Welcome to issue 30; this month we continue with part 5 of our serialisation of the UK's primary Legionella control document, the Health and Safety Commission’s Approved Code of Practice (ACoP) "Legionnaires' disease: The control of legionella bacteria in water systems" (L8)", with extracts dealing with management responsibilities, training and overall competence. We also feature an excellent guide that deals with the new “super bug”, Clostridium difficile, and look at how the environmental performance of commercial kitchens and restaurants can be significantly improved with the introduction of grease traps.

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In this issue:

• Is this the new "super bug"? Clostridium difficile - a simple guide.
• Part 5 - The UK's Approved Code of Practice (ACoP) and Guidance "Legionnaires' disease: The control of legionella bacteria in water systems" (L8).
• Improving environmental performance using a grease trap.
  

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Is this the New "Super Bug"?

Clostridium Difficile - A Simple Guide

This guide explains what Clostridium difficile is, how it developed and ways in which it can cause infection.

Clostridium difficile is the major cause of antibiotic-associated diarrhoea and colitis, a healthcare associated intestinal infection that mostly affects elderly patients with other underlying diseases.

Background

C. difficile is a bacterium of the family Clostridium (the family also includes the bacteria that cause tetanus, botulism, and gas gangrene). It is an anaerobic bacterium (i.e. it does not grow in the presence of oxygen) and produces spores that can survive for a long time in the environment.

Its usual habitat is the large intestine, where there is very little oxygen. It can be found in low numbers in a small proportion (less than 5%) of the healthy adult population. It is kept in check by the normal, ‘good’ bacterial population of the intestine. It is common in the intestine of babies and infants, but does not cause disease because its toxins (poisons) do not damage their immature intestinal cells.

Although C. difficile was first described in the 1930s, it was not identified as the cause of diarrhoea and colitis following antibiotic therapy until the late 1970s.

What does it cause?

C. difficile can cause diarrhoea, ranging from a mild disturbance to a very severe illness with ulceration and bleeding from the colon (colitis) and, at worst, perforation of the intestine leading to peritonitis. It can be fatal.

Generally, it is only able to do this when the normal, healthy intestinal bacteria have been killed off by antibiotics. When not held back by the normal bacteria, it multiplies in the intestine and produces two toxins (A and B) that damage the cells lining the intestine. The result is diarrhoea.

Who gets C. difficile infection?

Patients who have been treated with broad spectrum antibiotics (those that affect a wide range of bacteria, including intestinal bacteria) are at greatest risk of C. difficile disease. Most of those affected are elderly patients with serious underlying illnesses. Most infections occur in hospitals (including community hospitals), nursing homes etc, but it can also occur in primary care settings.

How does it spread?

Although some people can be healthy carriers of C. difficile, in most cases the disease develops after cross infection from another patient, either through....more >>

Extracted from a guide originally published by the Department of Health - © Crown copyright

For your complimentary copy of this excellent guide please e-mail info@accepta.com quoting the full title of the document.

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Approved Code of Practice Part 5

Approved Code of Practice (ACoP) and Guidance

"Legionnaires' disease: The control of legionella bacteria in water systems" (L8)

Managing the risk: management responsibilities, training and competence.

Regulations

• Control of Substances Hazardous to Health Regulations 1999, Regulations 8 and 12.
• Health and Safety at Work etc. Act 1974, Sections 2, 3 and 4.
• Management of Health and Safety at Work Regulations 1999, Regulation 5.

ACOP

39 - If the assessment shows that there is a reasonably foreseeable risk and it is reasonably practicable to prevent exposure or control the risk from exposure, the person on whom the statutory duty falls (see paragraph 23) should appoint a person or persons to take managerial responsibility and to provide supervision for the implementation of precautions.

40 - Persons who carry out the assessment and who draw up and implement precautionary measures should have such ability, experience, instruction, information, training and resources to enable them to carry out their tasks competently and safely. In particular, they should know:

(a) potential sources and the risks they present;

(b) measures to be adopted, including precautions to be taken for the protection of people concerned, and their significance; and

41 - Where the above expertise is not possessed by the person or persons appointed under paragraph 39, it may be necessary to enlist help and support from outside the organisation. In such circumstances, the person or persons appointed under paragraph 39 should take all reasonable steps to ensure the competence of those carrying out work who are not under their direct control and that responsibilities and lines of communication are properly established and clearly laid down.

42 - Management and communication procedures should be periodically reviewed as appropriate.

Guidance

43 - Inadequate management, lack of training and poor communication have all been identified as contributory factors in outbreaks of Legionnaires’ disease. It is therefore important that those people involved in assessing risk and applying precautions are competent, trained and aware of their responsibilities.

44 - The duty holder (see paragraph 23) should appoint a person to take day-to-day responsibility for controlling any identified risk from Legionella bacteria. The appointed ‘responsible person’ should be a manager, director, or have similar status and sufficient authority, competence and knowledge of the installation to ensure that all operational procedures are carried out in a timely and effective manner. If a duty-holder is self-employed or a member of a partnership, and is competent, they may appoint themselves. The responsible person should have a clear understanding of their duties and the overall health and safety management structure and policy in the organisation. Further guidance is given in Successful health and safety management HSG65.3

Competence

45 - Those who are appointed to carry out the control measures and strategies should be suitably informed, instructed and trained and their suitability assessed. They should be properly trained to a standard which ensures that tasks are carried out in a safe, technically competent manner. Regular refresher training should be given and records of all initial and refresher training need to be maintained. Although training is an essential element of competence, it is not the only factor – it should be viewed as is a product of sufficient training, experience, knowledge and other personal qualities which are needed to undertake a job safely. Competence is dependent on the needs of the situation and the nature of the risks involved.

Implementation of the control scheme

46 - The implementation of the system control scheme should be regularly and frequently monitored and everyone involved in any related operational procedure should be properly supervised. Staff responsibilities and lines of communication should be properly defined and clearly documented.

47 - Arrangements should be made to ensure that appropriate staff levels are maintained during all hours that the water system is in operation. The precise requirements will depend on the nature and complexity of the water system. In some cases, for example where there is complex cooling plant, shift working and arrangements to cover for all absences from duty, for whatever reason, may be necessary. Appropriate arrangements should be made to ensure that the responsible person or an authorised deputy can be contacted at all times.

48 - Call-out arrangements for people engaged in the management of water systems which operate automatically also need to be made. Details of the contact arrangements for emergency call-out personnel should be clearly displayed at access points to all automatically or remotely controlled water systems.

49 - Communications and management procedures are particularly important where several people are responsible for different aspects of the operational procedures. For example, responsibility for applying precautions may change when shift-work is involved, or when the person who monitors the efficacy of a water treatment regime may not be the person who applies it. In such circumstances, responsibilities should be well defined in writing and understood by all concerned. Lines of communication should be clear, unambiguous and audited regularly to ensure they are effective. This also applies to outside companies and consultants who may be responsible for certain parts of the control regime.

50 - The employment of contractors or consultants does not absolve the duty holder of responsibility for ensuring that control procedures are carried out to the standard required to prevent the proliferation of Legionella bacteria. Organisations should make reasonable enquiries to satisfy themselves of the competence of contractors in the area of work before entering into contracts for the treatment, monitoring, and cleaning of the water system, and other aspects of water treatment and control. More general information on selecting a health and safety consultancy can be found in a free HSE leaflet.4

51 - An illustration of the levels of service which should be expected from service providers can be found in the Code of Conduct developed jointly by the Water Management Society and the British Association for Chemical Specialities (WMS/BACS).5 The Code of Conduct does not have any legal status under health and safety law, but should help occupiers choose a suitable service provider to help them control the risks from Legionella bacteria.

Extracted with permission from "Approved Code of Practice (ACoP) and Guidance "Legionnaires' disease: The control of Legionella bacteria in water systems" (L8)" © Crown copyright

more next time.....>>

About Legionella Training

For information about Accepta's specialist Legionella training courses please call us on +44 (0) 161 240 2100 or email info@accepta.com.

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Improving Environmental Performance

Using a Grease Trap

A good quality, well designed grease trap can help to significantly improve the overall environmental performance of commercial kitchen facilities and restaurants by reducing the levels of solid organic waste, grease and fats discharging into the local sewer system. This helps in several ways, by improving the quality of wastewater discharges, minimising unpleasant odours and reducing costly drain cleaning call-out charges, to name but a few.

Accepta’s range of high quality stainless steel grease traps have been developed to do just that. Once installed these grease traps significantly improve the performance of domestic, commercial and industrial drainage systems by minimising the problems caused by the unwanted accumulation of waste solids, grease and fats. Constructed from high quality stainless steel, Accepta’s grease traps incorporate an innovative high performance mesh system that acts to effectively filter out solid organic waste before it enters the drainage system, minimising its impact on drains, pipes, interceptors and wastewater discharge quality.

Benefits

Accepta’s high performance grease traps offer a number of significant benefits including:

• Minimise disruption and drain cleaning call-out charges.
• Better environmental performance - improved wastewater discharge quality.
• High performance stainless steel mesh system to filter out soild organic waste.
• Eliminate unwanted odours.
• Easy to maintain - quick and easy to inspect and clean with quick release watertight lid and lift-out filter basket.
• Corrosion free, high quality stainless steel (type 304) construction with fully welded seams for improved strength and durability.
• Can be used either internally or externally.
• Easy installation – uses standard “Multifit” connections.
• 2 year warranty.

Applications

Accepta’s range of grease and fat traps are suitable for most domestic, industrial and commercial applications including:

• Restaurants.
• Hotels and guest houses.
• Pubs, bars and cafes.
• Commercial kitchens.
• Fast food restaurants and takeaways.
• Bakeries.
• Food processing.
• Hospitals and healthcare facilities.
• Manufacturing operations.
• Industrial process applications and many more…

For further details about how Accepta's grease traps work, how to calculate the size of a grease trap, installation and maintenance instructions please click here >>