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welcome to scaling up H2O the podcast where we scale up on knowledge so we don’t scale up our systems I’m Trace
Blackmore and this is the start of Legionella awareness month now we’ve
been doing this for several years now and you might remember back when we were
all on the stay-at-home orders and the world was just going crazy we had
conferences all the time before that but then everything was canceled and the
Legionella conference the prevention of disease and injury from waterborne pathogens and Health Care conference was
scheduled to take place August 19th through 21st 2020 and they announced
that they were canceling that conference and the great staff here at the scaling
up H2O podcast thought that that was a great opportunity for us to make sure
that even though we couldn’t go to a conference information Nation still came freely to you via the scaling up H2O
podcast so we started that back in 2020 and they are some of the most listened
to episodes that we do so we’ve been doing that each and every year now we
don’t really celebrate Lee Janella but we do celebrate getting better information out there for each other and
our clients we need to be able to counsel our clients so they can make the
best decisions possible so over the next few weeks we’re going to be celebrating
Legionella awareness month and if you want to dig in to all of the tools that
we have collected throughout the years all about Legionella go to our website scalingup h2o.com forward slash
Legionella and you will find a treasure Trove of information
at your fingertips so you can dive even deeper into this topic and make sure
that you’ve got the best information at your disposal when somebody asks you
about Legionella of course we’re going to be talking about Legionella this entire month for all the people that
signed up for the cwt practice exam course and of course we were given a
discount to celebrate the 4th of July and I guess that’s what it took people just needed a little bit more incentive
and that slight discount so many people signed up and you invested in yourself
and you are on your way to obtaining your certified water technologist
designation now if you’re in the same type of water treatment that I am this
is the designation that you want to get to prove to everybody that you are among
the elite and water treatment industry and just think having those three letters after your name says so much to
your clients to your potential clients to your supervisors and everybody you
come in contact with in this industry about the type of industrial water
treater that you are now if you were not one of those people that took advantage
of that promotion don’t worry it’s still available and you can go to scalinguph2o.com forward slash cwt prep
and that will be all of the information that you want to know now maybe you want
to get a little taste about what that course is you can sign up for a free
version of that course and that is yours truly going through the cwt exam
handbook that you will receive from the association of water Technologies I go through everything through that handbook
so you know what you have to do in order to get and keep your certification and
all of that is free to you of course it’s my hope you then go ahead and subscribe to the practice exam course
where this will get you in the mode to start taking a standardized test it
which gets you into the mindset to start thinking about how questions might be
asked what are some of the different things that you could be asked now keep in mind I have no idea what you’re going
to be tested on on that exam but I can get you prepared for taking an exam and
that’s exactly what that is so one more time that’s scaling up h2o.com forward slash cwt prep
Nation today is one of my favorite shows it’s when I’m answering questions from the scaling up Nation yes that’s right
we are opening up the scaling up H2O mailbag but before we take the bow off
of that mailbag I’ve got a couple of events that you might want to put on your calendar the 10th Annual
International Water Association and water engineering specialist conference
is being held in Brisbane Australia September 10th through 14th and this is
where they develop better engineering around biological processes and urban
water recycling based on the knowledge of underlying microbiological ecology
and all the things they’re like so if that sounds like something that you are
interested in go to our show events page and we will have all of that information for you also the 2023 water reuse Texas
conference is 10 taking place September 20th through 22nd in Frisco Texas so if
you want to learn more about this conference and this is all about water reuse and all the people that are
involved in that sector will have that information on our show events page
coming up October 4th through 7th in Grand Rapids Michigan we have the awt
annual conference and Expo this of course is an event that we are always at
with the scaling up H2O podcast and I will be there and I get to meet so many
people at this conference that listen to this podcast so I hope to see you there
to find out more information about the awt annual conference please go to scalingup h2o.com and go over to our
events page there is always something to do in the water sector it’s just
difficult to keep track of all of it so that’s why the team here at scaling up H2O is making it very easy for you to
find what you need to be going to you can go over to our show events page and
everything is listed out in calendar format and you can very easily add events to your calendar and go to the
event Pages themselves to get you registered for whatever conference you
see fit so thanks again for the fine staff here at scaling up H2O Nation as I
just mentioned this is one of my favorite episodes because we are answering your questions so here we are
we are opening up the scaling up H2O mailbag and the first question I have is
what is Legionella and that’s a simple question but it’s also a very complex
question and it really depends on who’s asking the question question so if we’re just talking to maybe a
client that doesn’t know much about Legionella we’re going to tell them that Legionella is a type of bacteria that
can cause a severe respiratory illness called Legionnaires disease and the
bacteria is commonly found in all natural water sources and the problem is
is when we start cycling up in man-made systems such as Plumbing Systems cooling
towers hot tubs Spas decorative fountains that Legionella because it
likes a temperature range of around 90 to 120 can really grow rampant
throughout the system now just because we have a system that has a lot of
Legionella bacteria in it does not necessarily mean that somebody is going
to get Legionnaires disease and we’re going to talk a little bit more about the differences between the two and what
the illness symptoms are these are all questions that people are asking but I
really want to make sure that we get our nomenclature straight so Legionella is the bacteria
very important that we call it correctly Legionnaires disease is the disease
that’s caused by the bacteria now I’m trying not to say everything all at once
because we have all these different questions here the next question is how
does Legionella bacteria cause illness for those microbiologists out there you
can have a field day studying how Legionella bacteria Works how it
propagates how it does all the things it does throughout its life cycle but for our purposes we are not going to go that
deeply we’re just going to talk about that if we have Legionella in a water
source if we drink that water we are most likely not going to get Legionnaires
disease because it has to go in through the lungs now maybe we aspirate some of
that water and that changes all bets but we have to inhale infected water
droplets it goes into our lungs and then as it starts to go through its life
cycle depending on the person that it is infecting it might not affect them at
all it might affect them slightly and it might become full-blown Legionnaires
disease again that is when the bacteria
causes pneumonia so I tried to put all of these in order
so they build on each other and it’s hard for me to stop in the middle of a
conscious thought so I can answer another question but we’re going to try to do it together here on this podcast
another question says what are the symptoms of Legionnaires disease and
then also isn’t there something else that it’s called well Legionnaires disease is legionnaires disease but I
think what they mean is Pontiac fever so let’s go back to that previous question so if we inhale contaminated water
droplets we could get sick we may not get sick so let’s say we don’t get sick
we don’t have to worry about it let’s say we start getting mild flu-like symptoms now this is not pneumonia and
this is actually the Pontiac fever that I alluded to earlier now this normally
will appear one to three days after Expo closure it lasts up to about five days
it normally does not require any hospitalization and about 95 percent of
the population is exposed to it it has probably had it and if you’re working
around cooling towers and other things you have probably had this at some point
in your lifetime you probably thought it was a flu a bad cold and you were fine
within a couple of days that’s Pontiac fever so now let’s talk about
Legionnaires disease and another term for it is legionellosis again we like to
throw a whole bunch of terms here in our Industries I don’t know why we do that but so many things mean the same thing
now this is pneumonia Legionnaires disease is the pneumonia that’s caused
by the Legionella bacteria now this can be potentially fatal and it is a
respiratory illness like we said it is pneumonia symptoms like this is high
fever chills muscle pain headache a dry cough diarrhea vomiting confusion
delirium could also be common with this typically this appears two to ten days
after exposure and Recovery can take a
long time and about five percent of the population is susceptible to this when
they are exposed now typically the at-risk people for Legionnaires disease
are immune suppressed people that might be on chemotherapy or after transplants
with immunosuppressants maybe they’re taking steroids
smokers are actually more susceptible to get this pneumonia people with lung
disease people that are generally sick or in poor health and the elderly and
infirm so the bottom line is a weakened immune system can’t fight off this
bacteria so that’s why these are more at risk individuals another question might
be well how do you treat Legionnaires disease and legionnaires disease is
treated with macrolides and that’s a specific type of antibiotics and you’re
probably familiar with some of the name brands so one is Azithromycin that’s a
z-pack another one is Levaquin tetracycline is a another one so if you
maybe had the onset of getting Legionella maybe it was just presenting
as a my held flu and they put you on one of these most likely it just knocked it
out if they were to do a test to figure out if you had Legionella bacteria in
your system or not and they and they actually found it they would most likely prescribe one of those antibiotics that
I just mentioned another question asks how do you know you have Legionella
bacteria in your body well how do you know most likely you’ll have some
symptoms well that doesn’t tell you anything and then they would take a sample and the sample might be might
start off with an x-ray to see if you have pneumonia and then if they suspect Legionnaires disease they’ll do a urine
test or maybe they do a lab test on a uh on a lung biopsy or maybe a sample of
the phlegm that you have in your lungs now a question that wasn’t asked but I’m
sure somebody’s wondering is how do you test for it in the system and many of us have taken Legionella samples and of
course there are all sorts of different Labs across the world but typically they will take a suspected system and they
will take a sample there’s a preservative that’s in the sample and then they actually send that to a lab
and then there’s a culture period they read that culture and then they let us
know if it was positive and it’s not just if it was positive or if it was not detect it was how much was actually
positive now this question wasn’t asked but I think it’s always important when we talk about testing it is very
important for you to know what you are going to do if you get a positive and
what you’re going to do at the different levels of getting a positive so
everybody thinks if they don’t do their research that the only a reasonable test to get back or the only good test to get
back is non-detect well what if you get a very small amount if you send a test
and you haven’t had a conversation with your customers and have a plan into effect what you’re going to do when you
receive those results folks you probably tested too early know what you’re going
to do with your clients and it’s their decision they’ve got to make these decisions before you start testing then
you should have a plan for what you’re going to do through all of the different
Milestones that you might hit of Legionella bacteria colonies so maybe something from less than 100 maybe
something less than a thousand maybe something over a thousand I don’t know however you do it you need to make sure
you know what the action is going to be before you get that positive result back
otherwise the client’s going to assume that anything that is not non-detectable is going to be an alarm
Okay well it could be an alarm but what are we going to do about that alarm and if we don’t know we should probably
figure it out before we send that test in another question asked can one person
infect another person with Legionnaires disease and the answer is no we have
never seen a case where that has happened like I said earlier you have to get it through infected water droplets
and you inhale that and then it starts growing into the lungs I have never
heard of a case where somebody has sneezed on somebody or coughed on
somebody and now they have spread Legionella that way so with that it’s
infected water droplets and in fact Janet Stout who’s always a great supporter of the scaling up H2O podcast
she says one of the largest Legionella colonies that she’s ever seen was in a
water sample at a grocery store where they just had a reservoir of water that
just kept recirculating recirculating until it would Mist over all of the produce and she said when she tested
that that was one of the highest Legionella samples that she had ever tested and that was going into a mister
it’s going into a distribution device so not really what you want there but we’re
learning more all the time and that was an older story that she had told me from a while ago so now we know a lot better
and hopefully those if they’re still in existence those systems are getting
treated our next question is how did Legionella get its name
Legionella sounds like Legion sounds even more like legionnaires so the
American Legion was having their conference in 1976 in Philadelphia at
the Bellevue Stratford hotel and as you can imagine all of these veterans were
coming together and most of them were over 70 years old we already talked
about how a weakened immune system and typically this is in the elderly can be
more susceptible to getting Legionnaires disease well they had a great time at
this venue they went home they started getting sick and over a hundred of them
died well folks nobody knew what was going on back then and people were
wondering was a foreign body invading us where they try trying to kill our
veterans if you looked at Time Magazine they’re talking about tracking the
Philly killer Newsweek says the mystery of the killer fever they had no idea what was going on
of course biologists were looking into this and they found a specific type of
bacteria that they had not seen before now we all know Lee Janella bacteria has
been around for a long time but until it was discovered we didn’t know about it we definitely didn’t know about what it
did and we did not have a name for it so the microbiologists went ahead and gave
it the name of Legionella to honor where it was found at the American Legion
convention so now you know and by the way if you’re wondering they found it at
that hotel in the cooling tower yes that’s right you heard it here the
cooling tower so now Legion Ella is always put together with the cooling
tower and if there is ever an outbreak they always look at the cooling tower
first now the poor cooling tower is presumed guilty until proven innocent
but that just means that we need to talk to our clients make sure they understand
that and we need to make sure they know all the options of the choices they have to make sure that they’re doing their
due diligence to keep not just the cooling tower but all of their water
systems within their facilities as risk free as possible now notice I didn’t say
annihilated of all Legionella I said as low risk as possible now with that you
are never going to get zero Legionella bacteria it’s coming in in the Raw water
it’s coming from our lakes rivers and streams but what we can do is not allow
it to concentrate up in systems that we are not monitoring and treating and
that’s the conversation that we have to have with our clients so it’s not no
Legionella it’s no Legionnaires disease that means we don’t want people getting
sick somebody else writes in and they want to know what the difference is between
testing for Legionella and a water management plan well that’s a great question and a water
management plan in my opinion is something that everybody should have and
if you live in New York there are laws that say you will do certain things
because they have laws around Legionella and how you’re testing for it how often
you’re testing for it and what you are doing about them so Legionella in New York has taken very seriously because
that’s where one of the first outbreaks happened right after we had ashrae’s 188
published now the fine folks of New York just took part of that 188 document and
that was about the cooling tower so there of course is a lot more that we have to worry about than just the
cooling tower and it is the Complete Water System throughout that facility
and that’s what a water management plan is just testing is not a water
management plan now it could be part of a water management plan and we’re going
to have the CDC tool kit for Legionella Water Management plans on our website so
we’re going to have the CDC toolkit which talks exactly about this question and how to establish water management
plans and that is going to be available on scalingup h2o.com forward slash
legionel as I mentioned on the top of this show we’re going to have all of our resources there we’ve had all of our
resources there and we’re going to make sure that we keep that up to date so you have one place to go to find all of your
legionello related questions and resources so let’s go ahead and talk about that just briefly because the
Legionella tool kit the CDC put out is very simple it’s got pictures in it so
that everybody loves that right well it talks about how you are going to establish if you are in a building
that’s considered at risk so there’s going to be four questions that it asks
you and it’s going to ask you if your building is a health care facility where
people are staying overnight and if that’s yes well then you’re going to need one of these next question is going
to ask you is does your building primarily House people over 65 years of
age and then it’s going to ask you does your building have multiple housing units
with a centralized hot water system and then finally does your building have
more than 10 stories if you answered yes to any of those then you’re supposed to
have a water management plan and then there are four more questions does your
building have a cooling tower okay well it’s recommended that you have a water management plan does your building have
a hot tub it’s recommended that you have a water management plan does your building have a decorative
Fountain and then finally does your building have a centrally installed Mr
atomizer air washer or humidifier so again all these things can be
distribution devices that Legionella can use and then you can inhale infected
droplets so if you answer yes to any of those it is recommended that you have a
water management plan and a water management plan is not as complicated as
I think people make it out to be there are seven steps and I’m going to just read them to you number one is establish
a water management program team so who is the team that’s going to be on it and
it’s not just going to be you and the engineer it’s going to be people that understand health care it’s going to be
people that understand the facility it’s going to be people that understand who is in the facility we’re getting all of
these people together and they’re going to become the program team next we’re
going to describe the building water system using flow diagrams so how is the
water coming into the building and what are all the points that water goes through the building
next we’re going to identify areas where Legionella can grow and spread from that
document we’re then going to decide what the control measures need to be how
we’re going to apply and monitor those so on that diagram if we decide that the
cooling tower is an area where Legionella can grow and spread what are
we going to do about it how are we going to measure it how are we going to
maintain it how are we going to then establish this is number five ways to
intervene when the control limits are not met and then we’re making sure the program
is running as designed and that’s just simply we’re doing exactly what the
program is telling us to do and if everything looks good we’re going to document that everything looks good but
if we miss one of those control measures we now have something that we can do we
all know that if we get a positive test that comes back add a designated rate we
can then go to whatever that designated rate is and within our plan and we can take that action and then finally we’re
documenting everything we are communicating everything everything is
getting written down and then we are constantly learning and figuring out how
do we make this plan better because now not only have we written the plan we followed the plan in this specific
system we’re learning more about the system and as we learn those items were
continuously updating the plan folks that’s what it is I know a lot of people
kind of fear away from that but it’s because I don’t think they’ve looked into it and a lot of your clients think
that if they don’t test for it it doesn’t matter or they think if they don’t do research it doesn’t matter and
ignorance just is not an acceptable defense so make sure you know how to
have that conversation with your clients because when you do they can make better
decisions and most likely they are going to turn to you to help them with that
Nation my last question asked what is the latest outbreak of Legionnaires
disease now I’m going to be honest with you and I think you all know this this show is not live so when I am recording
this show and I’m using Google to do a search on this it says that uh in May
there were 12 cases in Lithuania and those 12 cases two were hospitalized and
that’s all it says so there might be some more current information about it I don’t see anything in the United States
that’s happened recently but maybe my Google is not searching as well as it
should and I’m sure if you are curious about that and you have access to some of the fine microbiologists that we have
here on the scaling up H2O podcast they would know that information so all I’m
able to do is just look up what’s online and folks here is what I want to read
into this question is when is it time for us to do something so here in
Atlanta we had an outbreak a couple of years ago and I have to say I really thought we were going to be the next New
York and there was going to be legislation that we were going to have to do similar things that the folks have
to do in New York and it never came but we decided that we were going to get
ready for that and we are having conversations with our clients some are
very appreciative and they want to do whatever they can do and others said you know what we’re going to wait until
we’re told what to do it is my advice to all of you that you
learn what you should be discussing with your clients so they can have the best
information now the biggest thing that our clients get confused on is they
think that us as the water treater are responsible for Legionella bacteria in
their system and if they get Legionella bacteria in their system it is a fail of their water treatment program and let’s
face it that’s fair if you don’t understand what it is that we’re talking about why not think that but folks it is
up to us as industrial water treators to make our clients more intelligent about
Legionella bacteria and what water treatment does so water treatment ensures that we don’t have excessive
corrosion it ensures we don’t have scaling in the system it ensures that we don’t have excessive dirt and debris in
the system and then it also has a microbiological component but it’s all
about heat transfer it’s all about cleanliness it’s not about disease
disease goes up and above a regular water treatment program our program is
for equipment longevity and efficiency not about eradicating a specific
bacteria now we need to have that conversation with our clients and make
sure that they understand one when a water treatment program does and what a water management plan does and then fill
in those gaps so the better you can convey that information the better your
customer will understand it and now you guys are working together because before that conversation it’s just a bunch of
finger pointing and that’s not fun it is fun however when everybody is working
from the same page we’re all working towards a common destination and that’s
how we help clients and that’s how we ensure that they know how much that we
do for them and folks I want to thank all of the people that have written in
and asked questions about Legionella we’ve learned a little bit about Legionella today and we’re going to
learn a lot more about Legionella in the upcoming week so let’s face it that’s
what this podcast is all about how do we learn something that makes this job a
little bit more fun how do we learn something that makes us better at doing this job and folks let me tell you if
you were ever bored in this job you are doing it poorly you should never be
bored in this job you should learn something new each and every day and
that’s how I’ve never been bored in the many many years that I have been an industrial water Trader the day I don’t
learn something I start scolding myself and saying you did not take advantage of this day and I of course learned that
from my dad and I probably learned that from him because he was getting bored and he said hey I don’t have have to get bored I am in the best job on this
planet I’m an industrial water Trader well somebody who definitely agrees with
what my father thought what I thought is James McDonald he thinks that this is the best job on the planet and here is a
brand new installment of periodic water table with James hello and welcome to the periodic water
table with James where we think and learn about water chemistry drop by drop please use your week to search online
ask your colleagues or even pick up a book to learn more about each week’s
periodic water table topic if you do at the end of the year you’ll be 52 water
chemistry smarter so let’s raise the water table of knowledge together and get started
today’s topic is sodium hydroxide
this week’s topic is a little basic but let’s go what are all the uses for sodium hydroxide in industrial water
treatment how is the solubility of sodium hydroxide impacted by concentration and temperature
in what environments in what times the Year may this make a difference when shipping and using sodium hydroxide
what’s the chemical formula for sodium hydroxide what problems can it cause in an
industrial water system why is sodium hydroxide used in some chemical product formulations
what safety precautions should be taken when handling sodium hydroxide why is sodium hydroxide also called
caustic or caustic soda remember knowledge is power and taking
the time to learn more about water chemistry each week will help make you a force to be reckoned with
be sure to post what you learn to social media and tag it with hashtag water table23 and hashtag scalingup H2O I look
forward to learning more from you well thank you James and Nation I will
have a brand new episode for you next week try to learn something new about Legionella and remember we’ve got so
many resources at scalingup h2o.com forward slash Legionella have a great
week folks foreign