In 1976, more than 200 hotel guests — in Philadelphia to celebrate the anniversary of the Declaration of Independence — became victims of a new malady, what came to be known as Legionnaires’ Disease. Over 220 were hospitalized, and 34 died after being stricken with what originally was thought to be pneumonia.
It’s 40 years later, and Legionella Bacterium remains a threat throughout the US. Each year, 8,000 to 18,000 people contract the disease. It can be treated with antibiotics, but if left too long can be fatal. Even after successful treatment, patients often suffer complications. Recent outbreaks include:
- Hospital in Columbus, Ohio: In May 2019, 16 cases were reported among patients of a local area hospital that just opened in April. One 75-year old woman died.
- Racetrack in West Virginia: In May 2019, 17 people at a horse track came down with the disease — 10 were diagnosed with Legionnaires’ and 7 with Pontiac fever. A locker room hot tub was the source.
- Prison in Stockton CA: In March 2019, two inmates at a correctional facility were diagnosed with Legionnaires’ disease and one died. After another 18 became ill with the same symptoms, the facility water systems were shut down and prisoners provided with bottled drinking water.
- Municipal water supply in Union County, NJ: In May 2019, 22 people were diagnosed with Legionnaires’ in an outbreak where 5 died. The only common link was that each was a resident or recent visitor to Union County.
Legionnaires’ Disease defined
According to the World Health Organization (WHO), outbreaks result from exposure to legionella bacterium that resides within water systems. “The source of transmission is inhalation of contaminated aerosols that have been linked with: hot tubs, whirlpool spas, swimming pools, in-room wet bars and kitchens, plumbing systems, decorative fountains, drinking water systems, hot water tanks and cooling towers.” The bacteria is transmitted to people via mist or spray and aspirated into the lungs
Who is most at risk?
According to the Cleveland Clinic, those most at risk are:
- People over 50
- Smokers
- Those with weakened immune systems from conditions like COPD, cancer, kidney failure or diabetes
- Individuals suffering from chronic lung disease
Lessons learned
Organizations like ASHRAE (formerly the American Society of Heating, Refrigerating, and Air Conditioning Engineers) have taken steps to help prevent the spread of Legionella.
ASHRAE designed the voluntary consensus Standard ASHRAE 188 as a framework for managing building water systems and reducing the potential for Legionella growth. In 2018, the code was updated as ANSI/ASHRAE Standard 188-2018, Legionellosis: Risk Management for Building Water Systems to “establish minimum Legionellosis risk management requirements for building water systems.” It further states that building owners and facility managers are now responsible for implementing Water Management Plans that will keep building water systems free of Legionella contamination.
Mitigate liability with a solid water management plan
Today, most insurance companies require commercial clients to have one in place. As a leading insurance broker and risk management services firm, Gallagher develops plans specific to property and location. We monitor and document plans with periodic testing.
To be effective, plans must consider all water systems in and around the property — and include action items such as: disinfection and flushing of new plumbing systems, daily water temperature and chemical checks of running water, changing ice machine filters, and cleaning behind shower heads, to name a few.
We can recommend professionals to help develop a water management plan and document it. This keeps the program firmly in place and the corporate entity accountable.
General Liability vs. Environmental Policy
Adequate insurance coverage is a must. People are surprised to learn that their general liability policy doesn’t cover Legionnaires’ disease. Their insurance company requires an environmental policy to cover the exposure. Gallagher has had great success with underwriters to put the coverage under general liability, providing coverage for third-party bodily injury and business interruption if the entity loses sales or the property shuts down. If covered under general liability, the coverage falls under the umbrella policy, which has a higher liability limit. If not, environmental coverage comes into play with lower liability limits.
Bottom line
Legionnaires’ disease is a potential risk to any facility where water systems are present. A water management plan, well implemented and documented, coupled with solid liability coverage, can go a long way to mitigate risk to both users and organizations.