Annual Education Conference
In 2015, there were approximately 6,000 cases of Legionnaires’ disease reported, according to the CDC. Additionally, the rate of legionellosis cases reported quadrupled from 2000 to 2014. Because the disease is often underdiagnosed, this number is most likely an underestimate of the true number of cases. Legionella is bacteria that is naturally-occurring in fresh water aquatic systems and becomes a risk when it enters human-made water and plumbing systems. It thrives in warm water environments and is known to grow in hot tubs, spas, pools, fountains, ice machines, and faucets.
The Legionella bacteria was first discovered in 1976 in Philadelphia during an American Legion Convention. Many participants at the convention became ill with a type of pneumonia, which was later found to be caused by the respiration and inhalation of water droplets containing the Legionella bacteria.
The respiration or inhalation of water droplets or aerosols containing the bacteria can lead to community-acquired pneumonia, or Legionnaires’ disease along with Pontiac Fever which is a milder form of legionellosis that presents flu-like symptoms. There are over 60 species of Legionella, with six different serogroups that can cause disease in humans but most cases of legionellosis are caused by Legionella pneumophila serogroup 1, the pneumonic form of Legionella.
Environmental Health Significance
Because Legionella is a recently-emerging environmental health issue, the resources and materials available to address the concerns presented by the bacteria are insufficient. The significant increase in reported legionellosis cases over the last two decades results in a demand for more comprehensive public and environmental health programs to target the risks associated with Legionella. In addition, further education and training for public and environmental health professionals around building water systems and premise plumbing is necessary to develop programs for preventing and mitigating these risks.
NEHA conduct an environmental scan of existing Legionella programs in health departments at both the local and state levels to gain more information about current programs, the components of effective programs, and the resources and tools that programs are currently lacking. Ultimately, this information will be used to develop methods for best practices and to identify model Legionella programs components for environmental health departments.
What roles do environmental health programs play in the prevention and investigation of Legionella?
In many instances, environmental health programs serve as a nexus - bringing together information from academia, industry, clinicians, and the community to address environmental issues that impact public health. This is especially true with legionella -- where ongoing research, diagnosis, and industry practices evolve daily. NEHA in continuing to engage all of these sectors in identifying and developing best practices, impactful partnerships, and applying the latest research. Our initial scan has identified the following needs and core competencies needed for a well -rounded program.
Necessities of a functioning program:
New and Upcoming Resources
- NEHA's Annual Educational Conference and Exhibition (AEC) June 2018
- 6/27/2018 8:00AM-9:50AM
Environmental health expertise is key to preventing and investigating outbreaks of Legionnaires’ disease. CDC investigations show that almost all Legionnaires’ disease outbreaks were caused by problems in building water systems preventable with more effective water management. Join CDC for an interactive, mock outbreak scenario, to develop environmental health skills to assist in the prevention of Legionnaires’ disease.
Presenter: Jasen Kunz
CDR Jasen Kunz, MPH, REHS is an environmental health subject matter expert for Legionnaires’ disease prevention and response at CDC’s National Center for Environmental Health/ Environmental Health Services Branch. CDR Kunz also co-leads CDC’s Model Aquatic Health Code program.
- 6/27/2018 8:00AM-9:50AM
- Webinar: How Enviromental Health Programs are Impacting Legionella Outbreaks
- Coming in July 2018!
- Online Course: Preventing Legionnaires’ Disease: A Training on Legionella Water Management Programs
- Coming late Summer 2018
- CDC Water Management Program Toolkit
- CDC Legionella Information
- EPA Legionella Literature Review
- ASHRAE Standard 188 – Legionellosis Risk Management
- 2017 Centers for Medicaid and Medicare Services (CMS) Requirement to Reduce Legionella Risk in Health Care Facilities
CDC Legionnaires' Disease Factsheet
EnviroAtlas is a web-based decision support tool that combines maps, analysis tools, downloadable data and informational resources that states, tribes, communities and individuals can use to help inform policy and planning decisions that impact the places where people live, learn, work and play.
Vote on the Code!
The Model Aquatic Health Code provides national guidance for the creation and updating of aquatic facility regulations around the country. The Council for the Model Aquatic Health Code (CMAHC) works to regularly update the MAHC through the collection and analysis of code change requests. This allows for the collection and analysis of data-driven, science-based information from public health and aquatic industry experts and helps to keep the MAHC current, sustainable, easily understood and implemented.
Every other year, The CMAHC invites public health and industry leaders to gather at the Vote on the Code Biennial Conference for discussion and member voting on new language and content for the MAHC. The next vote is coming up this October 17 & 18th at the Vote on the Code Conference, held in conjunction with the World Aquatic Health Conference. This year, there are 179 change requests that are up for voting by the CMAHC membership. NEHA has reviewed the requests and identified 66 that likely or possibly have environmental public health impacts. An overview of those change requests can be found below or printed for an easy voting reference. A larger voting guide for the environmental public health elements is also available,which includes the rationale for the decision and future action to be taken. The full listing of all change requests is also available.
Relevance to Environmental Health
|184.108.40.206.2-0001||Revises definition for paint as indoor VOC vapor retarder.||Possible||YES||YES|
|220.127.116.11.3.1-0001||Revises language around air handling system codes.||Possible||NO||NO|
|18.104.22.168.5-0001||Adds latching to door reference.||Possible||YES||YES|
|22.214.171.124-0001||Revises language for aquatic venue shape.||Possible||YES||YES|
|126.96.36.199-0001||Further defines swimouts.||Possible||YES||YES|
|4.5.4-0001||Standardizes stair requirements.||Possible||YES||YES|
|188.8.131.52-0001||Standardizes stair requirements.||Possible||YES||YES|
|184.108.40.206-0001||Standardizes stair requirements.||Possible||NO||NO|
|220.127.116.11-0001||Clarifies language for projections/obstructions.||Possible||YES||YES- as modified|
|18.104.22.168-0001||Improves underwater bench definition.||Possible||NO||NO|
|22.214.171.124-0001||Limits hydrotherapy jets to spas and therapy pools.||Possible||NO||NO|
|126.96.36.199-0001||Clarifies definition of underwater ledges.||Possible||NO||NO|
|4.5.18-0001||Eliminates allowance for underwater shelves.||Likely||NO||NO|
|188.8.131.52.6.2-0001||Adds requirement for rope designation between pool areas.||Possible||NO||NO|
|184.108.40.206.4-0001||Clarifies depth marker units.||Possible||NO||NO|
|220.127.116.11.1-0001||Clarifies lighting requirements.||Possible||NO||NO|
|18.104.22.168.2.1.4-0001||Adds annex section on SCRS devices.||Possible||YES||YES|
|4.7.3.-0001||Adds allowance for new filtration technology.||Possible||NO||NO|
|22.214.171.124.1.3-0001||Protocols to mitigate chlorine gas exposure.||Likely||YES||YES|
|126.96.36.199.1.3-0002||Eliminates loopholes for chemical feeder requirements.||Likely||NO||NO|
|188.8.131.52.2.2-0003||Eliminates free available chlorine dosing requirement.||Possible||YES||YES|
|184.108.40.206.2.3-0002||Eliminates free available chlorine dosing requirement.||Possible||YES||YES - as modified|
|220.127.116.11.1.2-0001||Provides alternatives to secondary disinfection for small pools.||Possible||NO||NO|
|18.104.22.168.2-0001||Change secondary disinfection requirements.||Possible||YES||YES- as modified|
|22.214.171.124.2-0002||Clarifies full flow treatment.||Possible||YES||YES- as modified|
|126.96.36.199.3.3-0001||Require UV secondary treatment for splash/spray areas.||Likely||YES||YES- as modified|
|188.8.131.52.3.4-0001||Require shutdown if UVT is less than minimum transmissivity.||Likely||YES||YES- as modified|
|184.108.40.206.5-0001||Secondary treatment filtration options.||Possible||NO||NO|
|220.127.116.11.1-0001||Clarify language on filtration.||Possible||YES||YES|
|18.104.22.168.7-0001||Limits wing wall use.||Possible||NO||NO|
|22.214.171.124.4-0002||Stair requirement for 3m diving stands.||Possible||NO||NO|
|4.8.4-0001||Stair requirement for pool slide.||Possible||NO||NO|
|126.96.36.199.2-0002||Clarifies lifeguard chair requirements.||Possible||NO||NO|
|188.8.131.52.7-0002||Additional latching requirements.||Possible||YES||YES|
|184.108.40.206.2-0002||Adapts lazy river lifeguarding operations.||Possible||YES||YES|
|220.127.116.11.1.1-0001||Protocols to mitigate chlorine gas exposure.||Likely||YES||YES|
|18.104.22.168.1.1.3-0001||Protocols to mitigate chlorine gas exposure.||Likely||NO||NO|
|22.214.171.124.4.1.1-0001||Protocols to mitigate chlorine gas exposure.||Likely||YES||YES- as modified|
|126.96.36.199.3-0001||Add requirements for stabilizer certification.||Possible||YES||YES- as modified|
|188.8.131.52.3.2-0001||Lower CA stabilizer limit.||Likely||ABSTAIN||YES|
|184.108.40.206.5.1-0001||Add requirement for pool grade salt.||Possible||YES||YES- as modified|
|220.127.116.11.2-0001||Addition for ozone generator feedback.||Possible||NO||NO|
|18.104.22.168.2.6-0001||Compressed oxygen NSF 50||Possible||NO||NO|
|22.214.171.124.2-0001||Add NSF/ANSI certification requirement.||Possible||YES||YES- as modified|
|126.96.36.199.1-0001||Reduce minimum pH to 6.8.||Possible||NO||NO|
|188.8.131.52.2-0001||Add NSF/ANSI certification requirement.||Possible||YES||YES|
|184.108.40.206.8-0001||Require continuous monitoring of UVT.||Possible||YES||Yes|
|220.127.116.11-0001||Notation of FAC or ORP/HRR prior to opening each day.||Possible||NO||NO|
|18.104.22.168.1-0001||Addresses lifeguard UV exposure.||Possible||YES||YES|
|22.214.171.124.2-0001||Provides guidance on spinal injury board construction.||Possible||YES||YES|
|126.96.36.199.9-0002||Ensure provision of needed lifeguard equipment.||Possible||YES||YES|
|188.8.131.52-0001||Ensure easy access to lifejackets.||Likely||YES||YES|
|6.0.1-0001||Protocols to mitigate chlorine gas exposure.||Likely||YES||YES|
|184.108.40.206.1-0001||Protocols to mitigate chlorine gas exposure.||Likely||NO||NO|
|220.127.116.11.6.3-0001||Ensure lifeguard instructors maintain high training quality.||Possible||NO||NO|
|18.104.22.168.6.4-0001||Ensure lifeguard instructors maintain high training quality.||Possible||NO||NO|
|22.214.171.124.3-0001||Ensure lifeguard instructor is present for entire course.||Possible||YES||YES|
|126.96.36.199.5-0001||Protocols to mitigate chlorine gas exposure.||Likely||NO||NO|
|6.3.2-0001||Clarifies needed number of lifeguards.||Possible||YES||YES|
|188.8.131.52-0001||Facility attributes requiring qualified lifeguards.||Possible||YES||YES|
|184.108.40.206-0002||Facility attributes requiring qualified lifeguards.||Possible||NO||NO|
|220.127.116.11.1-0001||Clarifies needed number of lifeguards.||Possible||YES||YES|
|18.104.22.168.3-0001||Protocols to mitigate chlorine gas exposure.||Likely||YES||YES|
|22.214.171.124-0001||Protocols to mitigate chlorine gas exposure.||Likely||YES||YES- as modified|
|126.96.36.199.1-0001||Alter crypto/diarrhea hyperchlorination protocol.||Possible||YES||YES|
|188.8.131.52-0002||Protocols to mitigate chlorine gas exposure.||Likely||NO||NO|
Tribal Water Program Improvement Resource Kit
The resources collected below can be useful in creating or improving private drinking water programs.
For environmental health professionals or homeowners that are new to private drinking water wells, we recommend taking free Private Well Class. The Private Well Class is being provided to NEHA at no-charge by the Illinois State Water Survey and the Illinois Water Resources Center at the University of Illinois. The funding for the Private Well Class program comes from the USEPA through a cooperative agreement with the Rural Community Assistance Partnership. Originally intended for well owners, this course has proven to be a resource for EH professionals for basic well and groundwater understanding. The class consists of 10 courses that can be taken in sequence or individually and are eligible for one (1) CE each from NEHA.
Community Outreach & Risk Communication
Partnership & Stakeholder Development
Policy & Regulation Development
Private Well Testing & Test Interpretation
Community Environmental Health Assessments
A webinar series for representatives of state environment and health agencies, tribes, local governments, communities, and others interested in learning about EPA tools and resources available to help inform decision-making.
The montly webinar series is providing a forum for EPA to communicate directly with state personnel and other drinking water small systems professionals, which allows EPA to provide training and foster collaboration and dissemination of information.
This month: Decision Support Methodology for Small Systems to Evaluate and Select Treatment Technologies.
The annual fall meeting of the NYS Conference of Environmental Health Directors is scheduled to be held at the Hampton Inn & Suites Conference Center in Cazenovia, New York. The meeting format includes a full day technical session on current environmental health issues and regulatory updates, followed by a half day business meeting providing member committee reports.
Less than 2 months remain until the 2017 Southern California Joint Technical Symposium on Wednesday, October 18th, 2017 at our New Location The Carson Center in Carson, California.
There is still time to take advantage of discounted early bird rates:
- Attendee Registration (save $50)
- Exhibitor Registration (save $100)
- There are also Sponsor & Exhibitor Opportunities
Discounts are available for Groups of 3+ attendees, save $100, e-mail firstname.lastname@example.org for more details.