
14:25.9
14:30.3
Legionella testing as part of the
validation then it’s a bad plan because
14:30.3
14:34.8
it won’t help you prevent Legionnaires
disease it will help you check the Box
14:34.8
14:41.2
I’ve done a plan but that’s not the goal
is it the goal is to prevent the disease
14:41.2
14:48.2
and to save lives and so you can’t do
that without testing so the best plans
14:48.2
14:55.0
follow a sure a standard 188 build-out
the all those decisions that go into it
14:55.0
15:00.8
and and then also include testing in
order to determine whether or not that
15:00.8
15:05.8
plan is effective and to protect the
building occupants you just mentioned
15:05.8
15:11.2
testing and I know your lab does a lot
of Legionella testing and I’m sure
15:11.2
15:14.4
you’ve seen the
proper method of testing and probably
15:14.4
15:20.8
the not so proper method of testing so
can you explain to the Scaling UP! Nation
15:20.8
15:27.4
what the proper way is to collect
samples for Legionella so when testing
15:27.4
15:33.9
for Legionella there’s several parts to
this one is collecting the sample the
15:33.9
15:38.9
next part is what method are you going
to use to test for Legionella and who’s
15:38.9
15:43.1
going to be doing that testing so in
terms of sample collection if it’s a
15:43.1
15:47.3
water distribution system and you’re
standing in front of a faucet turn the
15:47.3
15:51.3
hot water faucet on and immediately
collect the water coming out of that
15:51.3
15:57.0
faucet do not flush the line the loosely
adherent Legionella occupying that
15:57.0
16:02.6
faucet and shower or what you want to
collect because the question that you’re
16:02.6
16:08.4
asking is is the person using this
fixture going to be exposed to
16:08.4
16:13.4
Legionella the best sample to answer
that question is the first draw hot
16:13.4
16:19.1
water sample so that’s really important
in the case of a cooling tower what you
16:19.1
16:24.1
want to do is answer the question is the
water treatment program working to
16:24.1
16:29.6
control Legionella so you don’t collect
the sample right where you added the
16:29.6
16:35.2
biocide and right after you’ve added the
biocide you collect the sample right
16:35.2
16:42.5
before the next dosing and away from
where the dosing is occurring that tells
16:42.5
16:46.4
you whether or not the program is
controlling Legionella and whether you
16:46.4
16:51.5
need to make any adjustments to that so
that’s how you collect the sample the
16:51.5
16:56.8
method of testing which you want to make
sure and remember you know there’s a
16:56.8
17:01.2
lawyer on my shoulder what you want to
make sure is that you’re doing a
17:01.2
17:06.5
standard method in an accredited
laboratory that knows how to do
17:06.5
17:10.9
microbiology so you don’t want to be
doing Legionella testing in your garage
17:10.9
17:17.0
you want it to be done by people who are
professionals why because they will give
17:17.0
17:23.7
you the right result not just a result
right and it’s defensible right always
17:23.7
17:28.0
with the little lawyer on my shoulder
so that’s a decision that you have to
17:28.0
17:32.7
make who’s going to be doing the testing
and what method and it should be in an
17:32.7
17:36.4
accredited laboratory you know and
there’s all kinds of requirements for a
17:36.4
17:41.1
laboratory for accreditation and
proficiency to demonstrate that the
17:41.1
17:45.5
methods that are being done and by the
people that are doing them are to
17:45.5
17:51.8
standards and for Legionella standard
culture is the gold standard are there a
17:51.8
17:58.6
lot of garage Legionella testing pop-ups
out there well I think they’re coming if
17:58.6
18:02.6
they’re not already here and the reason
I say that is you know we’ve evaluated
18:02.6
18:08.9
every disinfection technology and we try
to evaluate every testing methodology as
18:08.9
18:15.4
well and we do that so that we can tell
you and Scaling UP! Nation what works and
18:15.4
18:20.1
what doesn’t what their limitations are
pros and cons and so we have always been
18:20.1
18:26.2
an objective arbiter of these
technologies and what we have seen is
18:26.2
18:31.8
you know a little dippy pregnancy type
tests that claim to detect Legionella at
18:31.8
18:36.4
a hundred colony forming units per ml
and then when we put water into that
18:36.4
18:40.7
device that had three thousand
Legionella per ml it was completely
18:40.7
18:47.2
negative so you are taking
responsibility for the method that you
18:47.2
18:51.6
are recommending to your client and if
you want to do the testing yourself
18:51.6
18:57.2
you’re taking on that that liability as
well so it’s really too serious of a
18:57.2
19:02.1
matter to be fooling around with non
standardized methodology when a sample
19:02.1
19:07.2
arrives in your lab what do you guys do
so it comes in and all these people in
19:07.2
19:12.9
white coats come and they make sure all
the documentation is correct and one of
19:12.9
19:17.3
the things that we do in in doing the
standard culture method is we do
19:17.3
19:22.2
multiple different plates which means
each plate has Culture Media in it with
19:22.2
19:26.1
different inhibitors and growth
requirements so that we optimize the
19:26.1
19:30.3
ability to grow Legionella and in fact
one of those culture media relations is
19:30.3
19:35.5
our own dating back to the days when we
were at the Pittsburgh VA we optimized
19:35.5
19:41.3
the antibiotic combination and
added a dye to help identify Legionella
19:41.3
19:45.0
and we’re the only laboratory that uses
that culture method well Janet you
19:45.0
19:48.6
mentioned CMS a couple times and that
stands for Center for Medicare and
19:48.6
19:53.3
Medicaid Services and back in two
thousand seventeen and eighteen they
19:53.3
19:57.9
issued a memorandum entitled requirement
to reduce Legionella risk in health care
19:57.9
20:03.2
facility water systems to prevent cases
and outbreaks of Legionnaires disease I
20:03.2
20:09.6
was hoping we could talk a little bit
about that and how the CMS memo differs
20:09.6
20:14.0
from the previous health policy
standards I’m so glad you asked that
20:14.0
20:18.2
question and it’s really really
important for your listeners that deal
20:18.2
20:25.1
with health care facilities so CMS is
like you know when CMS speaks everybody
20:25.1
20:31.5
listens because they hold the purse
strings and in 2017 they came out of the
20:31.5
20:38.6
blue with this memorandum and I was like
this is interesting and I’m reading
20:38.6
20:46.4
reading reading and what sort of left
off the page to me was not that they
20:46.4
20:52.2
said implement a water management
program that considers ASHRAE and C CDC
20:52.2
20:58.5
toolkit and document control measures
but the next bullet was environmental
20:58.5
21:04.6
testing for pathogens well this is a
Legionella memorandum I’m like oh my
21:04.6
21:11.3
gosh this is the first regulation this
is not a voluntary thing this is all
21:11.3
21:17.2
healthcare have to do it the first time
Legionella testing has been required and
21:17.2
21:24.2
I just about fell out of my chair and
then I left up in and joyous expression
21:24.2
21:29.6
and I immediately sent an email to the
guy on the memorandum saying what you’ve
21:29.6
21:33.4
done
will advance Legionella prevention more
21:33.4
21:38.6
than anything more than a Shrey more
than CDC any of these things because you
21:38.6
21:44.6
have included that requirement so I was
happy for I don’t know about 10 months
21:44.6
21:52.5
and then in 2018 they issued a revision
yeah okay what’s this about
21:52.5
21:59.6
and the revision was to remove that
requirement so you can only imagine how
21:59.6
22:06.6
distraught I was but I turned it around
and I got really mad at CMS for doing
22:06.6
22:13.7
that so what’s different about CMS in
2017 was really good and then they back
22:13.7
22:20.3
pedaled it out and so it’s really kind
of more of the same in terms of
22:20.3
22:26.6
Legionella prevention it does require so
it takes what ASHRAE did is a voluntary
22:26.6
22:32.4
standard and in healthcare requires that
those facilities have a do a risk
22:32.4
22:37.5
assessment and implement a water
management program so that’s good and as
22:37.5
22:42.0
long as it’s not a two page document
with one page being definitions right so
22:42.0
22:45.9
that’s good it does make that
requirement but they have fallen short
22:45.9
22:53.4
now of that meaningful validation step
of testing for Legionella and and so
22:53.4
22:58.7
that that is something that really
changed things for me Trace so what I
22:58.7
23:03.0
have decided is that as long as you’re
leaving Legionella testing at the
23:03.0
23:08.9
discretion of the facility it means that
our work is that much more important to
23:08.9
23:12.5
make sure that those facilities
especially healthcare facilities
23:12.5
23:17.5
understand that the risk of not testing
for Legionella is greater than the risk
23:17.5
23:23.8
for testing for it Jenna what’s the wall
in between why an agency isn’t saying
23:23.8
23:28.1
you have to test what do we have to
overcome so people are now testing for
23:28.1
23:32.4
things and they can do things from those
tests well the conclusion that I came to
23:32.4
23:38.5
trace after CMS backpedaled on this is
that it really needs to go the way of
23:38.5
23:44.0
New York and and there are more states
that are doing more in terms of
23:44.0
23:49.4
regulatory requirements for Legionella
testing of healthcare facilities and
23:49.4
23:53.6
cooling towers and I really think when
people are left to their own devices
23:53.6
23:58.1
they’re more inclined not to do
something even though it’s the right
23:58.1
24:04.2
thing to do and so I think as much as we
all know the idea I think it
24:04.2
24:09.7
it sort of takes the decision away from
the individual if there is a regulatory
24:09.7
24:14.4
requirement and I think that really is
necessary in order to really make
24:14.4
24:20.1
meaningful change and to get to where I
want to remember to get to the end which
24:20.1
24:25.6
is to end Legionnaires disease then the
CMS memo address any other bacteria and
24:25.6
24:30.3
water systems that can cause infections
well how is another thing about the CMS
24:30.3
24:35.8
memorandum that was so surprising so
it’s about Legionella it’s in the name
24:35.8
24:41.1
of the memorandum right but if you read
on they say you know do these things
24:41.1
24:45.0
have the water manager plan do a risk
assessment to address whether the
24:45.0
24:49.3
conditions within your systems promote
the growth and spread of Legionella and
24:49.3
24:55.7
other waterborne pathogens like
stenotrophomonas Malta philia
24:55.7
25:00.8
Acinetobacter non-tuberculous
mycobacteria and Pseudomonas where the
25:00.8
25:05.0
bacterial pathogens they mention and I
that was another moment I fell out of my
25:05.0
25:11.4
chair I was like where is that coming
from and while those bacteria do cause
25:11.4
25:16.3
infections in hospitalized patients and
many of those infections may be
25:16.3
25:21.2
associated with the bacteria being in
water the tricky part about those is
25:21.2
25:25.6
that the mode of transmission the way
that they get from water to cause
25:25.6
25:32.0
infection is not just through exposure
to the water there’s hand the hand
25:32.0
25:37.9
transmission they can colonize devices
that are in the patient’s so it’s not as
25:37.9
25:43.0
simple and straightforward a prevention
strategy as it is for Legionella so it’s
25:43.0
25:47.5
kind it’s more complicated and so for
that reason when water treaters are
25:47.5
25:52.2
talking to engineers they really need to
make sure that the infection
25:52.2
25:55.6
Preventionist
is on the water management team is
25:55.6
26:01.0
consulted about the meaning of the CMS
requirement because it’s it’s more
26:01.0
26:05.7
complicated and and that’s a real
important message for anybody addressing
26:05.7
26:10.7
that statement in CMS so you can learn
about other waterborne pathogens like
26:10.7
26:14.4
Pseudomonas Acinetobacter and Senate row
from onus and non-tuberculous
26:14.4
26:18.4
mycobacteria
by reading the fact sheets on special
26:18.4
26:25.0
pathogens lab comm so for somebody that
is interested in learning all they can
26:25.0
26:29.4
about Legionella and Legionnaires
disease
26:29.4
26:34.9
what advice do you have for them there’s
lots of information about Legionella on
26:34.9
26:39.6
the internet and and sometimes in my
lectures when I talk about disinfection
26:39.6
26:44.8
technology I say you know you want to do
some research about it and I say don’t
26:44.8
26:51.5
just google it and the reason for that
is that what you read from out there in
26:51.5
26:57.1
cyberspace may or may not be true there
are people that over promise and under
26:57.1
27:02.5
deliver so you wanted to get it from an
expert I’m on the other end of the phone
27:02.5
27:07.4
for Scaling UP! Nation any time they
would like to talk about Legionella and
27:07.4
27:11.9
I can direct specific articles and
things to them depending on the question
27:11.9
27:16.8
that they have so right now I think
unless they want to lock themselves in a
27:16.8
27:20.4
room with a lot of articles the easiest
thing to do is just pick up the phone
27:20.4
27:26.0
and call Dr. Janet what’s the one
thing you want to make sure comes over
27:26.0
27:32.2
loud and clear to the Scaling UP! Nation
it’s very simple and I said it earlier
27:32.2
27:38.3
three words
test to protect it’s not that hard we
27:38.3
27:45.0
can do it and if we do it we will and
Legionnaires disease all right Janet
27:45.0
27:50.1
well so far you have done very well on
Scaling UP! but now it’s time for the
27:50.1
27:55.6
lightning round and it’s anybody’s game
at this point are you ready I’m ready
27:55.6
28:02.2
all right so now you have the ability to
time travel you can go back in time and
28:02.2
28:09.0
visit yourself as the first day where
you became a microbiologist what advice
28:09.0
28:16.0
would you give yourself you know I I
think it would be really discouraging to
28:16.0
28:23.6
talk to myself way back then so brand
new microbiologist and I’m talking to me
28:23.6
28:30.3
back then and I’d say
what what if I told you after in 1982
28:30.3
28:34.5
you told the world that all you have to
do is test your hospital water system
28:34.5
28:38.4
and you can prevent cases of
Legionnaires disease what if I told you
28:38.4
28:48.6
in 2019 we were still arguing about that
and I would say well that surprises me
28:48.6
28:55.7
but I guess if you’re still at it in
2019 you’re patient and you persevere
28:55.7
29:00.2
and you believe that you can actually
prevent Legionnaires disease ultimately
29:00.2
29:05.5
and I would say yes we are so close
well I’m very curious of this next
29:05.5
29:08.6
question I want to know what kind of
books you’re reading so what are the
29:08.6
29:15.3
last few books that you’ve read well I
usually don’t read a lot of fiction and
29:15.3
29:22.3
so the book I just finished the title is
called bad blood and it’s by John Kerry
29:22.3
29:27.8
rue and it’s about the company Thera
nose and its charismatic leader
29:27.8
29:33.3
Elizabeth Holmes and how they
over-promised and under-delivered and
29:33.3
29:38.3
some of you might remember they promise
from the prick of blood from the tip of
29:38.3
29:44.3
your finger they could do a hundred
tests to detect diseases and things like
29:44.3
29:49.7
that and it’s all about how they fooled
everybody so it’s a great read about
29:49.7
29:53.7
over-promising and under-delivering and
the public health impacts of that and
29:53.7
29:58.3
then a book that you probably have
already read it’s called traction by
29:58.3
30:03.4
Gina Whitman I love that he actually
I’ve had several people from his company
30:03.4
30:08.7
on the show ok so really really valuable
for those of you that are running your
30:08.7
30:15.1
own business and then the last one is
atomic habits by James clear it’s about
30:15.1
30:19.1
how you can change your behavior a
little bit at a time
30:19.1
30:24.5
we had another guest on earlier who was
reading the same book no kidding and
30:24.5
30:27.5
she’s a life coach so there you go now
good
30:27.5
30:32.9
so Janet eventually Hollywood they’re
going to learn about all the things that
30:32.9
30:37.3
you are doing to prevent Legionnaires
disease they’re going to create a movie
30:37.3
30:39.5
I’m pretty sure Dwayne Johnson’s going
to be
30:39.5
30:46.1
but who plays channet style well that
would be really fun and and fun is my
30:46.1
30:50.7
middle name so when I when I think about
this the the person that comes to mind
30:50.7
30:58.7
is very good at portraying characters
now people that speak other languages so
30:58.7
31:02.7
that’s Meryl Streep and I figured she
could do a legion knowledge is pretty
31:02.7
31:06.7
good now have you coined that word is
that an official word it’s an original
31:06.7
31:12.7
Janet Stout word so does that mean the
study of legionella G it means that I’m
31:12.7
31:18.3
a microbiologist that studies Legionella
so that’s how I get to Legion illallah
31:18.3
31:24.3
gist I love it last question you now
have the ability to speak with anybody
31:24.3
31:29.9
throughout history who would it be with
and why I would like to talk to Leonardo
31:29.9
31:35.7
da Vinci because he was right brain and
left brain so great artists great
31:35.7
31:41.2
engineer I understand from the history
books he was a little curmudgeon so I
31:41.2
31:45.8
think it would be fascinating to talk to
Leonardo da Vinci well Janet it was
31:45.8
31:51.2
fascinating talking with you today thank
you so much for coming on Scaling UP! h2o
31:51.2
31:58.0
and dispelling so many myths that we all
have around Legionnaires disease well
31:58.0
32:02.1
thank you so much for the opportunity
trace it’s always a tremendous pleasure
32:02.1
32:07.4
to talk with you
Janet thank you so much for coming on
32:07.4
32:12.7
the show again I know we’re gonna have
you back because this is a world that is
32:12.7
32:19.8
constantly changing and as new laws as
new regulations happen as new documents
32:19.8
32:25.6
enter into the water treatment community
we need your help to help explain some
32:25.6
32:30.9
of these items to us and I’m sure Janet
will come back and help explain some of
32:30.9
32:36.6
those items to us well last week I also
told you about a couple things that were
32:36.6
32:40.4
coming up with the Association of Water
Technologies one of those is the
32:40.4
32:45.6
business owners meeting so if you own a
water treatment business and you want to
32:45.6
32:50.6
talk to other water treatment business
owners your opportunity is coming up
32:50.6
32:54.3
February 10th and 11th in Clearwater
Florida
32:54.3
32:59.7
now you can find out more by going to
awt org forward slash business meeting
32:59.7
33:04.7
20 and figure out if this is the place
that you need to be I’ve heard great
33:04.7
33:09.2
things about this and folks if you want
a business you need to consider going
33:09.2
33:15.5
there now if you are a water treat or
you need to consider going to aw teas
33:15.5
33:19.9
training seminars you’ve got two
opportunities to do that one on the west
33:19.9
33:26.3
coast in Seattle February 26 through 29
and then on the East Coast March 18th
33:26.3
33:31.2
through 21st in Cleveland Ohio that’s
not really on the East Coast but anyway
33:31.2
33:35.7
that’s that’s where they’re saying their
East is and I will be at both of those
33:35.7
33:41.5
so folks please come up to me let me
know that you enjoy this show and what
33:41.5
33:47.9
you want me to talk about next
I love teaching at these training
33:47.9
33:52.9
seminars and I know that this is
worthwhile for you to come so I hope to
33:52.9
33:56.6
see you there nation there’s one more
thing I want to bring to your attention
33:56.6
34:02.7
the IWC the international water
conference which is a group that invited
34:02.7
34:07.6
me to record at their event last year
you’re going to be hearing that
34:07.6
34:14.3
recording very soon they have a deadline
for their submission of papers on March
34:14.3
34:21.6
next so if you want to present in
Santonio Texas on November 8 through 12
34:21.6
34:27.0
where their convention is going to be
you want to make sure that you go to
34:27.0
34:33.1
their call for paper site and get your
paper in we will have a link on our show
34:33.1
34:36.5
notes page so you don’t have to worry
about finding that you can link directly
34:36.5
34:42.7
up to that and look forward to that
episode coming out very soon nation you
34:42.7
34:47.6
know one of my favorite things is
bringing this podcast to you so thank
34:47.6
34:52.7
you so much for listening if it wasn’t
for you listening I would not have a
34:52.7
34:58.1
podcast I’m going to ask you to go one
step further and find somebody that does
34:58.1
35:02.6
not know about this podcast or maybe
they don’t listen to it on a regular
35:02.6
35:07.9
basis let them know all the nuggets of
information that you get from this show
35:07.9
35:14.6
and help me expand the Scaling UP! Nation
even further nation I can’t wait until
35:14.6
35:25.8
next week’s show and until that time I
hope you have a great week
35:28.0
35:32.8
nation one of the goals when I started
this podcast was to create a community
35:32.8
35:40.3
for us water treaters I believe that the
skimming up nation has received that and
35:40.3
35:47.0
we now have a community for ourselves
I’ve gone even deeper and I’ve created
35:47.0
35:52.7
the rising tide mastermind and the
rising tide mastermind is to bring the
35:52.7
35:58.8
success that I have personally had with
my own mastermind groups and bring it
35:58.8
36:04.2
into the water treatment community the
rising tide mastermind is now meeting we
36:04.2
36:10.0
have active groups and we want you to be
a part of it go to Scaling UP!
36:10.0
36:16.9
h2o com forward slash mastermind to see if
the rising tide mastermind is right for
36:16.9
36:22.8
you where we are serving both owners and
non owners folks you deserve it to
36:22.8
36:30.3
yourself to have a trusted group of
advisors that you can do life with go to
36:30.3
Scaling UP! h2o com forward slash mastermind
36:35.7