Real-Time Continuous Surveillance of Temperature and Flow Events Presents a Novel Monitoring Approach for Hospital and Healthcare Water Distribution Systems

Harriet Whiley, Jason Hinds, James Xi and Richard Bentham
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Harriet Whiley: College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
Jason Hinds: Enware Australia Pty Ltd., 11 Endeavour Road, Caringbah, NSW 2229, Australia
James Xi: Enware Australia Pty Ltd., 11 Endeavour Road, Caringbah, NSW 2229, Australia
Richard Bentham: College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia

IJERPH, 2019, vol. 16, issue 8, 1-8

Abstract: Within hospitals and healthcare facilities opportunistic premise plumbing pathogens (OPPPs) are a major and preventable cause of healthcare-acquired infections. This study presents a novel approach for monitoring building water quality using real-time surveillance of parameters measured at thermostatic mixing valves (TMVs) across a hospital water distribution system. Temperature was measured continuously in real-time at the outlet of 220 TMVs located across a hospital over a three-year period and analysis of this temperature data was used to identify flow events. This real-time temperature and flow information was then compared with microbial water quality. Water samples were collected randomly from faucets over the three-year period. These were tested for total heterotrophic bacteria, Legionella spp. and L. pneumophila . A statistically significant association with total heterotrophic bacteria concentrations and the number of flow events seven days prior ( rs [865] = −0.188, p < 0.01) and three days prior to sampling ( rs [865] = −0.151, p < 0.01) was observed, with decreased heterotrophic bacteria linked to increased flushing events. Only four samples were positive for Legionella and statistical associations could not be determined; however, the environmental conditions for these four samples were associated with higher heterotrophic counts. This study validated a simple and effective remote monitoring approach to identifying changes in water quality and flagging high risk situations in real-time. This provides a complementary surveillance strategy that overcomes the time delay associated with microbial culture results. Future research is needed to explore the use of this monitoring approach as an indicator for different opportunistic pathogens.

Keywords: Legionella; Pseudomonas; non-tuberculous mycobacteria; healthcare; opportunistic waterborne pathogens; water quality; water management; public health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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