Legionella Guidelines, Standards, And Regulations

This page was updated on December 5, 2019.

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Since Legionella bacteria can cause a serious type of pneumonia, it’s important to maintain proper water systems in facilities — including hospitals, hotels, and other public buildings. Many organizations have created Legionella standards and guidelines for maintaining water safety and responding to Legionnaires’ disease outbreaks. These include the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) and the Occupational Safety and Health Administration (OSHA) Legionella regulations.

Below, you’ll find a list of industry water quality standards and documents for effectively managing the risk for Legionella bacteria. It’s imperative for buildings to remain in compliance with clean water regulations that have been mandated by the local and state governments. Understanding and following guidelines on Legionella control keeps communities as well as employees, customers, and patients safe. Failure to comply usually results in a fine.

Standard

  • Legionellosis

    Risk management for building water systems. ANSI/ASHRAE standard 188–2015. Atlanta, GA: ASHRAE; 2015.

General Guidelines

  • Minimizing the risk of legionellosis associated with building water systems.

    ASHRAE guideline 12-2000external icon. Atlanta, GA: ASHRAE; 2000.

  • Cooling Tower Institute.

    Legionellosis guideline: Best practices for control of Legionella.

  • Centers for Disease Control and Prevention.

    Model aquatic health code.

  • Centers for Disease Control and Prevention.

    Disinfection of hot tubs contaminated with Legionella.

  • Occupational Safety and Health Administration (OSHA)

    Legionellosis (Legionnaires' Disease and Pontiac Fever).

State Regulations

  • New York

    Environmental health information related to Legionellosis in healthcare facilities.

Healthcare-specific Guidelines and Requirements

  • Centers for Medicare & Medicaid Services.

    Requirement to reduce Legionella risk in healthcare facility water systems to prevent cases and outbreaks of Legionnaires’ disease [4 pages]. 2017.

  • Centers for Disease Control and Prevention.

    Guidelines for environmental infection control in health-care facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. 2003;52(RR-10):1–42.

  • Centers for Disease Control and Prevention.

    Guidelines for preventing health-care-associated pneumonia, 2003: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. 2004;53(RR-3):1–36.

  • Centers for Disease Control and Prevention.

    Guidelines for infection control in dental health-care settings, 2003. MMWR. 2003;52(RR-17).

  • Department of Veterans Affairs.

    Prevention of healthcare-associated Legionella disease and scald injury from potable water distribution systems. VHA Directive 1061. 2014.

  • Infectious Diseases Society of America/American Thoracic Society.

    Consensus guidelines on the management of community-acquired pneumonia in adults, 2007.

  • Infectious Diseases Society of America/American Thoracic Society.

    Management of adults with hospital-acquired and ventilator-associated pneumonia: Clinical practice guidelines, 2016.

Laws

  • Environmental Protection Agency.

    Safe drinking water act.

  • Environmental Protection Agency.

    Federal insecticide, fungicide, and rodenticide act.

Literature Reviews

  • Environmental Protection Agency.

    Technologies for Legionella Control in Premise Plumbing [139 pages, 1.67 MB]

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