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Legionnaires cases on the rise

15 June 2007

2006 saw the recorded cases of Legionnaires' disease in England and Wales hit a new high. Mark Carter explains the reasons why.

Figures from the National Surveillance Scheme for Legionnaires Disease show that between 1980 and 2001 the average number of cases was 182. Over this 22 year period, on only eight occasions did this figure rise above 200, and three of these (1985, 1988 and 1989) were years of highly publicised outbreaks (Staffordshire Royal Infirmary, BBC and Piccadilly Circus, respectively).

Between 2002 (the year after the Barrow outbreak) and 2005 the total number of cases in each of the four years was over
300 and averaged at 344, an increase on the previous average of 189 per cent. Although not officially published at the time of writing, provisional figure for 2006 looks to be over 540 cases.

While travel abroad contributes to about half of the cases year on year, this figure has not substantially changed with the exception of 2006, where provisional figures indicate that less than 30 per cent of the cases were travel associated. This in turn means that the number of community acquired infections in England and Wales has grown significantly.

The factors that made last year notable for its climate patterns may have had a contributory hand in this rise too. Certainly the reduction in available water, coupled with the warmer temperatures, could conceivably have lead to an increase in the overall numbers of bacteria populating our open water systems.

Possibly of more effect than these conditions is how we operate the water systems and services within our buildings.The change over from summer to winter heating, and vice versa, was less easy to predict as systems were required to operate for longer at higher loading. Both of these factors, plus others, cause shifts in the operational status quo, which if not accommodated for could lead to loss of control. However, this in itself does not adequately explain the longer term trend from 2002.

An alternative explanation here could stem from the broader corporate strategy for outsourcing non core/critical functions to third parties, with the belief that the responsibility goes with it. While for some functions this may be true, for the majority, and in particular H&S, although you can delegate the task, the corporate body always retains the overall responsibility. However, it is still common to see third parties being tasked with risk assessments and management, which in turn are often subcontracted, taking the whole process to a level in the supply chain where it becomes invisible.

Even where the management is active, the majority of emphasis is placed on data collection, in terms of testing,sampling and inspection, rather than the information this provides and hence the knowledge of how effective the management is in controlling risk.

The evidence brought to light about the cause of the Barrow in Furness outbreak of legionella sadly reflects many of these points, but should serve as a clear demonstration of what can happen. There are many companies in England and Wales who have good, robust systems in place. There are more who believe they have systems in place, but just donft really know.
..Mark Carter is marketing manager at environmental consultants, ems


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