Legionnaires disease is caused by the infection of a gram –ve bacterium Legionella Pnuemophilia. It has been found up to 6kms away from the source of the infection and is airborne. It thrives at an optimum temperature of 25-45degrees centigrade.
In 1985 175 people were admitted to Stafford Hospital with the disease, 28 died. The source was traced to an air conditioning cooling tower that was on the hospital roof. Surprisingly at the time those infected were mainly out patients at the hospital and the hospital staff were not affected. It was later found that those who came into continual contact had developed antibodies to the disease, whereas the transient visitors to the hospital had not.
Legionnaires disaese presents itself as flu like symptoms 2 to 10 days after exposure and the disease has a fatality rate of 5-30%. This fatality rate can be dramatically reduced by the early provision of antibiotics. In 2002 Barrow- In –Furness Borough Council was convicted of corporate manslaughter after an outbreak in a council building, firmly attributing responsibility to those in charge of the building at the time.
Legionnaires disease is an issue for the dental practice and the dentist principals. Dentists have a legal and social responsibility to their patients. Dental practices are particularly at risk of an outbreak due to the continual stream of patients to the building, the use of air conditioning units, dental waterlines, compressed air and tap water. Legionella risk assessments should be carried out as outlined by The Health and Safety at Work Act 1974 and COSHH regulations 2002.
A management and communication structure should be established to control Legionella exposure. As with all issues of regulatory compliance it is easier and less time consuming to employ a consultancy firm.
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