Control of Legionella Regulations, 2006

L.N. 5 of 2006

PUBLIC HEALTH ACT, 2003

(ACT NO. XIII of 2003)

Control of Legionella Regulations, 2006

IN exercise of the powers conferred by article 26 (i) of the Public

Health Act, 2003, the Minister of Health, the Elderly and Community

Care has made the following regulations>-

The title of these regulations is the Control of Legionella Title.

Regulations, 2006.

In these regulations, unless the context otherwise requires>-

FREKWENZI TA ’ SPEZZJONI RAKKOMANDATI GĦALL - EVALWAZZJONI TA ’ RISKJU

LISTA TA ’ KONTROLLI 1: INSTALLAZJONIJIET GĦAT - TKESSIĦ TA ’ L - ILMA

SISTEMA / SERVIZZI

INKARIGU

FREKWENZA

Cooling tower u

Monitoraġġ tal-kwalità ta’ l-ilma, l-użu ta’ l-ilma u l-użu

Kull sitt xhur

kondensaturi

ta’ bioċida/kimika biex tiġi evalwata u żgurata l-effettività

evaporattivi

tar-reġim tat-trattament ta’ l-ilma, inklużi l-parametri

ewlenin kimiċi u mikrobioloġiċi u osservazzjonijiet tal-

kondizjoni interna ta’ l-għadira, pack u ilma

Funzjoni ta’ kontroll ċentrali, kalibrazzjoni tas-sensor

Kull xahar sa tlett

konduttiv, funzjoni ta’ blowdown, uniformità fid-

xhur, skond ir-riskju

distribuzzjoni ta’ l-ilma, il-kundizzjoni ta’ sprays/troughs,

eliminators, pack, għadira, immersion heaters, fann u

apparat li-jtaffi l-ħoss

Tindif u disinfettar ta’ cooling towers/kondensaturi

Kull sitt xhur

evaporattivi, make up tanks u sistemi assoċjati, inklużi l-

uċuħ mxarrba kollha, hekk li titnehħa l-ġebla kollha fejn

dan ikun meħtieġ.

Il-packs għandhom jiġu maqlugħa u mnaddfa meta dan

ikun prattikabli

LISTA TA ’ KONTROLLI 2: SERVIZZI TA ’ ILMA SĦUN U KIESAĦ

SERVIZZI

INKARIGU

FREKWENZA

Servizzi ta’ ilma sħun

Agħmel mezz li l-kampjuni jittieħdu mil-heaters ta’ l-ilma

Kull sitt xhur

sħun, biex tiġi osservata l-kondizzjoni ta’ l-ilma mid-

drain.

Ivverifika t-temperaturi tal-flow u irritorn fil-calorifiers

Kuljum

Ivverifika t-temperatura sa minuta biex tara jekk tkunx

Kull gimgħa

laħqet il-50 o C fis-sentinal taps

Ivverifika viżwalment l-uċuħ interni tal-water heaters

Kull sena

għal-ġebla u l-ħama.

Ivverifika l-vitien rappreżentattivi għat-temperatura

Kull xahar

bħalma hu indikat hawn qabel fuq bażi ta’ rotazzjoni

Servizzi ta’ ilma

Ivverifika t-temperatura ta’ l-ilma fit-tank il bogħod mill-

Kull sitt xhur

kiesaħ

balla u innota it-temperatura massima reġistrata minn

termometri fissi għat-temperaturi massimi/minimi meta

dawn ikunu mwaħħla

Ivverifika li t-temperatura tkun anqas minn 20 o C wara s-

Nota: Jista’ jkun li din

Kull ġimgħa

it-temperatura ma

sentinal taps jinfetħu għal żewg minuti

tinlaħaqx f’Malta

matul ix-xhur tas-sajf

Spezzjona viżwalment it-tankijiet ta’ l-ilma kiesaħ u

Kull sitt xhur

għamel xogħol rimedjali meta dan ikun meħtieġ

Ivverifika l-vitien rapreżentattivi għat-temperatura bhalma

Kull xahar

hu indikat hawn qabel fuq bażi ta’ rotazzjoni

Mnejn joħroġ l-ilma

Żarma, nadaf u neħħi il-ġebla mnejn joħroġ l-ilma tad-

Kull tlett xhur, jew

tad-doxxa

doxxa u manek

qabel jekk ikun hekk

meħtieġ

Żbokki li ma tantx

Ifflaxxja sew u itfa fid-drain

Kull ġimgħa

jintużaw

LISTA TA ’ KONTROLLI 3: SISTEMI OĦRA TA ’ RISKJU

SISTEMA / SERVIZZ

INKARIGU

FREKWENZA

Spray humidifiers, air

Naddaf u iddisinfetta spray humidifiers/air washers u

Kull sitt xhur

washers

u

wet

make up tanks inklużi l-uċuħ kollha mxarrba, u titneħħa l-

scrubbers

ġebla fejn ikun meħtieġ

Ikkonferma l-operazzjoni tat-trattament ta’ l-ilma mhux

Kull ġimgħa

kimiku (jekk preżenti)

Water softeners

Nadaf u iddisinfetta reżina u tankijiet ta’ ilma salmastru –

Kif ikun

ivverifika mal-manifattur x’tip ta’ kimika tista’ tintuża

rakkomandatt mill-

biex jiġi disinfettat il-qigħ tar-reżina

manifattur

Doxxox ta’ emerġenza

Ifflaxxja sew u itfa fid-drain

Kull sitt xhur jew

u sprays għat-tbaħbiħ

aktar frekwenti jekk

ta’ l-għajnejn

ikun hekk

rakkomandat mill-

manifattur

Sistemi ta’ bexxiexa u

Meta tkun preżenti għal testijiet ta’ bexxiexa u romblu ta’

Kull tlett xhur

romblu ta’ manka

manka żgura ruħek li jkun hemm riskju minimu ta’

esposjizzjoni għall-aerosols

Sistemi li jkessħu torn

Naddaf u iddisinfetta is-sistemi ta’ ħażna u ta’

Kull sitt xhur

u għodda ta’

distribuzzjoni

makkinarju

Banjijiet spa

Ivverifika il-filtri – filtri tar-ramel għandhom jiġu

Kuljum

backwashed ta’ kuljum

Ivverifika t-trattament ta’ l-ilma – pools għandhom jiġu

Tlett darbiet kuljum

trattati kontinwament b’bioċida ossidanti

Naddaf u iddisinfetta s-sistema kollha

Kull ġimgħa

Sistemi ta’ tbexxix fl-

Naddaf u iddisinfetta il-pajpijiet ta’ distribuzzjoni, spray

Kull sena

ortikultura

heads u make up tanks, inklużi l-uċuħ mxarrba kollha, u

neħħi l-ġebla fejn ikun neħtieġ

Funtani u apparat ieħor

Naddaf u iddisinfetta kull għadira, spray heads u make up

Kull ġimgħa

ta’ l-ilma

tanks, inklużi l-uċuħ mxarrba kollha, u neħħi l-ġebla fejn

(partikolarment fuq

ikun meħtieġ

ġewwa)

Ġaladarba r-riżultati mikrobioloġiċi jindikaw dawn il-livelli ta’

Wara li jittieħdu l-kampjuni u jiġi konfermat l-istess numru, is-

Suprintendent għandu jiġi informat bil-miktub fi żmien 24 siegħa

li jasal ir-rapport tal-laboratorju u għandu jinkludi kopji ta’

riżultati tal-laboratorju flimkien mal-miżuri ta’ kontroll li jkunu

qegħdin jittieħdu mill-persuna responsabbli biex jirrimedja s-

għadd ta’ batterji, il-persuna responsabbli għandha tinforma fi

Suprintendent billi ċċempillu jew bil-miktub fi żmiem 48 siegħa,

u dak ir-rapport għandu jinkludi kopji tar-riżultati tal-laboratorju

flimkien mal-miżuri ta’ kontroll li jkunu qegħdin jittieħdu biex

żmien 24 siegħa minn x’hin tirċievi r-rapport tal-laboratorju, lis-

LIVELLI TA ’ AZZJONI WARA LI JSIR MONITORAĠĠ MIKROBIOLOĠIKU GĦAS - SISTEMI TAL - COOLING TOWERS U TAL - KONDENSATURI EVAPORATTIVI

AVVIŻ LIS - SUPRINTENDENT

is-sitwazzjoni tiġi rimedjata.

L-għadd tal-kolonja jiġi determinat bi pour plate method skond ISO 6222(20) jew bi spread plate method fuq il-yeast extract agar

sitwazzjoni.

Xejn

jerġgħu jittieħdu kampjuni. Jekk l-istess numru jerġa’

jinstab, il-miżuri ta’ kontroll u evalwazzjoni ta’ riskju

għandhom jerġgħu jiġu riveduti biex tiġi identifikata kull

Għandhom immedjatament jerġgħu jittieħdu l-kampjuni.

Wara għandha tkun shot dosed b’biocida kif suppost

bħala prekawzjoni. L-evalwazzjoni ta’ riskju u il-miżuri

ta’ kontroll għandhom jiġu riveduti biex jiġu identifikati

L-għadd għandu jiġi konfermat billi immedjatament

AZZJONI RIKJESTA FUQ IS - SISTEMA

Definitions.

“accredited laboratory” means a laboratory which takes part

in an external quality assessment scheme for the isolation of

legionella from water and where the interpretation of any results

is carried out by an experienced microbiologist<

“the Act” means the Public Health Act<

“authorised officer” means any duly qualified person

authorised by the Superintendent to carry out any functions under

these regulations and includes any nominated officer<

“biocide” means a physical or chemical agent capable of

killing micro-organisms, including Legionella<

“clean” means to render free from visible sludge, foam, slime

(including algae and fungi), rust, scale, dirt, and any deposit or

accumulation of impurities or other foreign material<

“cold water system” means an installation of plant, pipes and

fittings in which cold water is stored, distributed and subsequently

discharged<

“cooling tower systems” includes>-

(a) a cooling tower, or a number of interconnected

cooling towers that use the same recirculating water< and

(b) any machinery that is used to operate any such

tower< and

(c) any associated tanks, pipes, valves, pumps or

controls<

“cooling tower” means a device whose main purpose is to

cool water by direct contact between that water and a stream of

air<

“designated area” means any premises or part thereof to which

the public or a section of the public has access, whether on payment

or otherwise<

“disinfect” means to carry out a process which is intended to

kill or remove pathogenic micro-organisms<

“drift” means the water aerosol which emerges from the

airflow outlet of a cooling system<

“evaporative condenser” means a device whose main purpose

is to cool a fluid by passing that fluid through a heat exchanger

which is itself cooled by the contact of water passing through a

stream of air<

“guidelines” means the European Guidelines for Control and

Prevention of Travel Associated Legionnaires’ Disease produced

by the European Working Group for Legionella Infections

(EWGLI) and endorsed by the Committee for the Epidemiological

Surveillance and Control of Communicable Diseases in the

Community, instituted by Decision 2119#98#EC of the European

Parliament and the Council<

“heat exchanger” means a device for transferring heat between

fluids which are not in direct contact with one another<

“heterotrophic colony count” means an estimate of the number

of viable units of bacteria per millilitre of water made using the

pour plate, spread plate or membrane filter test (also known as the

total bacterial count, total plate count or viable bacterial count test)

method<

“legionella” means bacteria belonging to the genus Legionella<

“premises” includes all non-domestic premises used for or in

connection with the carrying on of a trade or business (whether for

profit or not) and should include any healthcare facility and schools<

“responsible person” includes the person who owns, manages

or controls the cooling tower systems, or evaporative condensers,

or hot and cold water systems, or water fountains or a number of

these systems in the same premises<

“sentinel taps”, in relation to a hot water system, means the

first and last taps on a recirculating system. For cold water systems

(or non-recirculating hot water systems), the nearest and furthest

taps from the storage tank. The choice of sentinel taps may also

include taps which are considered to represent a particular risk<

“spa pool” includes a bath or a small pool where warm water

is constantly recirculated, through high velocity jets or with the

injection of air to agitate the water<

“the Superintendent” means the Superintendent of Public

Health.

“warm water system” means a piped water supply, including

any thermostatic mixing valve, which is designed to supply water

at a temperature of between 30 o C and 60 o C<

“water” means water supplied through the main water

distribution system or water supplied by an authorised private water

supplier or through a water supply approved by the Superintendent

or by the relevant competent authorities<

“water fountain” means any water feature located in a

designated area.

Impliment azzjoni ta’ azzjoni korrettiva –

Erġa irrevedi il-program operattiv –

azzjonijiet rimedjali.

Sistema taħt kontrol

azzjoni rimedjali.

>1000 u sa 10,000

BATTERJI TAL -

LEĠJONELLA

CFU / LITRU

>10,000

≤1000

determinat skond ISO 11731(19)

( INKUBAZZJONI TA ’

E TEROTROFIKA 1

CFU / ML F ’ 30 C

MILL - INQAS 48

G ĦADD TAL -

O

>10,000 u sa

KOLONJA

>100,000

SIEGĦA )

≤10,000

100,000

Normalment l-iktar post konvenjenti biex jitkejjel huwa

Din il-verifika tiżgura li s-sistema kollha tkun qed taħdem

ritorn f’kull dawra jibqa’ ma tinbidilx, jiġifieri kull dawra

Mod kif tista’ tkejjel dan huwa billi jintuża surface

Jekk ikun hemm wieħed imwaħħal, pocket għat-

termometru fil-wiċċ tal-ħażna tal-heater ta’ l-ilma sħun u

fuq ir-ritorn huma punti tajbin mnejn tista’ titkejjel it-

temperatura eżatta. Jekk ikun hemm pocket bħal dak

installat, dan il-kejl jista’ jsir u jiġi mniżżel minn building

fejn ikun hemm il-ħruġ tal-balla għal ġot-tank tal-ħażna

Dan it-test jiżgura li t-temperatura tal-provvista u tar-

tkun qed tiffunzjona kif meħtieġ

NOTI

management system.

temperature probe.

ta’ l-ilma kiesaħ

KONTROLL TA ’ TEMPERATURA GĦAS - SISTEMI TA ’ ILMA SĦUN U KIESAĦ

sew

l-ilma

għandha tkun ta’ l-inqas 50 o C

it-temperatura tal-provvista ta’

l-ilma għat-TMV għandha mill-

inqas tkun ta’ 50 o C sa minuta

l-ilma li joħroġ għandu jkun

mill-inqas 60 o C, u jirritorna

f’temperatura ta’ mill-inqas

l-ilma

għandha tkun ta’ l-inqas 50 o C fi

żmien minuta min meta l-ilma

jibda nieżel. Id-differenza bejn

l-ogħla u l-inqas temperatura

meħuda tal-vitien wara minuta

ma għandiex tkun ta’ iktar minn

minn meta jibda niezel l-ilma

f’minuta li l-ilma jibda jinżel

ILMA SĦUN

ta’

ta’

It-temperatura

It-temperatura

(1) Cooling tower systems and evaporative condensers Installation of new

are prohibited to be newly installed on healthcare facilities and cooling

systems and

schools.

evaporative

condensers.

(2) Installation of new cooling tower system or evaporative

condenser on any other premises should be restricted to those cases

only where no other suitable dry cooling facility is possible as an

alternative.

LIVELL LI JRID JINTLAĦAQ

50 o C

10 o C

l-ilma

inqas wara li l-ilma jitħalla

l-ilma

wara li l-ilma jitħalla nieżel għal

għandha tkun taħt 20 o C jew

nieżel għal mill-inqas żewġ

Preferibilment l-ilma għandu

jkun inqas minn 20 o C il-ħin

għandha tkun 20 o C jew inqas

ILMA KIESAĦ

ta’

ta’

It-temperatura

It-temperatura

żewġ minuti

minuti

kollu

Jekk hemm, l-input

għat-themostatic mixer

valves (TMV) fuq bażi

l-ilma li joħroġ u li

jerġa lura għal water

Id-dħul mnejn jidħol l-

ilma kiesaħ (ta’ l-inqas

vitien

darba fix-xitwa u darba

fuq

bażi ta’ rotazzjoni

IVVERIFIKA

rappreżentattivi

ta’

Sentinal taps

ta’ sentinellà

fis-sajf)

Għadd

heater

Kull sitt xhur

Kull sitt xhur

FREKWENZA

Kull gimgħa

Kull xahar

Wara li jittieħdu il-kampjuni mill-ġdid u jiġi konfermat li l-għadd

ikun l-istess, is-Suprintendent għandu jiġi informat bil-miktub fi

żmien 24 siegħa minn meta jirċievi r-rapport tal-laboratorju, kif ukoll

kopji tar-riżultati tal-laboratorju flimkien mal-miżuri ta’ kontroll li l-

Ġaladarba r-riżultati mikrobioloġiċi jindikaw dawk il-livelli ta’għadd

ta’ batterji, il-persuna responsabbli għandha fi żmien 24 siegħa li

tirċievi r-rapport tal-laboratorju, tinforma lis-Suprintendent billi

ċċempillu, u bil-miktub fi żmien 48 siegħa, u dak ir-rapport għandu

jinkludi kopji tar-riżultati tal-laboratorju flimkien mal-miżuri ta’

persuna responsabbli tkun qegħda tieħu biex tirrimedja s-sitwazzjoni.

kontroll li jkunu qegħdin jittieħdu biex is-sitwazzjoni tiġi rimedjata.

AVVIŻ LIS - SUPRINTENDENT

LIVELLI TA ’ AZZJONI WARA LI JSIR MONITORAĠĠ MIKROBIOLOGIKU ĠĦAS - SISTEMI TA ’ L - ILMA SĦUN U KIESAĦ

Xejn

Jekk kampjun wieħed biss jew tnejn ikunu pożittivi,

għandhom jerġgħu jittieħdu kampjuni tas-sistemi. Jekk l-

għadd ikun l-istess, il-miżuri ta’ kontrol għandhom jiġu

riveduti u għandha ssir evalwazzjoni tar-riskju biex tiġi

Jekk il-maġġoranza ta’ kampjuni tkun pożittiva, is-sistema

tista tiġi kolonizzata, forsi fuq livell baxx, bil-leġjonella.

Id-disinfettar tas-sistema għandu jiġi kunsidrat, iżda wkoll

il-miżuri ta’ kontroll għandhom jiġu riveduti u ssir

evalwazzjoni tar-riskju biex tiġi identifikata kull azzjoni

Il-kampjuni tas-sistema għandhom jerġgħu jittieħdu u immedjatament il-

miżuri ta’ kontroll jiġu riveduti biex tiġi identifikata l-azzjoni rimedjali,

(1) At the stage of installation of cooling tower system or an Design and

evaporative condenser, inspection shall be carried out by competent construction

cooling tower

persons so that the cooling tower and evaporative condenser pose system and

evaporative

minimal health risk to occupants of the premises and members of the condenser.

public.

(2) Cooling systems shall be designed and constructed so as

to minimise the release of drift and to aid safe operation, regular cleaning

and disinfection.

AZZJONI MEĦTIEĠA FUQ IS - SISTEMA

rimedjali oħra li tista’ tkun meħtieġa.

identifikata kull azzjoni rimedjali;

kif ukoll il-possibiltà ta’ disinfettar tas-sistema.

Sistema taħt kontrol

(ii)

(i)

determinat skond ISO 11731(19)

Jew

>1000 u sa 10,000

BATTERJI TAL -

L EĠJONELLA

CFU / LITRU

>10,000

≤1000

The cooling tower or evaporative condenser shall be located

at least five metres away from air circulating and ventilating inlets,

open windows and occupied areas, pedestrian thorough fares, traffic

areas, areas of public access, exhaust discharge from kitchens, air

handling systems or other areas where nutrients conveyed from these

systems could assist in the growth of legionella.

DIKJARAZZJONI TA ’ KONFERMA TA ’ ĦLAS DOVUT LIS - SUPRINTENDENT TAS - SAĦĦA PUBBLIKA

Suprintendent tas-Saħħa Pubblika

Diviżjoni tas-Saħħa

Jien, hawn taħt fil-kapaċità tiegħi ta’ ..........................(kariga) ta’ ........................................... (isem

tal-fond) hawn niddikjara li nħallas, fi żmien xaħar minn meta nirċivi l-fattura, l-ispejjeż kollha li

d-Diviżjoni tas-Saħħa tagħmel biex tieħu ..........(għadd) kampjuni, tittrasporthom, tippreparhom u

tanalizzhom, wara li dawn ġew miġburin mill- .................................................. (isem tal-fond) fi-

............................(data meta jittieħdu il-kampjuni) bħala parti mill-investigazzjoni ta’ każ jew

każ suspett tal-marda tal-Leġjonella.

(Firma)

Isem u Kunjom

F’isem

Numru tal-Karta ta’ Identità

Data tat-Twelid

Post tat-Twelid

Isem u Kunjom tal-Ġenituri

Indirizz ta’ Residenza

Indirizz fejn tintbgħat il-Fattura

Numru tal-VAT

Data

Make-up water shall be supplied either through the main

distribution system or by an authorised water supplier or through a water

supply approved by the Superintendent.

A WTORITÀ TAS -S AĦĦA

A VVIŻ TA ’ I NFURZAR

(Skond ir-regolament 18(2) tar-Regolamenti ta’ 2005 dwar il-Kontroll tal-Leġjonella)

Data

Lil

1. Wara li saru investigazzjonijiet mis-Suprintendent tas-Saħħa Pubblika, instab li r-

riskju

ta’

infezzjoni

mill

marda

tal-leġjonella

huwa

wieħed

sinifikanti

fi

2. Ir-riskju

ta’

infezzjoni

mill

marda

tal-leġjonella

għandu

x’jaqsam

ma’

3. Mingħajr preċudizzju għad-dritt li għandu s-Suprintendent li jieħu azzjoni skond id-

disposizzjonijoet tar-Regolamenti ta’ l-2005 dwar il-Kontroll tal-Leġjonella, qed tiġi mitlub li

tagħlaq IMMEDJATAMANT il- .....................................................................................................

sakemm tiġi informat xort’ oħra.

Suprintendent tas-Saħħa Pubblika

(1) Effluent water from cooling towers and evaporative

Discharge of water.

condensers shall be discharged into the public sewers as approved by

the respective competent authorities.

(2) The concentration of chemicals in the effluent shall be

within the limits established by the respective competent authorities.

Commissioning and

(1) Cooling towers and evaporative condensers shall be

commissioned, approved and certified by a competent warranted

engineer in terms of the Engineering Profession Act before use to ensure

that they operate correctly and safely.

(2) The entire air-conditioning system shall be clear of any

construction debris and dirt, and cleaned before operation starts.

(3) Precautions shall be taken to control the risks during

commissioning, start up and during the normal operation of the system

as per guidelines.

(1) It shall be the duty of the responsible person to ensure

that>

(a) any cooling tower system or evaporative condenser in

use is maintained and tested in accordance with the guidelines<

(b) the water of the cooling tower system or evaporative

condenser is maintained in a clean condition<

(c) the water of the cooling tower system or evaporative

condenser is continuously treated with>

i. one or more biocides to effectively control the growth

of micro-organisms, including Legionella< and

ii. chemicals or other agents to minimise scale

formation, corrosion and fouling<

(d) a chlorine-compatible bio-dispersant is added to the Disinfection,

cleaning and re-

recirculating water of the cooling tower system or evaporative disinfection.

condenser, and that the system is then disinfected, cleaned and re-

disinfected>

i. immediately prior to initial start up following

commissioning, or any shut down period of greater than one

month< and

ii. at intervals not exceeding six months<

(e) the cooling tower system or the evaporative condenser Routine inspections

and testing.

are inspected in accordance with the guidelines and Schedule 1<

(f) at least once every month take a sample of the recirculating Microbiological

sampling frequency.

water of the cooling tower system and the evaporative condenser

to an accredited laboratory for testing for heterotrophic colony

count and once every six months for legionella<

(g) a water sample shall be taken before the dosing of biocide Water sampling.

and in accordance with the guidelines.

(1) The responsible person must ensure that the actions Action levels

following

following microbiological monitoring of cooling towers and evaporative microbiological

condensers is in accordance with the procedures laid down in Schedule monitoring of

cooling tower

2 to these regulations.

systems and

evaporative

condensers.

(2) The responsible person shall immediately inform the

Superintended of any situation provided for in Schedule 2 of these

regulations.

(3) The responsible person shall carry out any further

monitoring and remedial actions as may be directed by the

Superintendent.

(4) The Superintendent may require the systems or part

thereof to be shutdown until all necessary remedial actions have been

taken by the responsible person and until microbiological sampling

results of any system would have returned within the recommended

acceptable levels as indicated in Schedule 2 to these regulations.

Maintenance of hot

(1)

The responsible person shall ensure that>

and cold water

systems.

(a) unless the system is shut down or drained of water or is

otherwise not in use, any hot and cold water system that the

responsible person owns, manages or controls is maintained and

tested in the manner set out in these regulations and according to

the guidelines<

(b) the hot and cold water system is disinfected by heat or

chlorination and cleaned immediately prior to initial start up

following commissioning, or any shut down period of greater than

one month<

(c) the hot and cold water system is disinfected by one or

more of the following methods>

i.

at least once each month by heat or chlorination< or

ii. continuously by means of automatic low level

chlorination< or

iii. continuously by means of ultra-violet light

treatment< or

iv.

a method approved in the guidelines<

(d) the hot and cold water system is inspected and that the

hot and cold water systems are maintained at all times in accordance

with the guidelines and Schedule 1 and 3<

(e) when biocides are used to treat water systems, they are

meticulously controlled and checked at least weekly or as otherwise

indicated to ensure that it is operating correctly<

(f) at least once every six months a sample of the water

from the hot and cold water system is taken and delivered to an

accredited laboratory for testing and reporting on Legionella.

(1) The responsible person must ensure that the actions

following microbiological monitoring of hot and cold water systems

are in accordance with the procedures laid down in Schedule 4 of these

regulations.

(2) The responsible person shall immediately inform the

Superintended of the situation provided for in Schedule 4 of these

regulations.

(3) The responsible person shall carry out any further

monitoring and remedial actions as may be directed by the

Superintendent.

(4) The Superintendent may require the systems or part

thereof to be shut down until all necessary remedial actions have been

taken by the responsible person and until microbiological sampling

results have returned within the recommended acceptable levels in

Schedule 4 of these regulations.

(1)

It shall be the duty of the responsible person to ensure Maintenance and

testing of water

that>

fountains.

(a) any water fountain under his responsibility is

maintained and tested in accordance with the guidelines and

Schedule 1<

Microbiological

(b) water in a water fountain is sampled>

sampling.

i. at least once a month for the purpose of determining

the heterotrophic colony counts< and

ii. at least once every six months for the purpose of

detecting legionella bacteria.

(2) The responsible person shall immediately inform the

Superintendent of the situation provided for in Schedule 2 of these

regulations.

(3) The Superintendent may require the responsible person Notice to carry out

inspection, test or

to carry out tests and maintenance of water fountains as he may deem maintenance of

necessary.

water fountains.

(1) It shall be the duty of the responsible person to ensure Maintenance and

testing of other risk

that any spa pool and any other type of water system under his systems.

responsibility is maintained and tested in accordance with the guidelines

and Schedule 1.

(2) Spa pools on display in retail outlets or exhibitions shall

be treated in the same manner as if they were being used.

(1) The responsible person shall>

Risk assessment.

(a) carry out a risk assessment to identify and assess the risk

of exposure to legionella bacteria from work activities and the water

systems on the premises under his control as identified in the

guidelines< and

(b) identify any necessary precautionary measures which

may need to be adopted< and

(c) review the assessment either annually or when the

situation changes or when the original assessment may no longer

be valid< and

(d)

keep a fully documented record of the risk assessment.

(2) When the risk assessment reveals that there is a

foreseeable risk which cannot be eliminated, the responsible person

shall adopt a scheme specifying the measures to be taken to minimise

the risk of exposure.

(3) The risk assessment and operation of the control

measures shall be audited by an independent competent person at least

every two years.

(4) All maintenance and risk assessment records shall be

retained for at least five years.

(1) The responsible person shall inform the Superintendent

of an outbreak of legionnaire’s disease or if it is suspected to have

occurred.

(2) In the event or on the suspicion of an outbreak of

legionnaires’ disease, the responsible person shall implement all

instructions which may be issued by the Superintendent.

(1) It shall be the duty of the Superintendent to investigate

any case or suspected case of Legionnaires’ disease at any premises

and to cause the sampling and analysis of any samples required to

investigate such case or suspected case.

(2) The expenses incurred for the elevation, transportation,

preparation and analysis of samples in case of initial investigation of a

case or suspected case of legionnaire’ disease shall be encumbered by

the Superintendent.

(3) If the results of the initial samples indicate the presence

of Legionella species, or if the investigation is within 24 months of the

first notified case or suspected case, the expenses of follow-up samples

or initial samples, as the case may be, shall be encumbered by the

responsible person>

Provided that the responsible person of the premises shall sign a

priori the declaration attached as Schedule 5 to these regulations

confirming his acceptance to pay any fees due to the Superintendent.

(4) Any person who fails to comply with sub-regulation (3)

of this regulation shall be guilty of an offence and the court, besides

awarding punishment, shall oblige the accused to pay the due fees.

(1) In the event that the responsible person fails to follow Closure of premises.

the instructions referred to in the preceding regulations, or the

Superintendent considers that the risk of infection with legionella from

that particular premises is significant, he may order that the premises,

part of the premises or any water related system, be immediately closed

until the risk of infection is controlled.

(2) The Superintendent shall issue an enforcement notice to Enforcement notice.

the responsible person and shall be in the form specified in Schedule 6

to these regulations, or in any other modified form as the Superintendent

may deem appropriate in the particular circumstances may deem.

(3) Once the premises, part of the premises or any water

related system has been closed by an enforcement notice issued by the

Superintendent, same enforcement notice may be lifted only after it is

confirmed by the Superintendent that the risk of infection has been

controlled.

(4) Any person who fails to comply with the enforcement Failure to comply

notice issued under sub regulation (2) of this regulation shall be guilty with

enforcement notice.

of an offence under the Act.

Any person who contravenes any of the provisions of these Offences.

regulations shall be guilty of an offence under the Act.

S CHEDULE 1

R ECOMMENDED I NSPECTION F REQUENCIES FOR R ISK S YSTEMS

C HECKLIST 1: C OOLING W ATER I NSTALLATIONS

S YSTEM /S ERVICES

T ASK

F REQUENCY

Cooling towers

and

Monitor water quality, water use and biocide/chemical use

6 monthly

evaporative

to assess and ensure effectiveness of water treatment

condensers

regime, including key chemical and microbiological

parameters and observations of internal condition of pond,

pack and water

Central control function, conductivity sensor calibration,

Monthly to 3

blow down function, uniformity of water distribution,

monthly, according

condition of sprays/troughs, eliminators, pack, pond,

to risk

immersion heater, fan and sound attenuators

Clean and disinfect cooling towers/evaporative

6 monthly

condensers, make up tanks and associated systems,

including all wetted surfaces, descaling as necessary.

Packs should be removed and cleaned where practicable.

C HECKLIST 2: H OT AND C OLD W ATER S ERVICES

S ERVICE

T ASK

F REQUENCY

Warm water services

Arrange for samples to be taken from hot water heaters, in

6 monthly

order to note condition of drain water

Check temperatures in flow and return at calorifiers

Daily

Check temperature up to 1 minute to see if it has reached

Weekly

50 o C in the sentinel taps

Visual check on internal surfaces of water heaters for scale

Annually

and sludge

Check representative taps for temperature as above on a

Monthly

rotational basis

Cold water services

Check tank water temperature remote from ball valve and

6 monthly

mains temperature at ball valve.

Note maximum

temperatures recorded by fixed max/min thermometers

where fitted

Check that temperature is below 20 o C after running the

Note: This temperature

Weekly

may not be reached

water for up to 2 minutes in sentinel taps

during the summer

months in Malta

Visually inspect cold water storage tanks and carry out

6 monthly

remedial work where necessary

Check representative taps for temperature as above on a

Monthly

rotational basis

Shower heads

Dismantle, clean and descale shower heads and hoses

Quarterly, or as

necessary, whichever

comes first

Little used outlets

Flush through and purge to drain

Weekly

C HECKLIST 3: O THER R ISK S YSTEMS

S YSTEM /S ERVICE

T ASK

F REQUENCY

Spray humidifiers, air

Clean and disinfect spray humidifiers/air washers and

6 monthly

washers

and

wet

make up tanks including all wetted surfaces, descaling as

scrubbers

necessary

Confirm the operation of non chemical water treatment (if

Weekly

present)

Water softeners

Clean and disinfect resin and brine tank – check with

As recommended by

manufacturer what chemicals can be used to disinfect resin

manufacturer

bed

Emergency

showers

Flush through and purge to drain

6 monthly or more

and eye wash sprays

frequently if

recommended by

manufacturer

Sprinkler and hose reel

When witnessing tests of sprinkler blow down and hose

Quarterly

systems

reels ensure that there is minimal risk of exposure to

aerosols

Lathe and machine

Clean and disinfect storage and distribution system

6 monthly

tool coolant systems

Spa baths

Check filters - sand filters should be backwashed daily

Daily

Check water treatment – pools should be continuously

3 times daily

treated with oxidising biocide

Clean and disinfect entire system

Weekly

Horticultural

misting

Clean and disinfect distribution pipe work, spray heads

Annually

systems

and make-up tanks, including all wetted surfaces,

descaling as necessary

Fountains and water

Clean and disinfect ponds, spray heads and make-up tanks,

Weekly

features (particularly

including all wetted surfaces, descaling as necessary

indoors)

laboratory report shall inform the Superintendent by phone and

Following resampling and similar counts are confirmed, the

receiving the laboratory report and should include copies of

laboratory results together with the control measures being taken

Once microbiological results indicate these levels of bacterial

counts, the responsible person within 24 hours of receiving the

Superintendent is to be informed in writing within 24 hours of

in writing within 48 hours which report should include copies of

the laboratory results together with the control measures being

N OTIFICATION TO S UPERINTENDENT

by the responsible person to remedy the situation.

taken to remedy the situation.

A CTION L EVELS F OLLOWING M ICROBIOLOGICAL M ONITORING FOR

Colony count determined by pour plate method according to ISO 6222(20) or by spread plate method on yeast extract agar

C OOLING T OWER S YSTEMS AND E VAPORATIVE C ONDENSERS

None

The system should immediately be re-sampled. It should

The count should be confirmed by immediate re-

sampling. If similar count is found again, a review of

the control measures and risk assessment should be

then be ‘shot dosed’ with an appropriate biocide, as a

precaution. The risk assessment and control measures

should be reviewed to identify remedial actions.

S CHEDULE 2

A CTION R EQUIRED ON S YSTEM

carried out to identify any remedial actions.

Review programme operation –

Implement corrective action –

System under control

Determined in accordance with ISO 11731(19)

L EGIONELLA

up to 10,000

B ACTERIA

>1000 and

CFU / LITRE

>10,000

≤1000

(Minimum 48 hours

C OLONY C OUNT 1

H ETEROTROPHIC

CFU / ML AT 30 C

up to 100,000

O

>10,000 and

incubation)

>100,000

≤10,000

temperatures on each loop are unchanged i.e. the loop is

If fitted, the thermometer pocket at the top of the hot

water storage heater and on the return leg are useful

points for accurate temperature measurement. If installed,

these measurements could be carried out and logged by a

This check makes sure that the supply and return

One way of measuring this is to use a surface temperature

The most convenient place to measure is usually at the

This check makes sure that the whole system is working

ball valve outlet to the cold water storage tank

N OTES

building management system.

functioning as required

T EMPERATURE C ONTROL FOR H OT AND C OLD W ATER S YSTEMS

properly

probe

temperature should be at least

Outgoing water should be at

difference between the highest

temperature

recorded at the taps after one

minute should not be greater

The water temperature should

be at least 50 o C within a minute

The water supply to the TMV

50 o C within a minute of running

The water temperature should

be at least 50 o C within a minute

The

least 60 o C, return at least 50 o C

of running the water.

H OT W ATER

of running the water

lowest

S CHEDULE 3

S TANDARD T O M EET

that 10 o C

water

and

be below 20 o C or less after

The water should preferably be

be 20 o C or less after running the

The water temperature should

running the water for up to two

The water temperature should

C OLD W ATER

below 20 o C at all times

water for two minutes

minutes

If fitted, input to

mixer

valves (TMV) on a

and

returning to the water

Incoming cold water

inlet (at least once in the

winter and once in

Representative number

of taps on a rotational

leaving

C HECK

sentinel basis

Sentinel taps

thermostatic

summer)

Water

heater

basis

F REQUENCY

Six monthly

Six monthly

Monthly

Weekly

receiving the laboratory report, and should include copies of

laboratory report shall inform the Superintendent by phone and

Following resampling and similar counts are confirmed, the

Superintendent is to be informed in writing within 24 hours of

laboratory results together with the control measures being taken

Once microbiological results indicate these levels of bacterial

counts, the responsible person within 24 hours of receiving the

in writing within 48 hours which report should include copies of

the laboratory results together with the control measures being

N OTIFICATION TO S UPERINTENDENT

by the responsible person to remedy the situation.

A CTION L EVELS F OLLOWING M ICROBIOLOGICAL M ONITORING FOR

taken to remedy the situation.

H OT AND C OLD W ATER S YSTEMS

None

S CHEDULE 4

assessment should be carried out to identify any

(ii) If the majority of samples are positive, the system

considered but an immediate review of control

measures and risk assessment should be carried out

(i) If only one or two samples are positive, systems

should be re sampled. If a similar count is found,

then review of the control measures and risk

may be colonised, albeit at a low level, with

Legionella. Disinfection of the system should be

The system should be re-sampled and an immediate

review of the control measures and risk assessment

carried out to identify and remedial actions, including

to identify any other remedial action required.

A CTION R EQUIRED ON S YSTEM

possible disinfection of the system.

remedial actions;

System under control

Determined in accordance with ISO 11731(19)

Either

L EGIONELLA

up to 10,000

B ACTERIA

>1000 and

CFU / LITRE

>10,000

≤1000

S CHEDULE 5

C ONFIRMATION D ECLARATION OF F EES D UE TO THE S UPERINTENDENT OF P UBLIC H EALTH

The Superintendent of Public Health

Health Division

I, the undersigned, in my capacity of .............................(position) of ...............................(premises

name) hereby declare that I will pay, within one month’s time of receipt of invoice, all the

expenses that the Health Division will incur in the sampling, transportation, preparation and

analysis

of

........(number)

of

samples,

which

have

been

taken

from

................................................(premises name and address) on the ........................(date of

sampling) as part of the investigation of a case or suspected case of Legionnaire’s disease.

(Sgd)

Name and Surname

o.b.o.

I.D. No.

Date of Birth

Place of Birth

Parent’s Name and Surname

Residential Address

Billing Address

VAT No.

Date

S CHEDULE 6

H EALTH A UTHORITY

E NFORCEMENT N OTICE

(As per regulation 18(2) of the Control of Legionella Regulations, 2005)

Date

1. Following investigations carried out by the Superintendent of Public Health, it was found

that the risk of infection from Legionnaire’s Diseases is significant at ...............................................

2. The risk of infection from Legionnaire’s Diseases relates to ..............................................

3. Without prejudice to the Superintendent’s right to take action in accordance with the

provisions of the Control of Legionella Regulations, 2005, you are hereby requested to

IMMEDIATELY close down the .................................................................................. until further

notice.

Superintendent of Public Health

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