Healthcare Purchasing News – The most fundamental basics for life are air and water which are things we take for granted even in a healthcare setting, never giving a thought to the possibility of either of these life-giving properties presenting a life-threatening situation. Unfortunately, the risks to health are real, particularly when a patient is very young, elderly, or immunocompromised.

Proper Air & Water Stewardship

The ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) Position Document on Airborne Infectious Diseases states: “Many infectious diseases are transmitted through inhalation of airborne infectious particles termed droplet nuclei. Airborne infectious particles can be disseminated through buildings including ventilation systems. Airborne infectious disease transmission can be reduced using dilution ventilation, specific in-room flow regimes, room pressure differentials, personalized and source capture ventilation, filtration, and UVGI [ultraviolet germicidal irradiation]. ASHRAE should commit to improving the health of individuals who occupy buildings and should support further research on engineering controls to reduce infectious disease transmission.”

Water-treatment options

We can’t live without water, but there are rare cases when we can’t live with it, either. Pathogens in water can be life-threatening. Steve Schira, Chairman and CEO of LiquiTech Environmental Solutions, Lombard, IL, talked about the importance of pathogen-free water. “In 2002, the American Medical Association said, ‘Perhaps the most overlooked, important and controllable source of nosocomial pathogens is hospital water.’6 Yet, the majority of hospitals continue to take a reactive position, waiting until a Legionella or other bacterial outbreak creates a crisis necessitating costly remediation, damage to their image, medical-treatment costs, loss of lives, and potential litigation.”

The LiquiTech copper silver ionization system provides long-term remediation of waterborne bacteria.

“Water is incorrectly assumed to be bacteria-free when it arrives from municipal treatment sources and therefore is often overlooked as a source of infection,” stated Schira. “Recent research shows that waterborne pathogens such as Legionella, Pseudomonas, Acinetobacter, and mycobacterium are prevalent in hospital drinking water. For example, a range of studies has consistently found that approximately 70% of hospitals have Legionella in their water systems.7 Another study found that Pseudomonas is the fourth-leading cause of all HAIs.”8

Microorganisms that clump together and form an icky gunk clinging to the insides of water pipes is called biofilm. Biofilm is sticky; it just keeps on attracting more microorganisms, causing it to grow continually. Schira explained how their system works to combat biofilm. “Unlike other remediation techniques, the LiquiTech system penetrates the biofilm, the slimy residue that lines water pipes and harbors bacteria. Our system utilizes copper silver ionization, a chemical-free biocide. A flow cell chamber containing sacrificial copper silver electrodes is attached to the water supply. A direct current is applied across these electrodes to stimulate the controlled release of ions. The ions form electrostatic bonds with negatively charged sites on microorganism cell walls. These bonds create stresses that reduce the normal intake of life-sustaining nutrients, killing the bacteria. Research and testing show that, properly maintained, our system provides long-term, guaranteed protection against Legionella and a range of other HAI-causing bacteria.”

Schira noted infection comes with a hefty price. “Change is being fueled by regulations, with a number of value-based purchasing programs targeting incidence of infections as well as the attendant costs. Private payers are also refusing to reimburse the added costs of treating infections. Clinical research and government reports are revealing the true impact of infection. ASHRAE is expected to come out with a new building standard for Legionella this year, which will be a major factor in spurring all hospitals to take notice of this situation.”

Schira offered anecdotal evidence on the efficacy of the LiquiTech system. “Centers for Medicare and Medicaid Services say a single case of hospital-acquired Legionnaires’ disease costs an average of $86,000.9 We are finding that LiquiTech can save a 300-bed hospital an average of $600,000 dollars annually, not including resulting remediation and liability expenses.”

“The LiquiTech system has undergone years of intense clinical and regulatory scrutiny and analysis in the US and around the world. University of Wisconsin hospitals and clinics experienced a cluster of Legionella pneumonia cases in the mid-1990s. It tried a number of other disinfection systems without success. Using LiquiTech’s system, it has not had a case of Legionnaires’ disease since 1995.”

Looking toward the future

Never content with the status quo, vendors constantly seek more and better. Here is what these companies see on the horizon.

Kirschman, Aerobiotix Inc., talked about national changes in air handling that he believes will develop soon. “The US will ultimately adopt healthcare air-quality standards that limit the number of particles and/or bacteria levels. Europe has already adopted standards, and it is surprising that the US is lagging behind. We believe that, under the new paradigm of quality measurements, more facilities will be proactive and adopt environmental quality standards. This will support creative solutions through industry.”

Specific to Aerobiotix developments, Kirschman said, “Our technology supports water disinfection as well. We are actively investigating this.”

“UVDI is investing heavily in the emerging technology of photo-catalytic oxidation for gaseous contamination removal in critical environments such as hospitals,” said Hayes. “This technology removes volatile organic compounds (VOCs) and odors from the air that are often associated with helicopter jet wash, ambulance engines, and chemical odors in the hospitals. These VOCs and odors are potentially harmful to patients and healthcare workers and are a nuisance to everyone. Patients and family members visiting a hospital want the best experience possible. Microorganism-free, clean-smelling air is part of that experience.”

Schira, LiquiTech Environmental Solutions, referred to news coming from ASHRAE, which will soon release the first national guidelines (BSR/ASHRAE Standard 188P) on Legionella in building water systems. “The ASHRAE standard will bring increased attention to Legionnaires’ disease, but it will have an added benefit of making hospital leaders more aware of the range of harmful bacteria to be found in hospital drinking water, which constitutes a threat to patients’ health and to the hospital bottom line.”

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