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[Music] foreign [Music]
is proudly sponsored by the rising tide Mastermind the rising tide Mastermind is
one of my favorite things that I look forward to each and every week because I
get to see people that have my best interest in mind I know this because I
have their best interest in mind and when you get people together in a room
like that you can just imagine how people want to help other people if this
sounds like something you want to learn more about go to scalinguph2o.com forward slash Mastermind
foreign welcome to scaling up the podcast where we scale up on knowledge so we don’t
scale up our systems I’m your host Trace Blackmore and happy Legionella Awareness
Month scaling up nation of course we’ve been doing this for a couple of years now and the whole point behind this is
how do we get better information out there to you the industrial water Trader
so you can spread that to your customers where it really matters we’ve been doing
this for a couple of years and we’ve had great success over those years we’ve also been able to accumulate a lot of
information and sometimes it’s difficult to find places that you can have reliable resources well we’ve got a
place for Legionella information you can go to scalingop h2o.com forward slash
Legionella and let your fingertips do the walking because we have put together
so many resources that we’ve gotten from guest on this podcast from some that you
have sent to us we have so much information for you so don’t guess do
some research and we have all the information that you can do that research on at scaling up h2o.com
forward slash Legionella skeletonation as you know I love
collaborating on this show with our friend James McDonald so here’s
something that James has cooked up to get you in the mood for industrial water
week These Are the Voyages of industrial water week to boldly celebrate with
family friends and colleagues
Helm report it’s a borg ship captain
we’re being hailed captain on screen
[Music]
Collective celebration of industrial water week will adapt to celebrate like us resistance is futile wait a second
you’re insisting that we celebrate industrial water week like you as part of the collective but there are so many
ways to celebrate industrial water week it can be as a group an individual or both resistance is futile Gloria Shields
celebration as it has been is over this time forward you will celebrate
like us my name is Captain Herbert Henry oxendine the 18th and I’ll be darned if
I’m gonna let the Borg tell me how to celebrate industrial water week we can celebrate with you but not like you nor
as you in Communications
Direct Hit Captain H2O they’ve scratched the paint on the port they sell now I’m
really annoyed I just had that buffed and waxed evasive maneuvers Ada Ada Omicron modulate phaser frequencies
randomize Shield harmonics dust off those anti-boric Photon Torpedoes and give them all we’ve got and turn off
that blasted sound
report Ensign the boar cube is winning plasma Steam and chilled water sir
Shields are gone and power is fluctuating good now hail them
stop right there we’ve just kicked your Collective backsides stand down there’s
room for us all to celebrate industrial water week in our own ways my crew and I will have cake you’re welcome to join us
the point is we decide as individuals as companies as colleagues as friends
if you truly understand what we do it’s industrial water treatment professionals but we do and duster water week gives us
permission to celebrate ourselves and our Noble profession so will you join us at our assimilation
free party find your terms of Celebration to be acceptable good I was hoping you’d see
it our way by the way I see you’re vetting Steam and chilled water over there if you need help with your
industrial Water Systems just let us know they’ve ended communication sir
in the cold darkness of outer space where no one can hear you steam there is
one man who works tirelessly to celebrate what we do that man as Captain H2O best water treater this side of the
Milky Way celebrating a duster water week the First full business week of October each and every year
based on Star Trek created by Gene Roddenberry no rights infringements intended Star Trek and all related marks logos and characters are solely owned by
CBS Studios Inc this fan production is not endorsed by sponsored by nor affiliated with CBS Paramount Pictures or any other Star Trek franchise and is
a non-commercial fan-made Audio Drama intended for recreational use no commercial exhibition or distribution is permitted no alleged independent rights
will be asserted against CBS or Paramount Pictures Nation I’m sure you’ve heard James and I
on a previous podcast we are both trekkies for good or worse for better or
worse I guess is how you say that so if you’re marking your calendar September 8th is Star Trek day and an even better
date to put on your calendar is industrial water week which is October
2nd through six it’s always the first full week of October and if you are
doing the math that is when a lot of us are going to be together at the association of water Technologies
conference so folks I don’t know how are you going to celebrate industrial water
week are you going to dress up as your favorite water character we don’t even have water characters see there’s so
much we can do for this holiday I’m hoping some people surprise me while
we’re at awt celebrating industrial water week I fully expect James McDonald
to be in a borg costume talking about water somehow so we’ll see what James
does with it Nation I hope to see you not only at that conference I can’t wait
to celebrate industrial water week with you October 2nd through 6th and of
course we’re going to have a brand new episode each and every day that week to
help you celebrate and you should have fun you should let your clients know
about it you should let your family know about it you should definitely let your co-workers know about it and do
something a little fun I can’t wait to see some of those posts on social media
here here are a couple of items that you might want to look into AquaTech Mexico and Mexico City is having their water
quality Association meeting on September 5th through September 7th so this is
where aquatex international trade show offers industry professionals to complete overview of products and
services of the world’s leading company so if this is something that interests you we’ll have all of that information
on our show notes page the Smart Water Summit is happening September 10th
through 12th in Scottsdale Arizona and this is for water utilities industry
concerns resolved all around operational technology extreme climate events and
political hurdles if this sounds like something that you want to learn more about we will have that information on
our show notes page as we always do One Stop Shop for you to figure out what is
going on in the industrial Water World we’ve got all of that on our events page
just go to scalingup h2o.com Nation I just mentioned James McDonald and of
course James just does double duty on this podcast so here is a brand new 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
sulfate what’s the difference between sulfate and sulfite what is the chemical
formula for sulfate what problems can sulfate cause in an industrial water system
what impacts its solubility with calcium what about barium what chemical products adds more sulfate
to an industrial water system what treatment Technologies can remove sulfate from water
how is calcium sulfate scale cleaned can you predict the solubility of
sulfate salts in a water system what rules of thumb or calculation programs are available
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
watertable23 and hashtag scalingup H2O I look forward to learning more from you
thank you James for all the hard work you do making learning more about water
treatment fun Nation we are right smack dab in the middle of Legionella
awareness month and one of our most popular guests is Dr Janet Stout she is
no stranger to this podcast and she is the one that I reach out to when I have
Legionella questions and she is our next guest talking about Legionella here is
that interview my lab partner today is returning guest
Dr Janet style Janet welcome back to the scaling up H2O podcast
it just makes me smile so big to see you and to be with your audience and to talk
about my favorite subject that of course is Legionella there we go Legionella but
we’re also talking about other waterborne pathogens too so we want to be all inclusive and not just hog it all
with Legionella that’s very true very true Janet do we know how many times
you’ve been on the show it’s got to be close to a dozen you know I was going to
say six but I’ll take a dozen well I I think you probably have six episodes but
uh in different conversations or or conventions we’ve been at you you’ve been on so I think if we count all of
that uh we’re maybe even above that number well that makes me smile too because uh it’s just well you’re just a
delightful person to talk to and I love what you do for the industry and for all
the people in in water treatment with all the different ways that you help them to learn and to and to support them
frankly so I I just love being part of it it’s a lot of fun and it’s totally
selfish because I get to learn so much from all the people that I interview well that’s a nice way to put it so
you’re a lifelong learner just like me um you know you never stop and and nothing gets me more excited than going
down the rabbit hole when I’m doing some research on something and then it takes me here and takes me there it makes my
my brain light up and so hopefully in this episode we’re gonna do that brain
light up for everybody listening I have no doubt that it already has and I was trying to think back back in the
pandemic days we had a Legionella conference that was canceled and the
scaling up H2O podcast folks decided that we were going to make August
Legionella awareness month and we did it and people loved it it was some of our
highest rated shows people asked when are you going to do it again and we said well I guess we’ll do it next August
this is the fourth time that we’ve done that and people really seem to enjoy it
so thanks for always coming back to Legionella awareness month but I don’t know if it’s an official holiday but
we’ve definitely declared it one well you know I always say that Legionella is a marquee microbe it loves the headlines
and so it certainly loves the spotlight that you shine on it with Legionella awareness month and I actually I don’t
know where he is but I have Lenny Legionella that you sent to me from the the course that I I took from you and
Janet I have to say that was so well done thank you and you know the the
Applause goes to everybody from iatmo assc and special pathogens laboratory in
our and the guests that we have uh as instructors for the training
um that’s another one of those things that gives me great pleasure to be a part of instrumental in creating and
delivering and I have a I have a headline to share with you about that when appropriate
well I thought maybe we could just start there because there’s so many things to
talk about when it comes to Legionella awareness and one of the things that many industrial water Traders are
becoming aware of is that people are requiring them to become certified if
they are going to do something with a water management plan so I thought we could unpack that a little bit that’s my
pleasure so where should we go should I should I just talk to you about why I
think that’s important or what’s new on the horizon for the training okay let’s
do that exact thing let’s start off with why you think Dr Janet Stout Legionella
export extraordinaire uh why you think that’s important and then what’s new
about that yes and and I I’m not just an infectious disease microbiologist anymore I’m a legionologist
so we always have to we always have to get my title correct right does that does it say that on your business cards
it doesn’t but should I add it Trace I think you should I think you should so the other thing I say is um when I
tell people Legionella is my life they’re either sorry for me or they’re impressed I’m you know it’s sort of 50
50. but a part of that dedication and Devotion to the prevention of
Legionnaires disease and advocating for that and I have my my end LD button on
uh for the broadcast because that’s our big hairy audacious goal and the mission
uh to end Legionnaires disease I share with everyone and particularly the
people that attend the assc standard 1280 certification training for
Legionella water Safety Management Specialists and so the idea for this came about geez like four or five years
ago where you know after ashrae 188 came uh you know I served it’s like Lemmings
to the Sea everybody and their brother and sister are like I can do this but I
knew that even the sort of minimum knowledge about Legionella was sometimes lacking and I wanted to fix that and so
I reached out to people I knew at ayatmo and assc because that’s what they do they create standards and on the asse
side and do the training for various standards on the I Atmos side and they were like great idea Janet and so asse
got experts together developed the training or the I’m sorry the certification standard and then the
certification exam questions which I don’t even know because I wasn’t involved in that and then on the training side it was like I that’s my
thing it’s just like you you know you want to deliver education so I worked with our team here at special pathogens
laboratory and ayatmo to create the the three-day training so it’s a the
requirement for the standard is 24 hours of training and taking a hundred
question exam and getting an 80 which is no problem for all of you because you’re all a high Achievers and then you become
certified for three years and then you you have to be recertified so this is a
live virtual training you mentioned the pandemic the initial intention was to have it in person but the pandemic came
it was ANSI approved in April of 2020 and the first training was scheduled for August of 2020 and we all know what we
were all doing around that time and so we we did it as a online virtual live
training and I emphasized live because it’s highly interactive as you recall so
it’s not just delivery of information from the instructors it’s from each other so people that are attending from
the very you know it’s infection prevention it’s professional water treaters it’s people from Health
departments various disciplines helping to teach each other and share with each
other their experience and I just love that part of the training and and so the
the we continued to do that the next training will be October 23rd through
the 25th so I encourage everybody to register register but here’s the the
news Trace just this month we have launched the self-paced online version
of the training through iapmo and you can get information from iatmo
learn.org if you want to check out registering for that excellent we’ll put that on our show
notes page so people don’t have to wreck their cars by taking notes they can keep their hands on Ten and two and be safe
and get it later so well that’s exciting you know if you if you can deliver the
education in the way that’s convenient for the learner that delivers the
information farther and wider and and really I think opens it up in a bigger
way to an international audience as well I’m curious you mentioned the
recertification process what is that process so it’s much easier than the initial
certification so that everybody just take it you know relax so it’s eight hours of training you still have to pass
a hundred question exam and get eighty percent but it’s much shorter and frankly for people that have gone
through the the virtual live training it’ll be easy peasy and you mentioned the examination that’s
a proctored examination somebody is reviewing your video from your web
camera and uh you take the examination you do not get a result because I think
they’re waiting for people to watch your video is that is that what’s going on there well when you take the certification
exam uh they and you finish it you do find out right away if you’ve passed and
I can’t I’m proud to say uh our pass rate is 96 uh and and to date we’ve
trained almost 600 people I’m very very proud of that excellent and I’ve taken several of
these courses because I love to learn and I was not only informed I was
entertained during the course you guys do a great job uh hand puppets come out
I mean it was amazing well people learn better when they’re
having a good time and I thank you for saying that because you know we intentionally do this you know we have a
we have a Wheel of Fortune game where we we test people’s knowledge by you know guessing the phrases with our own uh
Vanna White and Pat Shay Jack you know and you know like you said we’ve got the Lenny Legionella and Susie pseudomonas
as well I did leave her out so yeah you get a you get a welcome
packet when you take the course and uh there’s some treats in there and then also a plush Legionella toy aptly named
Lenny Legionella yeah and so we set the tone right when you get the guidebook in
the packet with the microbe the plush toy Lenny Legionella um and people I’m sure people open it up it’s like what is
this you know because we have Hand Clappers you know to to you know pat yourself on the back if you want to or
you know express some appreciation for the instructors and and so we have a good time uh while we deliver really I
think um the highest quality education on the subject available since people are getting certified now
are you seen either more water management plants out there or better
Water Management plans out there that I would say probably both the
trajectory of adoption of standard 188 from ashrae hasn’t been you know a
straight up it’s it’s like anything else there’s uh early adopters and and also late adopters and so I think especially
in healthcare virtually all of them uh have reached out to the awt audience or
the water Traders for help in doing that and so I would say absolutely with the
certification training the quality of the Water Management plans are better but I think most importantly I think it
gives confidence to the people doing the plans uh and and gives them better
language with which to talk to clients about what they need and why it’s
important and how to go about it um and and that is also one of the one of the
goals is to really help people feel confident in the knowledge that they have if somebody has a current plan that was
done previously by an individual that wasn’t certified do they need to be alarmed does anything need to be done
I would say to that is the SRI standard 188 requires an annual review of plans period uh I think if and
certainly I think it’s preferable for any organization to have a standard 1280 certified professional doing the work
with them it gives he’s also I talked about the confidence of the person the certified person but it’s also gives
confidence to the the client in the organization to know that they have a certified individual doing the work with
them so that gives them confidence and certainly I think if you’re reviewing a
plan that might have been done by someone lesser trained there would be
room for improvement let’s say and that’s certainly I think should be brought out and people that are
certified and I I hope you’re you do this Trace is that I see people put their certification in their signature
block on their emails or even on their business cards you know you want to let people know that you are Head and
Shoulders Above the Rest having completed that training that’s great advice I know a lot of people will take
the time to get a certification and then they won’t let anybody know about it
and I see it on people’s signature blocks and on their cards and I I just it makes you
know warms my heart right I’m just so thrilled that they are advertising that
they have met a higher standard of of knowledge something you also get in the packet
that you send out is a textbook and Janet I have to tell you this is one of
the better textbooks that I have ever read through it is actually not a dry
textbook I mean it’s got all the information in there but you don’t fall asleep as you read it it’s got easy
information to find well it’s got great information that’s easy to find but I
was just blown away by the textbook and I’m curious how on Earth did you ever
put all that together well it wasn’t easy I’ll just say but
you know we knew that we were working towards this assc certification standard
and that we needed to have for the education piece we needed to have this
guidebook available so I’m sure you’ve learned this lesson yourself if you’re
if you’re outside your area of expertise you go find people that have the expertise and you work with them because
by doing that whatever comes from it is better so I said all right uh never
wrote a book before and certainly not one designed as a teaching tool so we
hired a company to help us put it together right and then the people here
worked on the content and we knew that we wanted it to be easy to read
approachable attractive colorful interactive so there’s QR codes in there
there’s links to take you to other resources so it’s a very interactive guidebook but as you said it’s it’s
easily digestible so there’s Graphics you know chunks of information separated by you know attractive Graphics myth
fact kind of things you know call outs it’s it’s divided into modules that are
color coded so I that’s I I’m so happy to hear you
um you know that it was a good experience for you and that you appreciated all the hard work it took us
two years to put that book together we’re doing a lot with the scaling up Academy and uh that’s why I appreciate
that so much I mean you have this idea I want this course out there so let’s get it out there and there’s so many pieces
I can only imagine and you’re of course pulling out the the textbook right now I
can only imagine how many loops and and teas you had to cross and jump through
in order to get that quality book that I now have on my bookshelf
well I am glad that it didn’t put you to sleep too
puzzled by Legionella a guide to understanding detection prevention and water management and you can get it
online as well as part of the training so you can Google that and find puzzle
by Legionella a guide for understanding detection prevention and Water Management so we’re trying to make it
available not just through the training course but in general because it’s like it’s all the information that
you need compressed into one document that really brings you up to speed on
all aspects of Legionella and the other thing that we added to it which we’ll probably talk a little bit about soon is
we added a section on other waterborne pathogens because it’s not just about
Legionella anymore Janet we’ll make sure to put a link to that book on our show notes page again
keeping people safe ten and two people got to make sure that we’re uh we’re driving safely as we’re listening to the
scaling up H2O podcast you know the last episode we did together was episode 264.
it was entitled the one about the Legionella chill pill and I have to tell
you this was the best marketing I think I have ever seen if somebody doesn’t
know what I’m talking about can you tell them about the chill pills yes and I will
shake it for them because it is Dr Stout’s legionell chill pills and it’s in a bottle that looks like a
prescription bottle but inside are mints so no doctor’s visit necessary and on
the label just like your prescriptions at home it says for the treatment of Legionella related anxiety take two one
hour before Legionella testing and on the side it says if anxiety persists
contact the Legionella experts at our website specialpathogenslab.com so that you know
the reason for this Trace is and I’m sure you and and all the listeners have encountered this is that when you try to
talk to people about Legionella they’re like I don’t want to talk about it it’s nothing but trouble I’ll get in trouble
you know all kinds of reactions that are not really very helpful for the
conversation that you want to have about Water Management Legionella testing and so when you give them Dr Stouts
Legionella chill pills and they look at it and they start laughing now you’ve
sort of you know broken the ice right now you can say you know uh it’s serious
business but you know I can help you to manage this so that you don’t have
anxiety and and I and I I can get you as many chill pills as you want but I with
me you’re not going to need them because you know I have the knowledge and the expertise to help you navigate this and
to not be that ostrich with the head and the sand which we see so often it’s like I I don’t want to test my cooling tower
I don’t want to know the answer but you need to know the answer it’s just like we all need to get our routine uh
doctor’s visits and medical things like colonoscopy nobody wants to talk about
it but we have to do it Legionella is sort of like that well you bring up an interesting point because there are many
people out there that think if they’re ignorant into what’s going on that that is uh Absolution to liability
not anymore I’d say what maybe 10 years ago you could get away with that but not
anymore we’ve got various standards we’ve got Hospital organizations like
the center for Medicare and Medicaid services requiring water management for Legionella and risk assessment now as of
January of 2022 the joint commission for accrediting hospitals has followed suit
after CMS with basically the same requirements so there’s just no getting
away from it and so if you encounter people that are claiming that that’s a safe harbor you need to gently tell them
not anymore I truly believe that sooner or later our
laws are going to mirror what we see over in the UK over in Europe over in Australia and Canada we just haven’t
gotten that far yet so I want to talk about that what are the current
municipalities that have Legionella laws on the books and then what is your
forecast with who’s coming next well I don’t remember if we talked about this last time but after CMS
backpedaled on their requirement for for environmental testing for pathogens and
you know they had it in in 2017 they took it out in 2018 and and I thought of
the The Movie Network where the guys at the window going I’m mad as hell and I’m not going to take it anymore and he
throws the television out the window well that’s how I felt and so I went to
my state senator and I said I want to follow suit from New York state in New York City and we need a law we need
legislation for Legionella so as I sit here right now there are at least 10
states that have either introduced or passed legislation or public health law
about Legionella and testing for Legionella and monitoring Water Systems
risk assessment Water Management so we all know about New York Illinois New Jersey Virginia North Carolina
Pennsylvania Florida Ohio California and then just recently Nevada and so there’s
a lot of attention actually to this sort of Groundswell of legislative action
around Legionella it’s being driven by different entities you know
legionologists like me or other organizations that think this is important and it’s being actually being
followed by an ashrae subcommittee on government relations and so there are
people that are very interested in both sides of the issue on the one hand be
people like me that are advocates for prevention and want to see more of this there are others that are concerned you
know the what the cooling industry is concerned about you know vilifying cooling towers and so they’re very
careful about what the language is in there and there’s groups that are pushing that but I believe in terms of
crystal ball there is going to be more and more and I I would support all of it
and the reason is and I’m sure that you’ve seen this also is that you know all of these committees that I’m on or
you’re on uh they only go so far because understandably there’s all these
different interests and they’re there to protect their interests and so you know how aggressive can anything really be in
saying You must do this right because they’re always thinking about how does that impact my industry and so to get
away from that I think we’re going to have a combination of Standards guidelines there’s work going on now in
plumbing codes and mechanical codes to get stuff in there the the uniform Mechanical Code I’m on a committee for
that but those code Cycles are like every five years but there’s work on all
these levels to really address the continuing risk of Legionella associated
with building water systems when you spoke with your Congressman I know you
had the reflection of what New York State put into action and there were some things they got right there were
some things they could have done better so as we are talking with the people
that are making the laws where we are what are some things that we can learn
from how the laws have evolved how we know uh people are protected against
getting Legionnaires disease and what should that conversation start with
regulation because it includes Health Care New York City is just cooling tower
operation maintenance monitoring and you know there’s a lot of good stuff in that
New York City regulation and you would know better what to change around that for cooling towers but I think I think
it just all boats rise when there’s a requirement and so now when you’re
competing for business out there if everybody has to do the this minimum amount it really helps when you’re
trying to have a conversation with somebody about testing and the cost of it now it’s a requirement so it’s no
longer you know I have to convince you this is something you have to do and and then you just you know the money is
there people just argue about I don’t want to pay for this uh and the the thing that I like about New York State
as I said is that Health Care is where we have a lot of problems because people
are more compromised and so we must have higher requirements for health care and
so that whatever the the regulation is or the or the code standards it should
include uh health care and also uh long-term care we see a lot of cases of
Legionnaires disease in in residents of long-term care and you know they all say I have no money for water management
um but you know we try to make water management plans affordable we have a software called leggy doc that it’s like
five or six hundred dollars and they can have a a plan backed by our expertise
and so there’s there’s really no excuse so I would say to you trace that it has
to cover devices like cooling towers and decorative water features uh be careful
sitting next to that that water fountain at the bar of the hotel right or sitting under those misters in those nice warm
locations and then it has to have requirements for health care one of the stories I remember you
telling at a conference was one of the largest Legionella accounts I think in a body of water was found at the grocery
store misting station can you tell our our listeners about that right so there
was a very famous outbreak in Bogalusa Louisiana and luckily most of these types of misters aren’t used anymore I
had a reservoir and you know you can imagine Louisiana in the summer it’s hot and that water is just sitting there and
then you’re standing in front of the broccoli and all of a sudden the mister goes on and you’re just covered with the
Mist you’ve all been there right and you’re like oh it’s kind of annoying but in this case it killed people and then
there’s another one it was a little a small decorative water feature in a Mexican restaurant and it infected more
than 100 people and it took them a long time to figure out that it was this decorative water feature because they
were looking at all the cooling towers in that area but they finally figured it out and we processed some of those
samples in our laboratory and there was something like 10 000 Legionella per
milliliter in that water so these little innocuous devices can be great breeding
grounds for Legionella so let’s say there is an outbreak and
nobody knows where it’s coming from what’s the process to figure out where is the source
so this is one of the things that I always tell people test let’s just say it’s a cooling tower test your cooling
tower because and I’m not picking on cooling towers it’s just that when there’s a a big spike with a lot of
cases it’s often a cooling tower outbreak it’s in in potable water systems it’s like that goes on a little
bit at a time in case here in a case there so we got this big spike and one of the things that I tell people about
being proactive in testing is that you can rule yourself out as a source
because if you’re if the type of Legionella in your cooling tower does not match what they’re growing from the
patients you are excluded as a possible Source right and that’s basically uh
everybody remembers the the Bronx outbreak and that’s that’s how the detective the microbiological public
health detective work is done you sort of look at where the cases are you try
to get the organism from the patient since you test a bunch of possible sources you get those environmental
strains and you compare them genetically to see if they match or don’t match and
and if you don’t match you’re excluded you are not part of the pool of possible
sources so you’re not just talking about Sarah group you’re talking about the actual
makeup of the cell well the the molecular analysis or
subtype typing has different levels right but basically we take the organisms from the patient and the
environment bust them up get their DNA out and see if they uh match up
fascinating it is it’s really interesting stuff did you ever imagine
that this is where Legionella was going when you were first studying Legionella
you know I I’m sure you feel the same way about
your career Trace I landed as a graduate student right in a hospital that was
experiencing many many cases of Legionnaires disease in the very early stages of our understanding and so it’s
kind of like a a seed being planted in incredibly fertile soil and I had a
great mentor Dr Victor Yu and we studied every aspect of the disease and and you
know being in that position and being the sponge at an early stage of what was
happening in Legionella I learned so much and and it makes me sort of a a bit
of a unicorn right there aren’t too many that have grown up in Legionella and and
and I feel like it’s my responsibility to share that knowledge and that’s how I feel about doing the trainings and also
talking talking to you today there we go there’s the benefit there’s the payoff everybody’s looking for right with the
scaling of nation you know these these are our people our peeps how did you go from being a microbiologist to studying
Legionella how did you say my life isn’t complete I need to find Legionella right
well you know as a graduate student you have to pick you know where you’re going to study and who you’re going to study
under and and just through you know fate for little events I landed in this this
place and there was so much happening and you can just imagine you know a
young microbiologist just out of graduate school where else would I want to be frankly and and then when it came
time to get my PhD you know I got some advice from some very uh Wise
microbiologists It’s like you are in a great spot just keep going and from
there uh you know basically became you know the Legionella expert or legionologist yeah it seems to have
worked out well for you yes it has uh yeah and you know I again
you know going to a public health school at the University of Pittsburgh my emphasis has been always been on you
know how do we protect people and it just you know fate happened where the the laboratory was closed at the
Pittsburgh VA and you know is it the proverbial Fork of the road and said okay let’s keep doing our work under our
own control as special pathogens laboratory the commercial laboratory so that we could continue the mission and
and all of you all supported us in that mission over all these years and I’m very grateful so thank you so much
so so far it’s been all about Lenny Legionella but let’s get Susie
pseudomonas into the conversation and let’s talk about other waterborne pathogens because it’s now we need to
know about these other things and they are a mouthful uh yes and and thank
goodness some of them have abbreviations so pseudomonas and uh and I wanted to
sort of emphasize this one bacterium because I think it’s an up and coming and sometimes I say it’s the next
Legionella because we learned so much about how to manage the risk for that
waterborne pathogen and there’s another one that’s almost exclusively in water uh and it’s called non-tuberculous
mycobacteria or thank goodness by the initials NTM and and some data that came
out of the CDC that talked about the the disease burden of Legionella pseudomonas
and NTM said that the the costliest diseases or where NTM costing annually 1.5
billion with a B in health care costs and pseudomonas was a distant third with
uh 453 million and so these other organisms in addition to Legionella are
a tremendous disease burden and a burden on our Health Care system and you know
there are growing numbers of non-tuberculous mycobacteria infection
it’s not reportable disease like Legionella is so we really don’t have a
good handle on the thousands and thousands of cases but but it’s it’s more than Legionella it affects patients
in hospitals with cystic fibrosis it affects elderly people some of the
similar risk factors as Legionella and the other thing is you thought it took a
long time for Legionella to grow right so we start to see Legionella colonies in four days it takes for some of these
non-tuberculous mycobacteria species some are fast Growers or rapid Growers likely Janella but other ones are slow
Growers six to eight weeks so you thought Legionella took a long time so because
of that and you know because this is a growing recognized waterborne pathogen
and in fact is is named in the CMS memorandum and The Joint Commission uh
so people are like okay how do we test for this and so we’ve developed a PCR
assay that tells you whether these organisms are present or not in your hot
tub your shower your potable water a lot of the scope reprocessing that’s done in
healthcare you want to make sure that those don’t have non-tobraceous mycobacteria in them so we can you don’t
have to wait six weeks for the result to tell us where the these organisms are present we can do it in two days with
this non-tuberculous mycobacteria PCR test and then when you pair that with
the culture for non-tuberculosis mycobacteria now you’ve got the organism isolated but you’re alerted early and to
its presence and and in fact we’ve done we’ve done research on how to isolate these organisms more effectively and
publish that research in that where’s my article here oh yeah it’s a free Open
Access Journal called plus one and we’ll make sure I give you the link to that
where we published on a new medium to grow these organisms easier because they
take an even richer culture media which means the old media were overgrown all
the time and we’d never know whether they were there so we worked with the developers of this new commercial media
and were able to show it was incredibly better than the previous media and we
actually presented that at a Nash International non-tabricous mycobacteria Conference
back last year very interesting we’ll make sure to have that on our show notes page and I find
it fascinating you developed your own agar to culture Legionella you created your own procedures I think it’s just
amazing how uh you don’t just take the status quo you figure out how to make it better
well you know the the fact that CMS out of the blue sort of lobbed over the over
the fence uh not only do you need to be worried about Legionella but other waterborne pathogens non-tuberculous
mycobacteria pseudomonas my favorite one to say is stenotrophomonas maltophilia
and you’ll remember from the training how we all said that together because it’s so fun and I always feel like I
should be doing a line dance when I say it stenotrophomonas maltophilia kick don’t you think so trace it sounds like
it fits so all of these organisms all of a sudden everybody’s reading the memo and
going I have to know about them too and so the answer is yes and and if any of
you are working with Healthcare facilities um both at CMS and Joint Commission say you need to address the risk
well thanks for keeping us up to date also your website is a great resource to
see what is new what we should be doing and you call it a treasure Trove of
information and I think that is aptly put well thank you I’ve heard people talk
about our website it’s not a typical commercial website because it has this emphasis on on teaching and educating
and providing resources to to the people that are either our current clients or prospects and and that expertise
translates into your interactions with the people that are working here at special pathogens laboratory we have
lots of expertise because you know Lord knows you can’t know everything right you’re not a microbiologist I’m not a
water treater you teach me I teach you and and it’s one of the advantages of using our laboratory is that depth of
knowledge well I thought it might be fun to throw some questions at you that us water
treatment folk get every single day so these are comments that we hear how
would Dr Stout answer them are you ready to play I’m ready all right I only test
once a year whether I need to or not [Laughter]
okay well this is what I tell people about testing it’s always about answering a question
and and also understanding and this is why the training is important understanding the risk uh you know in
the ashrae standard 188 talks about having knowledge of Water Systems as it relates to legionellosis and that last
part is what we’re trying to sort of accomplish by testing right we’re not just willy-nilly doing it it’s about
assessing risk and giving you information about your you know for example your buy side program of a
cooling tower how well is it controlling Legionella in the spring in the high heat load of the summer and in the fall
because that’s when outbreaks have occurred so that’s when you need to be
testing so that you get feedback about your program that’s the purpose of it
and then in the case of potable water well I always tell people the the most important time to test is the first time
because that tells you whether you’re in the 50 that have Legionella in your water or 50 that don’t you need to know
whether the risk exists at all and then you go from there you know you depending
on what the results are and now we’ve got a lot of good interpretive criteria I always refer people to the cooling
technology Institute CTI guideline 159 for a good resource for their water
management of cooling towers it has reasonable criteria it talks about Regional test results not being about
the health risk but about performance of the biocide program so you can reframe
it for those people that are like you know I’m going to do perfunctory once a one one test and that’ll be that it’s
not useful and it in testing will keep you out of trouble and I think most
people respond to that so this next statement only applies to
40 of the 50 states but I don’t need to do that it’s not the law nobody’s making
me well you know I heard I heard somebody
talking one of our actually one of our instructors on The Joint Commission talking about
uh being at the bottom you know doing the very minimum and uh sure you know
you could do that but we all know if you don’t take care of things you do the minimum you’re going to get into trouble
right eventually and let’s say you don’t change the oil in your car right it’s always helpful to create an analogy
what’s going to happen to your car right it’s it’s something bad’s gonna happen and and so saying you don’t have to is
not a good excuse and then I always talk to people about the little lawyer on my shoulder trace the lawyer is there with
me all the time and and people even if you’re not required at this point in
time uh certainly ashrae standard 188 is considered the industry at best practice
while it’s still a voluntary standard you don’t want to get into a legal situation where you’re having to argue
why you didn’t do something and people died right and so really bringing the
Specter of legal consequences is not an empty threat I get calls from attorneys
every week because they are litigating cases of Legionnaires disease and it is
happening all the time so I think those are the things that I would say to
somebody that says I don’t have to so the next statement is any test that
comes back positive I need to treat as Defcon 1.
and this is where we give them the Dr Stout’s legionell chill pills right
um the answer to that is all Legionella are not created equal they are not all
uh Defcon one and one of the things that’s really useful I think and
beneficial of the ashrae standard 188 is they gave a framework within which we manage the risk we minimize the risk
right we’re not eliminating risk we’re saying okay what can we do to optimize
performance of devices and also to keep Legionella under control and now we’ve
got you know For Better or Worse different criteria for what is under control and zero legionnel is not what
you’re trying to achieve because you can’t it’s not possible it’s a normal
part of the Flora and so what we want to do is control it we use the percent positivity metric less than 30 percent
New York State also uses that and has actually published data showing that that’s useful especially in outbreak
investigation so that you’re not trying to get to zero and people are on bottled water for a year because you can’t get
to zero uh so so this is again you know helpful to have experts at your side to
to help you and your clients say you know Legionella Anissa is not a highly
pathogenic strain of Legionella I don’t worry about it and it and that you could say the same thing as Me Trace but
because I’m a legionologist they’re like oh okay I I’ll relax now
that’s why I call you so often and when I see it’s you I always answer
you always do I love that all right so the next statement is I only need the
chiller plant operator and the water treater to be on my water management plan team
okay so the Water Management multi-disciplinary
reason it’s multi-disciplinary is because understanding that part about the risk of Legionella requires input
from different people that are managing different types of water one other person that needs to be part
of that or at least receiving reports is Administration they write the checkbook
right and actually one enterprise system a Healthcare System Had Each Hospital
send their report their water management report their you know quarterly or whatever to an administrator who had to
sign off on that so now not only does the administrator understand what’s
going on but the people doing the work know that somebody above them cares about it and that the there’s meaning in
what they’re doing because so many times people are doing things and they’re like nobody cares you know this is a useless
use of my time so so administrators in in health care you have to have
infection preventionists as well as facility Engineers it might be a mean
one of those Venus Mars situations where they they may or may not Jive but they
bring different information and both are very important we did a little study where we looked at who was on the team
in various Healthcare organizations that we were helping with water management 90
some percent had facilities engineers and only 50 percent had infection
preventionists my hope is that that’s changed at this point in time because it’s really really important and
especially another risk situation is construction and renovation and we
actually devote a lecture to this and a module in the guidebook to construction and renovation because of the risk of
outbreaks associated with that so the in health care infection prevention needs to weigh in on construction as well
well here’s the last statement a water treatment program’s primary responsibility is to keep that customer
Legionella free as I said you can’t and I I think in all
of all things you need to manage expectations I’m sure with water treatment cooler cooling towers and
boilers you let people know what needs to happen in order to keep their equipment healthy and if you don’t do
these things you’re going to run into trouble and so managing expectations around Legionnaire testing what it’s for
what’s a reasonable expectation which is not zero okay just people don’t
understand I think that you can’t get them to zero that’s understandable you
know this is microbiology right and the analogy I usually give people is you have billions of microbes on your skin
No One’s Gonna you you can’t wash your hands and get rid of all the microbes what you’re doing is you’re reducing
them to a level that minimizes the chance of disease occurring and there’s
lots of information literature that shows if you minimize it you prevent disease so that’s it’s it’s incumbent
upon us I think to help establish what those reasonable expectations are we
don’t live we live in a gray world not a black and white world where you can’t there aren’t absolutes you’re not going
to get rid of every Legionella but you can control it effectively and and your listeners are in a great position to
help people to do that Jenna to add to that the primary responsibility of water treatment is to
prolong equipment life and increase its efficiency and now we throw on here the
the Legionella the specific species well that’s not really dealing with
efficiency and heat transfer so how do we properly talk to our customers that
this is really above and beyond a typical water treatment program well I
think everything evolves right so the initial charge for water treatment as
you said was to prolong the life of the equipment prevent microbial fouling and you do that right but the ways that you
monitor for General microbial fouling with heterotrophic play counts doesn’t tell you anything about the risk of
Legionella right so now we’ve got more than 40 years of experience with Legionella we know that not managing a
tower that looks clean like I’ve seen I’ve been there this this Tower is
linked to an outbreak it’s it’s water is like you know mountain spring water now
they they were using great um algae control like a carbamate or something but they weren’t using an
oxidizing bio side and so Legionella was having a field day in there because it was it was unaffected by the the biocide
for the algae so so I think a little bit of microbiology 101 uh I think the thing
that clients want to hear is I’m trying to protect you not only your equipment but you and your organization from Bad
outcomes this is a known bad outcome if we don’t do just a little bit we have a
water management plan for our devices and buildings and we test just enough to
give us information about how well the program’s working Janet what’s the one thing that you want
to make sure all of our listeners leave with to protect as
the at the top of our in our conversation as I’ve got my B hag and LD
uh badge on this is our mission and you are part of the mission because you are
out there talking to people about this is a real risk whether it’s a building water system cooling tower decorative
water feature we want to stop disease from occurring and we can do that
because legionnel is in the water and if we control Legion on the water we don’t have disease the only way to verify that your program
is working it’s called validation right is to test you can do all the water
treatment in order to answer is it working to control the risk of Legionella you have to test not a crazy
amount just the right amount right to give you feedback that what you’re expecting in terms of control is what’s
actually happening and you can’t tell by looking you can’t tell by doing ATP or
HPC you have to test specifically for Legionella and so if you can get your
customers your clients to do that you know do the plan with them get them into
the plan use testing to validate you will take us to that goal of ending
Legionnaires disease Janet you have been on the program so many times we have to invent new
lightning round questions every time you come on so are you ready for our latest
rounds of lightning round questions I all right so uh what are three things on
your desk right now that you use every day I’m kind of old school right and uh and
so even though I have electronics and you know all kinds of apps on my phone and things I I like paper and so I have
a stapler I have a highlighter right because because that helps me to gather
my thoughts and to know what I want to communicate to you and your listeners
and and of course the phone like is anybody more than like six inches
away from your phone I know at any given time it’s ridiculous but
it you know it’s a symbol of staying connected in this program that you’re
doing helps us stay connected and and I think that’s really important and you
know just call a friend every once in a while just because and surprise them I
love that advice a couple of years ago I made a I never make resolutions but I
try to do something different every year and I decided whenever somebody was on
my mind I was just going to either text him or call him right there and let them know that I was thinking of them and I
have had some great conversations because of that and I am amazed at how many people are surprised that I was
calling because they were thinking of me too there’s got to be something to that that’s great Janet what are three books
that everyone should read before the end of this year so I don’t know if you know about the
stoics but there’s a book called The Daily stoic by Ryan holiday meditations
on wisdom perseverance and the Art of Living
and it’s it’s a little reading from the philosophers of the Greeks uh Greek time called the stoics little ones for each
day and it’s a great way to sort of set the tone for the day or at the end of
the day get you thinking at a level above the day today so I love that they
made a movie out of this book but I highly recommend the book where the crawdads sing by Delia Owens just a
wonderful book just a wonderful book and then of course our business Bible Stephen Covey the seven habits of highly
effective people love that book been around a long time but the the lessons are Timeless and if you haven’t read it
uh do it this year I never met Stephen Covey but I met his son uh he was at a
conference and I got to eat lunch with him and I asked him what was his take on
green and clean if you remember he was the little boy that did not keep the
yard green and clean and uh he just looked at me in between bites of food
and said Trace I was seven
so if you don’t know what we’re talking about you’re gonna have to read the book Janet what is the best advice you’ve
been given over the course of your career that’s a that’s a tough one
um it’s not so much advice but what was demonstrated to me by my mentor Victor U
it were a couple of things one is work harder than anybody else right uh and I
sort of had a sense of that even as a young high school student volunteering for the Biology experiment you know that
nerdy kid that was me and and so I was doing more than what was required and
and I think I think if I was going to give advice to anybody that would be the thing that I would tell people is you
always do more than what is required and you will be successful so hard work but
also being kind uh you know you can never be too kind to people and and it
really does come back to you uh many many times over so being kind and
generous and hardworking I think are the things that the life lessons that I’ve gleaned over the years that I think are
most important and most most contributed to my success kind of a spin on that same question but
what advice do you wish somebody told you when you were first starting out
well I like that you know in my experience right I told you the story about how the VA closed our lab and uh
you know it was very terrible but one of my watertreater friends told me actually
at the time he said Janet you’re going to look back on this and it’ll be the best thing that ever happened to you and
uh and I think having perspective and maybe being forewarned a little bit that
life is going to throw you serious curveballs and and um and not to let it throw your offer kilter but you know I
think that would be probably the one thing expect the unexpected so if the
lab stayed open we would have special pathogens Laboratories that’s right and that would have been a a poor government
worker all my life we would have never met it’s funny how life works out it’s great
it’s great and um in the water treatment industry and your listeners and others
have been great support of us at special pathogens from the VA days to today and
I’m always very very grateful for that and for for the sharing of the knowledge that you all have with me uh sometimes I
think I have a minor in uh in plumbing and water treatment but I know enough to be dangerous and so I always call you
and my other water treatment professional friends when I I need advice well Janet as always thank you
for coming on the scaling up H2O podcast and helping us celebrate Legionella
Awareness Month and thank you for dedicating a whole month to my favorite microorganism
Legionella once again Janet thank you for coming
back to our scaling up H2O podcast we always learn something new when you are
here and I think just like water treatment Legionella always has something new to learn when we have
people like Janet in the industry she’s always trying to figure out how to do things differently how to do things
better how to inform more people she’s definitely done that on this podcast and
she continues to do that in the Legionella realm so if you want to learn
more about Legionella and that’s the whole point of this month this whole
series of podcast episodes that we are doing by all means I want to direct you
to scaling up h2o.com forward slash Legionella you will have so much
information there and you will be able to learn more than you ever thought and research to your heart’s content when we
know more we are are more confident to talk about things properly and when
we’re talking about things properly we’re educating people when we’re educating people we are empowering them
to make better decisions it all starts with you so use this month to bolster
your information your knowledge on Legionella awareness Nation I’m going to
have a brand new episode for you on Legionella awareness next Friday until
then have a great week folks thank you
today’s episode is proudly sponsored by the rising tide Mastermind each and
every year the rising tide Mastermind gets together in Atlanta for a live
event this is one of the most anticipated events within the rising
tide Mastermind normally we have a zoom call each and every week but this is
where we all come together and we become better friends we learn more about each
other and we help each other with their issues it is my favorite thing and I’m
sure it is going to be your favorite thing to look forward to if you were a
member of the rising tide Mastermind that could be a possibility to find out
if the rising tide Mastermind is right for you and you are right for the rising tide Mastermind go to scalingup h2o.com
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find out more [Music]