The following transcript is provided by YouTube. Mistakes are present. To hear the podcast episode, click HERE.
[Music]
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[Music]
welcome to scaling up the podcast where
we scale up on knowledge so we don’t
scale up our systems i’m trace blackmore
a nation really fun show today really
informative show of course every episode
of scaling up is an informative show
and i hope that you are using this
podcast to make sure that you got the
latest greatest information you know
where to go you’re constantly
challenging yourself and you’re also
making sure that you have the mindset
that even though i know something today
it doesn’t mean that there’s not more or
better information about it out there
something is always being updated we’re
going to learn about a lot of those
things today around a particular topic
but before we get there something that
we’re always trying to do is become a
better water treater and of course our
friend james mcdonald is helping us with
that so here is our next installment of
james’s challenge
[Music]
hello scaling up nation the next james’s
challenge as we grow as an industrial
water treatment professional drop by
drop is
[Music]
perform a condensate survey throughout a
facility
condensate systems can be quite complex
in both their general layout and in the
chemistry that’s happening
just collecting an aggregate sample at
the end of the line may not adequately
show what’s happening within the system
is the ph within the recommended control
range throughout the entire system or
are there low spots after pressure
reducers etc
is process contamination being diluted
by the overall condensate volume so you
don’t see it or is the contamination
intermittent
one can learn a lot by grabbing a few
basic items and taking a trip around the
condensate system
be sure to share your experience on
linkedin by tagging it with hashtag jc21
and hashtag scalingup h2o this is james
mcdonald and i look forward to seeing
what you share
nation it’s hard to believe that
halloween is just around the corner we
will be celebrating halloween just next
week but something i do want you to put
on your calendars right before halloween
on october 29th michael wardy member of
the rising tide mastermind and also
expert on what we need to know when we
are transitioning our businesses he’s
going to be
meeting with us in our awt webinar
series
that’s going to take place on the 29th
at 11 a.m eastern time and i know what
you’re saying trace i have no intention
of selling my business or
i know i’m eventually going to have to
do something with my business but it is
so far down the road
i don’t need to worry about it and i
don’t think that is a correct way to
answer the question of course i didn’t
really ask you a question but if i did
ask you a question it would be how are
you planning to transition your business
and if you’re not thinking about that
now i promise you are not running your
business
to the best of your ability
once you start looking at your business
as an asset
all the things that you do on a
day-to-day basis translate over to your
balance sheet and they are all assets
when you start looking at things that
way and how you would convey that asset
to another person another entity
you will look at your business in a
totally different light and when you run
your business as if you are ready to
sell your business at any time
i promise you are going to be running a
much more efficient business and when
you know what your numbers are telling
you you are going to sleep better at
night well michael is going to help us
get started with that so to sign up for
this valuable program
free of charge you just need to invest a
little bit of time and of course invest
some time going to the website that
website is scaling up h2o.com forward
slash webinar
nation i alluded that today’s show was
all about updates and we are talking to
none other than janet stout
janet stout has educated so many of us
on how we need to look
at legionella things that we need to be
telling our clients so they can make
better decisions so once again we’re
going to learn what’s new in the world
of legionella with janet stout
my lab partner today is dr janet stout
of special pathogens laboratory janet
welcome back to the scaling up h2o
podcast
i’m just thrilled to be here with you
trace you know you’re more engaging and
energizing than you know a cup of coffee
or a red bull i just love sharing this
time with you well i appreciate that i
i’m going to take that as a compliment i
think that’s a that’s a good thing
absolutely and definitely i am a lot
less calories yeah definitely a lot less
calories so janet uh you and i were
doing the math and this is your fourth
appearance on scaling up h2o so how
awesome is that that is so awesome and
you know i i reached out to you uh
because i you know so much has happened
since the last time we were together
that i thought your listeners would be
you know very interested to hear about
and so thank you so much for the
opportunity for the fourth time it’s
awesome and i’m sure i will have another
chance to ask you something maybe an
event that we attend in the near future
so uh you know four i think is the
official number but i think if we listen
back to other episodes you’ve answered
questions for us uh
uh questions from the audience where
we’ve done uh legionella month last year
you were a big contributor with that
so i’m sure the number is way north of
four if we were really doing the math
well you just uh you really do wonders
uh for educating your listeners and i’m
just thrilled to be a part of that
well it’s totally selfish because i’m
learning along with everybody else but
you you are one of the people that has
just given me so much i want to say
confidence in the world of legionella
because when this first hit us what
15 years ago is that
it’s like what are you supposed to do
owning a water treatment company and now
everything’s falling on the water
treater thank goodness you invented the
chill pill
and now we know what we’re supposed to
be talking about and how we can arm the
customer the end user with better
information
yes
and i actually have some chill pills
here with me today
in case we need them
always good to have on standby well the
last time you were on was episode 121
that was january of last year
what’s been going on since then
lots of things as i said and you know
for those uh listeners that don’t know
me i am an infectious disease
microbiologist
and what i always say as trace knows you
know when an infectious disease
microbiologist studies legionella for
more than 30 years i say i’m no longer a
microbiologist i’m a
legionelogist and a legionelologist with
a mission to end legionnaire’s disease
so this is our big hairy audacious goal
here at special pathogens laboratory and
for you can’t see it everybody listening
but i’ve got endl d earrings on and an
nld button on
uh i even have nld
shoes and um and so you know we’re very
serious about that and we we work
together with the water treatment
professionals and awt and other
organizations to advance that mission
and so when i talk about what’s going on
or what’s happened since the last time
we’ve been together i think about all
the things that
we and i we at special pathogens and
also myself as an individual have been
involved in around kind of the things
that we are noted for so we’re noted as
sort of the legionella experts with more
than 30 years of experience in
clinical and environmental legionella
detection control prevention it’s all
about prevention
and remediation and we’ve evaluated and
introduced into the industry you know
many legionella disinfection
technologies we don’t do remediation but
we do the studies to prove their
efficacy and we’ve been doing that also
for 30 years so that so that your
listeners and others that use that
technology understand the pros and cons
that are intrinsic to any disinfection
technology so you mentioned you know how
long uh we’ve been doing this and it
sort of brings to mind a
1996 awt convention where i had the
honor to receive the ray bom award and
in that acceptance speech i used the
word synergy to describe the
relationship that
special pathogens laboratory and i have
with the water treatment professionals
to do exactly what you said to share the
knowledge uh and and make sure that we
all you know sort of rise to the
challenge of preventing legionnaires
disease together and and this is just
another opportunity to do that and in
terms of what’s new since 2020 you know
we’re going to tick through uh a number
of these things but you know it’s really
about sort of a ground swell or the
snowball coming down the mountain of of
really regulatory you know whether it’s
standards guidelines legislation which
is just uh really interesting to me
uh and training opportunities uh so
we’ll talk about all those things so so
much has happened since 2020.
well we are going to mention all of
those things as you alluded to but i
want to go back to a couple of things
that you just said
you mentioned the word synergy and and i
love that word i love that mindset that
you and i can create something bigger
together than we can on our own
and it’s through that that i hope that
this podcast and the the conversations
that you and i have had throughout the
years not only help us but they can help
so many other people and they can spark
other conversations but you also
mentioned a hag a big hairy audacious
goal and that’s a jim collins term he
wrote from good to great and i was
introduced to that by a group that i
used to be a member of that you’re
currently a member of called vistage
and if anybody listens to this podcast
for any length of time they’ve heard me
encourage people to get into groups of
like-minded people so they don’t have to
live life alone they don’t have to
experience their issues alone they can
learn from others experiences they can
get picked up when they need a hand up
and then they can also brag about the
successes that the group helps them
achieve
so i wanted to ask you how long have you
been a member of vistage and maybe for
our listeners what exactly is something
like vistage
it’s a great question and like the
episode i’m in my fourth year of vistage
and uh it was introduced to me by sort
of a strategic partner who knew that we
wanted to take special pathogens
laboratory to the next level and you
have to go outside yourselves in order
to do that and so vistages appear to
appear and there’s different levels
obviously we’re in the ceo peer-to-peer
group where you you know you get
business solutions uh and you can ask
and and you know get those solutions
from the peers but they also present
educational information they bring in
speakers on a variety of topics like
cyber security or or hiring and
retention you know all those sort of
practical matters as the ceo you have to
deal with
and i can’t say enough about the
benefits
for special pathogens laboratory and
myself as an individual you know sort of
uh playing the role of leadership and
i’m proud to say that
i was the recipient of the leadership
award for vistage pittsburgh and then as
a result of that in august i was asked
to participate in a panel of a vistage
uh woman entrepreneur uh conference and
congratulations yeah share uh you know
how it has benefited our company and and
me personally so i i would encourage
anyone uh in that role either as ceo or
the coo so we have three people in our
organizations participating in vistage
myself
our co and our laboratory vp
you know to to sort of hone their skills
uh and and who doesn’t need that exactly
uh i would be celebrating my tenure
anniversary with vistage but i’ve
decided a couple of years ago to start
the rising tide mastermind and we we’ve
taken some of the things that we’ve
learned from vistage some other things
that i’ve learned from some other
leaders that have poured into me over
the years to try to create something
similar to that but more industry
specific and so many people out there
that i talk to they just don’t get it
you know why would i help somebody else
that does the same thing that i do
well there’s uh in my case obviously
there aren’t too many legionellologists
uh running a a special pathogens like
business so but the the things that we
all deal with from a business point of
view are very similar and the benefit is
tremendous so it’s you’re not in a
position where you are sharing things
that you don’t want to share
you share what you need to share and
you’re encouraged uh you know to be
authentic and and honest mostly with
yourself
and you get called out sometimes and
they use this term care frontation which
i really like you know sort of
gently but you know
really confronting you with things that
may not be quite right because we do
sometimes have a tendency to
to maybe not see things as they are yeah
we refer to that as the two by four
getting brought out and hitting you over
the side of the head but you’re doing it
in a caring way and we all have blind
spots and if we’re going through life
and we don’t recognize those blind spots
we can’t address them
right so it’s a great thing and it also
reminds me that through vistage i
learned about a book called traction and
by gina wakeman
who talks about a way to run businesses
called the entrepreneurial operating
system which is also another thing that
has boosted our company tremendously so
i recommend that book as well yeah we’ve
been on the eos system for about seven
years uh i’ve had i want to say
three episodes four episodes dedicated
to eos where i’ve had people from the
eos worldwide community come on and
basically give me free advice about my
business as everybody else in the
scaling up nation was listening but
we would not be where we are today had
we not instituted something like that
and it definitely would not be as
enjoyable well let’s shift gears back to
legionelogy did i use that word
correctly yes so so many things have
happened since you came on the podcast
last january where do we start
well that’s a great question because uh
there’s so many things obviously you and
i have the gift of gab and uh and in a
good way um you know when you ask me
what’s the most important things uh from
my point of view for your listeners to
know that have happened since 2020
there’s really three that came to top of
mind uh one is really some significant
changes in the guidance from the center
for disease control and prevention
regarding legionella monitoring and how
to sample which i want to talk about
when we talk about education you know
i’d like to talk about the assc
standard 1280 the professional
certification standard for professionals
in legionella water safety and
management and you know i think the
chain for those that deal with health
care the changes that are coming uh from
the joint commission and just what that
represents in terms of accountability
around water management i think that
sounds like a great plan let me start
out though a lot of people have been
asking me
they saw that they had previously
purchased ashrae’s 188 document and
recently we got an email stating that
there was an update available what
exactly is that update
so the ashrae standard is on continuous
maintenance and one of the things uh
that i want to tell people about and i
do this in my lectures is that you
should get on the list serve for ashrae
standard 188 and ashrae guideline
because you’ll be notified when there
are changes to the document just
recently was a publication dated 2021
and this was just in august of the
ashrae standard 188. there are let me
count them one two three four five
different addenda that have been done to
the standard since 2015
and this 2021 issue includes them and in
fact
at the back of the document on page 23
is an appendix d that lists all the
addenda and the description of what
those agenda are and so
my feeling about these you know for
example one of the agendas about
converting language to code compliant
language because ashrae is you know
working very hard with others in the
code uh writing area to get the standard
into code in order to do that it has to
be in the right language and the other
things are little tweaks
that are a result of that continuous
maintenance process so you really do
want to get that
2021 and you get it at you know you
think it’d be ashrae store.com but it’s
not it’s actually tech street t-e-c-h
street
store
if you google that and then search for
188 you’ll get access to the the most
current version and also within that
page it shows you the addenda also uh
which when you buy it you get those as
it goes on forward which there’ll be
more changes in the future you can get
those free once you buy the the guidance
document or the standard and it used to
be you could go to the site and you
could read the document for free you
just couldn’t download it is that still
the case
no it’s not
there you go you heard it i wonder why
trace i wonder why
understood lots of changes with that
there are always water treaters out
there that are dealing with trying to
get the best communication out there to
their end users and
they have that customer or in some cases
several customers that say
i will do something when i’m forced to
do it because of this update because of
the language being so easily taken from
that document putting in legislation do
we need to prepare these people that
it’s coming
you know
one of the things that i’ve been
frustrated with frankly and
and it disturbs me a little bit but it
just is the way it is is that oftentimes
people have to die in order for things
to change and and i’ve seen that with
legislation um and
and and i’ll back it up just a little
bit uh to talk about the center for
medicare and medicaid services
memorandum that came out in 2017. and i
popped the cork of the champagne
i popped it shh
because
it said have a risk assessment for
legionella all healthcare facilities
have water management
uh and it actually it also surprised me
they they tossed in their other
waterborne pathogens and so now your
listeners have to know something about
burkhold area stenotrophomonas
maltophilia which i actually really like
to say because it sounds like we should
do a line dance stenotrophomonas
multophilia kick don’t you kind of get
that i can see that yeah acinetobacter
non-tuberculosis microbiota you guys
throw a wild party i have no doubt yes
well we like to have fun here you know
and so
now the water treaters and people doing
water management need to understand uh
these other pathogens as well as
legionella as if legionella wasn’t
enough and we actually
do an educational thing it’s called
puzzled by legionella wednesday webinar
series which is every two weeks
approximately where we do it again it’s
free
20 minutes 25 minutes and we have
speakers in
some outside special pathogens
laboratory as well as our own speakers
and yesterday we did one on berkeley
area and the next speakers are going to
be a healthcare engineer from the va
system i’ve invited the epa to speak so
so people can
subscribe to that puzzled by webinar
series through specialpathogenslab.com
under the solutions tab and education so
so we we try to do that to make sure
that people are knowledgeable so getting
back to cms you know they they said do
environmental monitoring for these
pathogens and that’s why i popped the
court it was like finally i’ve lived to
see the day where the most important
thing to assess risk is being required
to your point well my party lasted one
year when
cms backpedaled and took that
requirement out and said it’s at the
discretion of the facility well
to your point trace you know when you
leave it to people to go hmm do i want
to do this or not you know they’re just
going to not do it and so i got really
mad like you know really mad and i said
all right
uh you know because i spent 10 years on
the ashrae standard 188 committee you
know they they leave it to the
discretion so i said all right it has to
come from legislation regulation
like new york city and new york state
which mandates the testing of cooling
towers on a certain schedule and new
york state mandates the testing of
health care facilities in addition to
having the risk assessment and water
management so i
called up the pennsylvania senator
wayne fontana and i said we need
legislation to deal with legionella in
pennsylvania and where else you know the
disease was discovered as a result of an
outbreak at the bellevue stratford hotel
in philadelphia
here in western pennsylvania we were the
first to issue a guidance document for
health care with the allegheny county
health department
so you know we we should be doing this
and so
he submitted legislation last year for
legionella and pennsylvania is one of
five i think
new jersey
illinois
florida
there’s one other one i’m blanking on
but at least five the north carolina one
came about because of the big outbreak
at that county fair there was the
outdoor spa
you know in fact and whenever there’s an
outbreak there’s deaths the illinois one
was after the veterans healthcare
facility in illinois over 50 cases and
multiple deaths
so that’s why i say sometimes
unfortunately people have to die for
change to occur but the the message here
is that change is coming and some of
that is coming through standards and
guidance
and we’ll talk about cdc in a minute and
some of it’s coming from
regulatory authorities like cms in the
joint commission so the joint commission
is the one that enforces the cms
regulations and in the fall of last year
they came out and they said you know
we’re sending out this uh this document
for public comment we are going to
strengthen the requirements for
healthcare around legionella water
safety and management and so they are
making
health care facilities more accountable
so the days are gone when you have the
plan you put it on the shelf it collects
dust and there is no no one asking you
you know
what is your corrective action where’s
the documentation uh that you have
evaluated that you have to do an annual
review you have to update it for any
changes that have occurred you have to
assess the risk groups within your
facility because certain patient
populations may be at greater risk so
much more detail in the joint commission
environment of care requirements which
will go into effect in january
so you’ve got cms joint commission
and the updates to ashrae and the
updated guideline for ashrae and one of
the addendum to the ashrae standard was
the adding the
cooling technology institute guideline
159 to the references section the awt
guidance document was there but the cti
guidance document wasn’t there and it’s
a great
great piece of information there with
lots of detailed guidance for water
traders on managing
large and small cooling towers and then
the the last piece was you know if
everybody’s uh doing legionella water
management there’s a spectrum of
knowledge out there right there’s people
that have been deep in it for a long
time and there are people that are new
to it well what we what we need is to uh
raise the bar make sure everybody’s at
the same level of basic understanding of
legionella legionnaires disease water
management and so that’s what what
prompted me to reach out to iatmo and
assc
two years ago
and say there’s a need for education and
iatmo is a training arm assc is a
standard making body to the ansi
standard
and so assc with a group of experts from
all industries created standard 1280
this professional qualification standard
which requires
hours of training and passing of a
hundred question exam
to be assc certified and so
assc also certifies the instructors
right so i’m a certified instructor for
assc and we deliver among others uh
along with uh the help of iatmo we
deliver that training and so we’ve
trained 300 or so people already that
are assc certified uh our next training
is october 18 to 20. if anybody that’s
listening is a healthcare facility
manager or professional healthcare
engineer we’re doing a special one uh in
november uh november 18 to 20. and all
of that information is on
specialpathogenslab.com
the solutions tab education you can get
information about registering for those
trainings also so i’m now an author
trace
so training requires a book right and so
we
wrote the book on legionella so it’s
called puzzled by legionella guidebook
and that’s part that’s given to the
people that attend the training but you
can also buy it online it’s even on
amazon and so it’s a great interactive
guidebook it’s it’s got qr codes so it’s
it’s always got new information it’s got
videos embedded in the qr codes
so that that education i think
complements uh what education other
people have so it’s different in that
it’s a sort of a specialized area but it
complements other trainings that they
may have
so when it comes to the 12080
certification we’ve got water treaters
that are listening to this podcast who
needs that certification
well if you are a water treater that’s
delivering the services of water
management and risk assessment
and you
want a multi-disciplinary
education about that so for example
if that’s something you’re doing you
want to be as knowledgeable as you can
about all aspects of this the laboratory
part the regulatory part the healthcare
part how to respond to an outbreak uh
all of that is is oh and disinfection
technology all of that is covered in the
training and then what’s really great
and this sort of relates to the
discussion about vistage is the
peer-to-peer interactions and so what we
do is we build in
breakout sessions
and case studies and then we listen to
each other and take questions from the
audience so that they learn from each
other uh because like you said we’re all
dealing with the same thing so there’s
sort of the lecture from the expert but
then the q a that’s live and over that
three day period is just gold
for all the attendees
you mentioned a lot of agencies one of
them was the centers for disease control
and they’ve recently updated their
toolkit what can we expect in that
update
well you know
i fell out of my chair when cms put
their memo out i fell out of my chair
again when i read the toolkit update it
came out in january right
and what made me fall out of my chair
was
like a like language i’ve never seen you
know figuratively come out of the cdc’s
mouth routine legionella monitoring now
for those that don’t really understand
you know aren’t deep in this like i am
the history is the cdc always said we
have no recommendation doesn’t mean the
recommendation like we think of it it’s
we’re not comfortable with the data in
order to make a recommendation that’s
what they mean by no recommendation so
they would always up until 2021 say we
don’t have recommendations about routine
environmental testing for legionella
which we all know is the cornerstone for
assessing risk in your building water
system or cooling tower right well there
it was and i i was just
whoa that’s a major change and not only
did they tell you uh that it’s
appropriate to validate your water
management program so that’s number one
and then so anybody sort of with dealing
with people that are going well we don’t
have to test for legionella well
actually
show them the cdc toolkit and the
language there that says
when do you do this when do you test you
test if you’re a healthcare facility
because you have
at-risk people you test if your control
measures aren’t sort of doing the job
fully like you know whether you can’t
maintain temperature or disinfectant
residual so they sort of tick down when
it’s appropriate to do this
and then there’s a table
that talks about the metrics for
interpreting testing and at the top of
the table there is routine legionella
monitoring and so there’s percent
positivity which is the way that we
interpret things you know greater than
30 percent of outlets in the building
positive particularly with legionella
and mafa sugar 1 there’s greater risk
but there’s also discussion about colony
forming units per milliliter
as well as what kind of legionella
you’re you’re isolating is it known
pathogens or the
majority of the legionella species that
have not been shown to cause illness and
then the other significant thing in
there is there’s always this confusion
about what volume of water to collect
and i say there’s always been confusion
because back in 1998 the cdc said
collect a leader if you can smaller
volumes are okay
when they go out to do an investigation
of an outbreak the cdc collects a leader
because they’re not coming back that’s
all they got
and so people misunderstand or
misinterpret that to mean we all have to
collect a leader from every faucet and
shower and it’s just not true for
routine monitoring so there in black and
white in this update is 250 ml bottles
are fine for collecting routine samples
and i was like yes finally you’re
helping to clarify and address that
confusion so those two things are
just groundbreaking in my perspective
you mentioned the term percent
positivity and i think a lot of our
listeners are confused about exactly
what that means can you help clear that
up
absolutely so we’re going on the way
back machine okay in the 1980s when i
started as a young legionelologist
i was at the pittsburgh va medical
center and we were investigating a one
of the largest outbreaks of healthcare
acquired legionnaires disease ever
reported and what we were doing is we
were collecting from faucets and showers
and hot water tanks
in this hospital different floors
different wings representative of the
water system we were doing that on a
monthly basis we were also doing it in
conjunction and in parallel with looking
for the disease in the patients in the
hospital right so as the percentage of
the outlets we tested so
to make it simple if you do a minimum of
10
faucets and showers representative if mo
three or more positive more than 30
percent we would see a case b goes up up
up up his over 30 percent bam a case and
then at that time we would heat and
flush we would knock it down as close to
zero as we could never really achieving
zero which is another
we want to achieve zero cases not zero
legionella and then we would do the heat
and flush and we would sample sample
sample and it would go up up up as it
will bam a case would occur as it
reached 30 percent we asked the question
did it correlate with the percentage or
did it correlate with how many
legionella bacteria the colony forming
units and it didn’t correlate with
colony forming units but it did
correlate with percent positivity and
the reason it can’t correlate with
colony forming units is every time you
open that fixture immediately collect
that hot water well when you come back
the next day it’s going to be a
different number because it’s not
consistent but it will always be
positive unless you remediate it
you also brought up the joint commission
i think a lot of people don’t really
understand what they do do you mind
explaining that and what we can expect
from them with their update so for those
of you that are older it’s like there
was that ad when ef hutton speaks
everybody listens well when cms the
center for medicare and medicaid
services and the joint commission speak
every healthcare facility listens
because that’s the dollars that are
available to them and if they violate
the cms rules
they get cited and in risk losing
accreditation and the the ability to
collect those dollars so cms sets the
rules the joint commission is one of the
groups that comes in and and assesses
surveys
the hospital for all these rules uh
environment of care is what we’re
talking about with regard to legionella
but they do all kinds of things around
medical procedures and medication
distribution narcotics all that so joint
commission
is the surveyor coming in to see are you
following joint commission rules and if
you’re not you’re sighted and that’s
very very bad for the hospital or
skilled nursing home and so they risk
loss of that income so they pay
tremendous attention to what cms and
joint commission say
and then now
what the joint commission has said is
i’m giving you
fair warning they came out this spring
and said as of july they said we are on
you are on notice that you will be
measured against these stronger
requirements from the joint commission
for legionella water management and risk
assessment starting january of 2022. so
they’re telling the healthcare
facilities
we’re going to look at this and if it’s
not right you’re going to get cited and
that’s very very serious
janet what does the joint commission say
about testing
so both both cms and joint commissions i
told you about the story about my
popping champagne and then great
disappointment around cms
leaving it to the discretion of the
facility so what what the joint
commission says is you know follow cms
so that means it’s still at the
discretion of the facility
but they are emphasizing monitoring and
and so one of the things that that
the other federal
authority that deals with monitoring is
the center for disease control and
prevention so they’re looking to make
sure in a very serious way that the risk
of infection due to legionella and other
waterborne pathogens so that’s also
included in the joint commission
is addressed and mitigated if there’s a
problem with regard to legionella we
know lots more about the link as i just
described between the presence of this
bacteria and water and disease
with with the other waterborne pathogens
it’s a little trickier and this is dealt
with in that assc training session
is what is the
epidemiology of these other waterborne
pathogens how are they transmitted and
what makes it more complex is it’s not
just water it’s in medication it could
be on surfaces it can be the hands of
the healthcare worker so people doing
legionella and waterborne pathogens
water management need to understand that
aspect of those pathogens
so that they can guide their clients on
how to do water management around those
and that’s that’s included in the assc
training so janet so many things we’ve
talked about ass e cms cdc awt cti joint
commission and there’s probably a dozen
i just left out so let’s go back to one
we haven’t talked about yet which is cwt
what does a certified water technologist
need to know how do they make sure that
they are advising their customers
correctly and with all these updates
what do they do
you know
i i love the fact that the association
of water technologies certifies their
membership on knowledge about the
chemistry and the application
of of biocides for the control of
organisms and water as well as you know
corrosion control and you know a myriad
of other things that a professional
water treatment person needs to do
a teeny tiny bit of that cwt training
touches upon legionella and probably i’m
guessing not much on the other
waterborne pathogens
so
the cwt certification is really
important and in fact i think you
probably know that that was one of the
requirements in the new york city
regulation about people that are allowed
to apply
biocides to cooling towers and and do
that testing around the the treatment of
the cooling towers so there’s
this information that’s very specific to
water treatment and the assc is very
specific about water management you know
reviews ashrae standard 188 risk
assessment all the other things that we
talked about about assc so these these
things are complementary and a cwt
is probably just like you and me we
advance because we say to ourselves
there are things we don’t know
and we seek out the knowledge from those
that do
and thereby become you know
better at our jobs and and to me that’s
what i think the the role of the assc
certification is for someone that is has
a cwt
in order to
make sure that and especially if they’re
an advising care facilities that they
have a full understanding of what does
water management and risk assessment
really mean
in terms of execution and and one of the
things i really think is important is in
the role of the water treatment
professional you’re often the right hand
to the facility manager and when there’s
an
outbreak or even a single case of
legionnaires disease they call the
facility manager and say
you know what happened and and it’s
really important to be able to help that
client
get through that experience because
there’s a lot to know around that you
know how what is the public health
authority going to ask of them
you know what is a good position for
them to take when you know there’s a
little push pull between public health
and the hospital you know what’s
reasonable for them to ask and push back
on and and you know that’s not something
you get when you get the cwt exam this
whole episode’s been about updates
and people are learning about these
updates for the first time on this
podcast some of them
what are some of the ways that we should
be staying up to date so when an update
takes place in january they don’t have
to wait for an episode of scaling up h2o
to come out in september
that’s difficult to be aware you know
and most of the water treatment
professionals that i know are
really busy so one of the things that we
try to do at special pathogens
laboratory is be that resource just like
you know that synergy that we talked
about that we you know special pathogens
and i have been to the water treatment
industry since before 1996.
so you know i i mentioned the guidebook
which is really great information and
because of those qr codes can be updated
over time when we deliver the training
i’m constantly updating so whoever takes
the training in october is going to get
the latest information
i mentioned the puzzled by legionella
wednesday webinar series
the speakers that i have on that
you know every other week are about
these issues that i think
your listeners need to know about uh and
and so
you know that’s why you know epa’s
coming healthcare engineers are coming
i’ve asked ashrae to talk about an
upcoming standard that we haven’t talked
about today which is 514.
um so i try to make sure that the
information that we’re bringing
to the audience is current and relevant
not that they shouldn’t
listen to your podcast every single time
trace
but i think between you and me
they’re good
well there you go now you mentioned an
upcoming standard 514 what is that well
uh there’s a sort of a long story behind
that which
i’ll share at the bar with you another
day
but
but the short story is it started at nsf
and migrated over to ashrae and the
concept is sort of a
a whole hazards approach to safety
within building water systems
and that whole hazard approach sort of
philosophically is not new but the idea
of applying that to a building so it’s
you know chemicals
not just disinfectant you know other
hazards physical hazards temperature as
well as um waterborne pathogens the
other pathogens because even though cms
and the joint commission talk about
these other waterborne pathogens
standard 188 is about legionella and
that standard is really important but
now we have to deal with these other
microbial hazards and being educated
about that and so those are some of the
topics that are being integrated into
that standard which should go out for
public review
in the coming months that’s another
reason to get that standards action
notification
because otherwise you wouldn’t know that
the public review is happening and i
strongly encourage your listeners to
participate in that public review
process
because while we seek perfection uh it’s
a it’s a large uh committee and uh and
there may be things in there that your
listeners are going no we can’t do that
and we have to hear from you in order to
change it because if we don’t hear from
you and there’s no changes it’s going to
be approved as is
you’ve updated us a lot about things
that we need to know about things we
thought we knew but they’ve since been
updated to quote gi joe knowing is half
the battle well now we know
the other half of the battle is having
these conversations with our customers
what should we be telling our customers
about these updates
um well this is when i i get my chill
pills out
so these are dr stout’s legionella chill
pills they are for the treatment of
legionella related anxiety
uh and it says take two tablets one hour
before legionella testing now they’re
mints you know so just reach out to me i
can send you some it’s really fun to
give these to people you’re talking
about monitoring for legionella
because it makes them laugh
and they have a hard time dealing with
the idea of getting a test result for
legionella whether it’s their cooling
tower or their building water systems
their decorative water features
there’s this this awkwardness about the
conversation
so what i want the water treatment
profession to do is to help those
clients understand
that now they’ve got a new tool
they can present the cdc 2021 toolkit
that talks about routine testing and
shows them this is when it’s appropriate
and you you fall into that
and if you don’t do this there’s risk
and when there’s risk there’s potential
for death because you know the mortality
rate especially in health care can be as
high as 30 percent so we need to be
proactively preventing by helping them
to understand they really should be
testing and here’s the guidance from cdc
even though cms or ashrae says it’s at
your discretion there’s a little lawyer
on my shoulder oh i forgot to mention
the little lawyer on my shoulder trace
but the little lawyer on it should be on
everybody’s shoulders and your your
water treatment professionals as well to
help them understand that they’re there
if something goes wrong
it’s going to be bad it’s either knock
knock knock the public health
authorities at your door or you know
here’s the the lawsuit that the lawyer
is bringing legionella is highly
litigated i get calls from attorneys
every week so i want the water treatment
professional to help have that
conversation
to bring this new information to their
customer to help the customer understand
that that information is feedback
to the water treatment provider as well
as them
how well is the water treatment program
working to control legionella and as you
know what you add in april in terms of
your buy side concentration may not
control it in july and august
and you need that feedback to say hey we
need to add more chemistry and so this
is important
sort of the context of it and and what’s
really clear i mentioned the cti
guideline 159
language in cti 159 clearly states that
the testing is not a health-based metric
it’s not predicting disease it’s helping
you to to predict and understand the
performance it’s a performance metric
about the program of treatment
it should be just like anything else you
know any of the other monitoring that’s
done so you know we need to help people
not be afraid give them the chill pills
educate them about how this has evolved
in this new change if they’re in
healthcare
and others uh the new language from cdc
so i think i think that’s really
important for the water treatment
professional to be an educator of their
client at the top of the show you talked
about five municipalities that were
considering legislation around
legionella how do we know if our state
our city is one of those next cities you
know that’s a great question
and the only reason i know about these
is because i
you know i was advocating pennsylvania
to do something because of how
frustrated i have become with you know
organizational standards uh and as far
as rb hag and ending legionnaires
disease and being proactive
advocates for proactive prevention
that’s why i got involved and so i think
what you could do
is reach out to your senator or
legislator and ask if there is any
because there’s no like sort of
centralized repository of this
information the ua which is an
organization for plumbing professionals
has an arm around legislation that you
know is actively looking into that i
know the awt kind of puts keeps a finger
on legislation as well and i would
recommend
members of awt to to talk to the
board about you know making sure that
this is top of mind
for them as well so it will take some
effort and again you know i’ll try to
keep updating people through our puzzled
by wednesday webinar series
jenna we talked about the made-up word
carefrontation
when we were talking about masterminds
and vistage so you’re now being
carefrontational
with our listeners of the scaling up
nation sometimes the two by four that
needs to hit them across the head so
they actually get it what is that two by
four
geez that’s a terrific question you know
the image of a two by four going across
somebody’s hell head is a little harsh
um but i understand and i’ll return us
back to our word synergy that you know
my experience sometimes of water
treatment professionals and you sort of
alluded to this when we were talking
about vistage just sort of go it alone
you know um either to protect territory
or their client you know from real or
imagined foes
you know to really recognize that we’re
we are in this together
and to not be afraid to
reach out to to me or people in our
organization to ask the simple question
you know in this particular situation is
there something that i should be doing
that i’m not aware of you know because
that’s what i’m here for and what
special pathogens laboratory is here for
is to guide people to prevention
and we have to be open to the fact that
we’re not going to be able to do that by
ourselves
and nor should we really and that that’s
really the way that we’re going to be
more effective uh as a professional and
also to be proactive in our prevention
efforts so i would say just be be open
to that
you know what is the saying just because
i’m paranoid doesn’t mean somebody’s not
after me but i think most of the time
you know that fear of collaboration is
unfounded and we’re gonna
help each other more by working together
than separately and so i really embraced
that concept of synergy i said it in
1996 when i accepted the ray bomb award
i say it today that’s what makes me get
up in the morning is to to be able to
help people uh in this area
janet i always love bringing you on
scaling up h2o but we’re not done with
you yet of course we have the infamous
lightning round questions are you
buckled in are you ready
i’m ready i’m a little afraid i think
i’ll have a chill pill
they are minty and delicious
so i just want everybody to know about
the chill pill
so here’s some new lightning round
questions so you haven’t been exposed to
these before since you’ve come back
several times so what would you say your
superpower is
wow my superpower you know immediately
what comes to mind for me is
communication
i’ve i’ve been told many many times when
i give lectures on these you know very
complex topics that i make it easily
understood
and and that to me is a wonderful gift
so i will say that’s my superpower
and i have been a recipient of that i
can definitely say that is your
superpower well now you have a magic
wand you can change anything you want in
the world what would it be
well goodness uh of course
i you know every morning when i put my
mask on i’m thinking about covid and so
my magic wand would be to eliminate
obviously
every variant
of covid
uh in whatever way we can and so i
mentioned to you uh trace at the
beginning we’re going to be attending
in-person conferences here in 2021 and
2022 and you know i just want people to
be safe
you know get vaccinated use their mask
because you just never know what’s going
to happen to you if you get infected
and now we have to deal with all these
variants and then protecting the people
around you you know whether it’s your
elderly parent grandparent or others
around you that you have no idea might
be immunocompromised and have a very
serious if not deadly infection so so
that’s an easy question today
the world we live in is just full of
conveniences things that somebody solve
by an invention
what’s the one thing that you can’t live
without
one thing i can’t live without that’s an
invention
i’d say gps for sure
um you know uh
yeah we like to think we know where
we’re going but
that invention uh is just a lifesaver so
many times um and i rely on it i am old
enough to know what maps are uh and and
they are a great plan b so if you’re for
example if you’re in acadia national
park and you lose service uh you still
know where you’re going because you have
a map but i would say gps um do you use
gps a lot too trace i do but i also know
how to use a map and there’s so many
people that i know that have no idea how
to use that technology so yeah it’s it’s
it’s hard to
navigate through atlanta through traffic
without something that has some sort of
traffic feature built into it but yeah
um that’s a great one gps yeah think
about the time it saves
oh tremendous it’s just great i read an
article it was a couple years ago but it
said
that of the millennials they surveyed
they could not get back from work to
their home without gps
so when an invention is so great
we become dependent on it that’s another
show we’ll bring you back and we’ll talk
just about that my final question what’s
your favorite beverage
favorite beverage now is is the category
any beverage or adult beverage uh how
about one from each okay one from each
uh every day i drink you know one of
these uh carbonated flavored waters um
so it’s it’s lacroix is the brand that i
and it’s lemon and i you know we’re all
supposed to hydrate more than we think
of it so that’s my way to make sure i
hydrate my favorite adult beverage is uh
and this is sort of funny i i have a
wimpy palette and so i’m a pilsner girl
and so you know you go out to these
micro breweries or anywhere and they
have ipas and all these different ones
and i’m in fact there’s a bar here a
restaurant here that has dad’s beer as
one of the beers and it’s a pilsner and
so i i’m sort of embarrassed i’ll have
dad’s beer please
but my my dad drank bedweiser so i guess
it fits there you go
now i know a little bit about spl and i
know there’s not only legionelology
going on but also some brew ology you
guys make your own labels
yes so
so that was one of my favorite awt
conferences we we made stout ale
and legionella lager and the label was a
petri dish with legionella colonies on
it for the legionella lager and and dr
stout’s picture was on a mic picture was
on the the stout ale and we did a taste
test if you remember it was in palm
springs and um and it was pretty much a
virtual tie
i think the world is ready to try that
again
okay
janet thank you so much for bringing
more knowledge around such a complicated
topic and you of course with your
superpower make it so much easier to
understand thanks for coming on the
fourth time to scaling up h2o now my
pleasure trace and you’re just
delightful and i look forward to the
fifth time
janet it is always fun when you show up
as my lab partner on scaling up h2o
janet’s superpower i’m gonna say she
absolutely nailed it janet has a way of
taking something that is so complex
something that she has spent her entire
adult life studying
and giving us all handles so we can take
bite-sized pieces to the people that
need to make decisions around legionella
and make better decisions she has armed
so many water treaters janet thank you
for continuing to do that thank you for
raising the bar in the legionella
community and making sure that we’re
always having the best conversation we
can have because the problem happens
when we are not having those
conversations with our clients and they
don’t know
the expectations they don’t know the
expectations that we have they don’t
know the expectations that all these
different bodies that janet mentioned
has on them
we are so valuable to make sure that we
can connect those dots for them and when
they understand the correct information
they can make better
choices it’s all about communication
it’s all about making sure
that we are helping each other know more
about particular topics so we can do the
right thing
you know speaking of the right thing and
the reason i chose to use that language
is in our day-to-day and it could be as
a water treater it could be as a husband
a wife son daughter
father mother
all the different things that we are as
listeners of the scaling up nation
we have to make so many decisions about
what we’re going to do next and
sometimes those decisions can be
really overwhelming
something i like to do is always look
ahead habit 2 with 7 habits of highly
effective people is always begin with
the end in mind
but sometimes that end is so far out of
sight it can just be paralyzing
trying to think about it and folks if
you do not make a decision that in
itself is a decision
now one not to act is probably going to
affect you negatively in the long run
so here’s the advice that i have for you
you know more about whatever particular
situation that you are in because you
have experienced it so look at yourself
as the expert in that instance you also
know all of the things
that allow you to get out of bed in the
morning
you know all the things that make you
you
you know things that you’re willing to
do things that you’re not willing to do
and you also know the reasons why you do
all of those things and you have all of
these relationships that you’re making
sure
stay
healthy along the way
so the next time you’re faced with a
decision like that don’t get paralyzed
don’t choose not to decide
what’s the next right thing that you can
do now you don’t know the next 10 right
things and you don’t know exactly what
the end is going to end up because this
is just such
a dynamic situation but you do know the
next small step you know the next right
thing that you can do
and that will take you to the next step
and then maybe there you can get some
help
maybe it’s through an organization or a
mastermind like janet and i were talking
about in the very beginning of this
episode and you can let your peers know
what you’re facing you can let them know
what is at stake
and most likely what will happen when
you surround yourself with a group of
people like this they can give you
advice to most likely
the exact situation that you are
experiencing and now you have the
benefit of all of their hindsight they
will give you a history of what they did
and if they had to do it again how they
would do it differently so i hope you
have a group like that like janet and i
do
if you do not there are many groups out
there janet mentioned vistage i was a
member of vistage for many years learned
so much from that group i’m also a
member of a couple of other groups and
as you know i’ve started the rising tide
just for what we are talking about so if
you have access to a group like that you
can do the next right thing and then you
can get advice from your group now if
you do not have a group like that one
i’m going to ask you to consider why you
don’t have a group like that
and then think on whatever that reason
is is that a valid reason not to have a
group of directors that you can have
conversations like this on
if you do not and you decided that a
group like this is not right for you
what are the resources that you have so
you can make sure the next step is the
most logical step and it fits within
your framework of the next right thing
nation i hope the next right thing next
week is you listening to a brand new
episode of scaling up h2o that of course
is going to be halloween where did the
year go nation i hope you have a very
safe week i hope you use this week to
learn something make yourself a little
bit better and take care of each other
out there have a great week folks
[Music]
scouting up nation so many people that i
talk to want to join the rising tide
mastermind but they’re concerned about
being able to commit one hour a week for
the mastermind calls folks i have to
tell you when you experience that hour
you realize that that is the power hour
that changes every other hour that you
will experience that week if we keep
doing the same things we will keep doing
the same results and that one hour a
week allows you to get out of the
day-to-day so you can work on your
day-to-day
do something different find out about
the rising tide mastermind by going to
scaling up h2o.com forward slash
mastermind
you