The Risk Factor for Legionnaires Disease - Term Paper Example

Case Study Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Course Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Lecture Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date Introduction Legionnaires’ disease is a disease caused by the legionalla pneumophila bacteria and which was first discovered in 1976 in America. The legionalla bacterium is found in environments which have warm waters for instance the hot tubs and is also found in conditioning systems especially in large buildings. Of importance to also note is that Pontiac fever is also caused by the bacterium that causes Legionnaires’ disease but the fever is milder than Legionnaires’ disease and hence less serious. Though everybody is prone to getting the disease, it is however not communicable and in most cases the disease goes undetected and if the cases are detected, very few cases are reported to the relevant authorities. The disease manifests itself through the following symptoms; patients feeling nauseated, headaches, complete loss of energy, high fever of approximately 1040F and pains in the chest among other symptoms (NHMRC 1998, pp. 5). People who are the risk of getting Legionnaires’ disease are the ones who are exposed to air that contain the Legionellae bacteria which could be in the water droplets (Benson 1992, pp.23). In regard to other researchers, Legionnaires’ disease can also be acquired through taking water that is contaminated with Legionellae and also through the contact of wounds of a patient with the Legionellae contaminated water. This therefore clearly brings out the fact that those people who work in water storage facilities and people taking water which is untreated are more prone to the disease than others. The risk factor for Legionnaires’ disease is dependent on individual’s resistance and the number of Legionellae bacterium that can reach the body. Those people who have a high susceptibility to the disease include persons who are immunocompromised as a result of illnesses for instance cancer, HIV or people also receiving medical treatment for instance chemotherapy. In the presence of other diseases like cancer and HIV, people get infected easily by low levels of Legionellae. People who are above 50 years are also more susceptible to the disease in addition to smokers and people with lung diseases. However, this does not dispute the fact that people who are still healthy can also get infected with the bacterium causing Legionnaires’ disease (Benson 1992, pp.30). Though the bacteria causing Legionnaires disease is found in rivers, fresh waters bodies and lakes, the temperatures in such places is low to the survival of the bacteria but certain risk factors increase the chances for the bacteria to survive and creates god grounds for the bacteria to multiply for instance; In artificial systems of water that have temperatures ranging between 20 – 450C Water which is stored Nutrients that speeds up the multiplication of the bacteria for instance the presence of sludge, rust and algae among others Conditioning systems that utilizes water cooling systems Artificial waters for instance water which is stored or water which is re – circulated Responsibilities placed on Acme Hydrocarbons and contractor Flow Systems. The health and safety of employees is jointly covered in the HSW Act and the subsidiary legislation. For instance, S2 of the HSW Act clearly conveys the statutory responsibilities of Acme Hydrocarbons Ltd towards its employees and the public in general. That is the company must ensure that the employees and the public at large are protected from the operations of the company. HSWA (Health and Safety at Work Act) 1974 and the COSHH (Control of Substances Hazardous to Health Regulations) 1999, gives the guidelines that are to be followed in regard to controlling the risk from legionalla bacteria. Under the HSWA, the risks arising from exposure from Legionella bacteria are covered and the Management of Health and Safety at Work Regulations (MHSWR) provides the framework through which the safety and health of activities at the workplace are controlled. Therefore the responsibility placed on the company under health and safety laws includes; Continuous risk assessments of the workplace Competent employees when putting into application health and safety laws Clear procedures that are to be followed if there was danger in the workplace Coordination between the employers if they happen to share the place of work COSHH provides the framework through which there are actions that are designed in mitigating the risks of hazardous substances and they are as follows; Assessment of risk Preventing exposure to the substance that is deemed hazardous or if possible the use of a procedure, technique or method that is considered less hazardous Controlling exposure where the above measures have failed i.e. prevention and substitution of a hazardous method or process Putting into place control measures for instance maintenance and examination of equipment Training employees, availing information and giving out clear instructions in the site Continuous checkups on employee’s health to prevent the occurrence of diseases which are hard to detect and also ensure that if the disease is detected, it does not go to adverse levels. In Regina v Board of Trustees of the Science Museum, the case summed up the liability that is placed n the employer in regard to the employer’s responsibility towards employees and the public. The Board of Trustees Science Museum was found guilty on the account of exposing the public to risks of Legionella bacteria by the Criminal Division. The Board of Trustees Science Museum had not implemented HSW Act S 3 (1) and thus this case made it clear that, the question was not on whether the risk had actually occurred but whether the employer had done enough to protect the public and the employees. On appeal, the Board of Trustees of the Science Museum for failing to impose the duties which were discharged to it in accordance with the HSW Act S. 3 (1), argued in favor of not breaching the duties imposed on it and which the appeal was dismissed on the grounds that putting people at risk included even the unforeseen dangers. Hence their defense of proving whether members of the public had actually inhaled the bacterium or whether they were conditions favoring the existence of the bacterium which people could inhale flopped. In Regina v Swan Hunter (Duty of host to contractors), the duty of the contractor towards the host is clearly spelt out whereby the employer is to ensure the safety of the contractors, subcontractors, hired workers are properly supervised, have been given clear instructions and are trained in the best of work practices so that they are not a threat to health and also the safety of other employees and the public. Regina v Associated Octel case also cements the need for clear information from the employer to the contractors. In R v. Swan Hunter Shipbuilder and Another (1982), Swam Hunter Ltd were found guilty for violating the Health and Safety Work Act 1974 S. 2 [2] [a], whereby the subcontractors did not receive the book of rules which was circulated by the company even though the employees received the book of rules. Echoing the words of the judge in the ruling of Regina v Swan Hunter (Duty of host to contractors), the employer should expressly ensure that the entire employee team is safe, have clear instructions among others so that they do not jeopardize the health and safety of other employees and also the public. The judge in the case of R v. Swan Hunter Shipbuilder and Another (1982), that the company was in breach of S. 2 [2][C] for failure to provide employees with information and instructions regarding their safety and S. 3 [1] for failing to give protection to the employees. Following the rulings and the decisions arrived at from the above cases by various judges, it is important to note that HSWA S3 places a legal responsibility on the parent company which cannot be passed to another company by means of a contract on the issue regarding the health and safety of a worker and this makes it impossible for Acme Hydrocarbons Ltd to transfer its liabilities to its subcontractors, Flow Systems Ltd (Health and Safety Executive 2002). Question 2 A company dealing with harmful chemicals or disease agents should work in controlled environment to ensure the chemicals or disease agents do not harm the immediate population or the people in the vicinity of any chemical processing plant. In the case of Acme Hydrocarbons this controlled environment should be reflected by adherence to the Control of Major Hazards Regulations 1999 and Control of Substances Hazardous to Health Regulations 2002 (COSHH). According to the information about the Surface water reservoir and the cooling system certain conditions necessary to prevent occurrence of Legionella bacteria are not being met. First, the average circulation rate of the water is far below the specified rate of 48,000 litres per day. To make things worse the rate keeps going down meaning that circulation of oxygen in the almost stagnant water is very low. Also low circulation rates means that the Biocides used to treat the water will not be effective as they will not be able to reach some of the stagnant water parts allowing for optimum condition for development of Legionella bacteria. Furthermore Acme violated the law by not shutting down operation to await arrival of the Biocide. Secondly the amount of Biocide and Water softener added to the reservoirs water is not constant meaning Legionella bacteria can survive when biocide concentrations are optimum for their survival. In the first 6 weeks 20 litres of Biocide were added every week instead of recommended application every two weeks, in the seventh week no biocide was added instead 40 litres were added in the eighth week. To make the situation worse in the 13th, 14th and 15th week no Biocide was added in the water. The amount of water softener added into the reservoir at various periods is also inconsistent. In the first 6 weeks 75 units of water softener were added but in the 8th week no softener was added, while in the 9th week 50 units of softener were used. Between 17th March 2011 and 7th April 2011, 150 units of softener were added only once. Water temperature are observed to increase with reduction in frequency of softener addition and increase in quantity of softener application after prolonged duration of up to 3 weeks. These inconsistencies in the Biocide and softener application in both frequency and dosage point to a possible contamination of the plants water reservoir and effluent with Legionella Bacteria (Sadhra and Rampal 1999). Thirdly, Acme Hydrocarbons and Flow systems ltd show lack of responsibility and disregard of regulation relating to cooling systems and cold water reservoirs by not making sure that components of the treatment system have no physical damage. In the third week the drift eliminator probably the most important equipment in the control of Legionella bacteria was damaged and it had not been repaired for more than 3 weeks showing a disregard of the approved code of Practice and Guideline (ACOP) 98, which makes it a must for the drift eliminator to be operating perfectly. Further analysis also found a number of issues at Acme that could put its workers and residents in the surrounding environment at risk of Legionella bacteria infection. The first issue was the cleaning of filters in the water system which was found to have been done only once within a period of 5 months. Secondly, Acme was releasing water into the river at temperatures above the minimum 20 degrees centigrade. Between 24th February and 26th May no water sample was taken for testing (Freije 2004, pp 218-265). The data from the water treatment log indicate multiple violations of the health and safety regulations and laws. By poor management of water treatment Acme violated the COSHH 2002 and the MHSWR. By failing to adhere to recommended operating conditions Acme violated Section 3(1) of the Health & Safety at Work Act 1974 exposing workers to Legionella bacteria. Secondly, Acme violated Sections 7 of the COSHH regulations by failing to prevent exposure of workers to Legionella Bacteria consistent with the risk assessment. The employees responsible for the water treatment plant also contravened COSHH regulation 8 and 9 by abandoning their responsibility over Legionella Bacteria risk management at Acme Hydrocarbons by not ensuring the drift eliminator was well maintained. Flow systems limited contravened MHSWR regulation 11and 12 by failing to inform Acme Hydrocarbons there was a possibility of an outbreak of Legionella when the drift eliminator got damaged and released water temperatures started rising above 20 degrees (HSE 2003, pp. 7). Question 3 Ivor plant Site manager Acme Hydrocarbons Ltd Strata way Cantaford CN24 1OU To Patrick smith Worldwide chemicals UK health Advisor Pending Health & Safety Advisor 11th July 2011 Dear Patrick smith Re: Inspections of Acme Hydrocarbons Ltd 28th march 2011 I write this letter in regard to the inspection that was carried out in our company (Acme Hydrocarbons limited) on 1st June 2011. The problems which were identified in our organization have been acknowledged, and as a company we intend to implement certain measures as well as improvements on the current condition in the company. Based on the issues as a company we are planning to implement the following measures so as to tackle the issues arising. These measures will include: episodic chlorination of water, automatic dosing as well as timely running of the stand by cooling towers and offering periodic refresher operator training to the operators working in the company. Based on the inspection the drift eliminatory been used is in an imperfect state, so as to solve this issue specialist authorized to repair it so that it can work within the required standards. Also based on the inspection there was some data that was missing in the company record this led to inconsistence of data: in reference to the Acme limited will employ adequately trained staff to manage and monitor their record.  As a company we will strive to review the company’s system design this will eventually lead to the elimination of faults as well as purchase policies thus the avoidance of issues that may arise in the supply of dosing chemicals in the company. Also copper ionization as well as ozone will be used instead of biocide in the cooling towers. The inspection that was carried out identified lack of competence as a major problem in the company, in Acme there are several individuals tasked with the duty of managing the system. Acme will make sure that all those with responsibilities in the management of the system are sentient to their responsibilities and that they work towards the proper alignment of their tasks to the overall management of the system. Acme limited has signed a contract with flow system limited back in December 2010, thus the terms and conditions of the ring fences removes them from bearing responsibilities in regard to their cooling system. I write to this letter to inform you that as the site manager I have a task of ensuring the treatment is done to the required standards (Stuart, 2010:160-200). As a company we have also breached various regulations this regulations include: the health and safety work act of 1974, management of health and safety at work of 1999 and the control of hazardous substances to health 1999. We have really acknowledged that we have breached the above regulations and therefore plan to undertake a comprehensive evaluation so as to deal with the exposure to Legionella bacteria risk assessment, the Legionella bacteria mainly attributed to the core activities of the company and the water systems and the measures and precautions to put in place when solving the problem. When undertaking the risk assessment, I will take into consideration the assistance in the risk evaluation for Legionella bacteria that is available on the water systems as well as the prevention of the risk (Pritchard & Kemshall, 1996: 120-179). In regard to the exposure to biological agents, a series of assessment will be carried out on the company’s cooling system since it has not been previously assessed as required by the regulation 6 of the control of hazardous to health (COSHH Regulations 2002). The cooling system ought to be improved by a review of the approved code of practice which clearly states and outlines the necessary advice in regard to exposure to Legionella in the health and safety in workplace. In essence the code of conduct operates as a guide to sections 6, 2, 4 and 3 of the HSWA and also regulations 6, 7, 8, 9 as well as regulation 12 of the COSHH which was modified by the consumer protection act of 1987, it gave a guidance on conformity with apposite sections of the management of health and safety at work regulations 1999.   The company ought to implement inform the local authority in the area that they are operating in, the notifications should include details of their specific location, notification form that they were given by the local environmental health department and their status of their operations. The company will therefore be seen as abiding to the cooling towers as well as the evaporative condensers regulations of the year 1992 and they will also be obeying regulation 9 of the COSHH 2002. In the Case law of Regina vs. Board of Trustees of the Science Museum, in making the final judgment the court reflected on the duty imposed by Section 3 of Health and Safety at Work Act based on the legal meaning of a risk. The Act states that employers have a responsibility to undertaking his business operations in a reasonable as well as in a practical way so as to protect the general public health as well as safety. In reference to this the museum we worthy of the prosecution due to their failure in maintaining their air conditioning system and this is termed as a major predisposing factor to the legionnaires disease though there was no evidence that there was any one who had contracted the disease. In relation to the 2002 The 2002 Barrow in Furness Legionnaires’ disease outbreak, Acme Hydrocarbons Ltd should not be prosecuted. I look forward to hearing from you. Regards Ivor Plant References Pritchard, J & Kemshall, H. (1996). Good practice in Risk Assessment and Risk Management. London: Jessica Kingsley Publishers. pp 120-179. Stuart, S. (2010). Design Risk Management: Contribution to Health and Safety. Lowa: Blackwell. pp 160-200. Health and Safety Executive (HSE) 2003, Legionnaire’s Disease: Control of Legionella Bacteria in Water Systems: Audit Checklists (Leaflet) Freije, M. R. 2004, Minimizing Conditions for Legionella and Other Bacteria in Plumbing Systems, HC Information Resources Inc, London. Sadhra, S.S. & Rampal, K.G. 1999, Occupational Health: Risk Assessment and Management, Government Institutes, London. NHMRC (National Health and Medical Research Council). 1988, Australian guideline for The control of Legionella and Legionnaires’ disease. Canberra: Australian Government Publishing Service. Benson, RF.1992, Direct immunofluorescent antibody examination for Legionella Species. In: Isenberg HD, ed. Clinical microbiology procedures handbook, Vol. 2, Washington DC: American Society for Microbiology. Health and Safety Executive. 2002. Legionnaire’s Disease. The control of Legionella bacteria in water systems Approved Code of Practice and guidance. [Online] at: http://www.pwtag.org/researchdocs/Used%20Ref%20docs/41%20HSE%20ACOP%20legionella.pdf . Retrieved on 1st May, 2012. Read More