All Dental practices require a Legionella Risk Assessment


Does My Dental Practice Require A Legionella Risk Assessment?

All Dental practices require a Legionella Risk Assessment.

Dental Practices are required to be registered with the Care Quality Commission. This has been a requirement since 2011. The Care Quality Commission (CQC) requires dental practices to demonstrate good practice, high standards and operations and be able to demonstrate evidence of this in relation to Health and Safety. This includes a Legionella Risk Assessment.

The requirement for Legionella Risk Assessment in Dental practises has actually been present since the HSE’s ACOP L8 publication was produced in 2001. In addition, HTMGuidance document 04-01 (Health Technical Memorandum HTM 04-01 – The Control of Legionella, Hygiene, “Safe” hot water, cold water and drinking water systems) was published in 2006 which again recommended Legionella Risk Assessments be undertaken.

However, the most recent HTM 01-05 (Health Technical Memorandum HTM 01-05 – Decontamination in Primary Care Dental Practices) states that it is a legal requirement for all dentists in the UK to have a legionella risk assessment.

 What Do I Need to Demonstrate for Compliance?

The Care Quality Commission requires that Dental Practices are able to provide evidence that they are complying with HTM and legislative requirements.

The Care Quality Commission’s guidelines for Legionella Control is to ensure adherence to HSE guidance ACOP L8. To do this, a Legionella Risk Assessment is required. In addition, a written control scheme and ongoing monitoring is also required.

What is the L8 Approved Code of Practice? (ACOP)

The L8 Approved Code of Practice applies to the control of Legionella bacteria in any undertaking involving a work activity. It also applies to premises controlled in connection with a trade, business or other undertaking where water is used, stored and there is a reasonably foreseeable risk of exposure to Legionella bacteria (L8 ACOP, paragraph 22).

The ACOP L8 regulations state that a sufficient risk assessment is the first step in Legionnaires’ Disease prevention. The objective is clear that a Legionella Risk Assessment should seek to identify all water systems were Legionella bacteria could potentially grow. It also requires that an assessment of risk to people being exposed to contaminated aerosols as a result of this.

All water systems should be taken into consideration as part of the Legionella Risk Assessment. However, there are some aspects which are highlighted in the ACOP L8 Code of Practice as higher risk. These include:

· Hot & Cold water systems  

· Cooling water systems, cooling towers and evaporative condensers

· Spa pools

· Spray humidifiers, misters, air washers and wet scrubbers

· Safety showers, sprinklers, vehicle wash systems

· Fountains and water features 

· Any other system containing water in which Legionella could grow and be released in aerosol droplets


What Does the Legionella Risk Assessment Need to Cover?

The Legionella Risk Assessment must cover both the domestic hot and cold water services within the practice as well as the dental unit water lines and associated water containing equipment.

NHS Or Private?

All Dental practitioners, both NHS and the private sector are answerable to the CQC in how they operate and maintain high standards of health and safety. Any Dental Practice must provide evidence that they are complying with Legislative requirements.

Are Dental Practices High Risk for Legionella?

Statistically, the overall risk from Legionella contamination in Dental Practices is low. However, this is not to suggest that there is no risk, and therefore a sufficient and suitable Legionella Risk Assessment is required to be undertaken.

In some NHS practices, it is also important to note that some patients may have increased susceptibility to Legionella infection due to compromised immune systems or other associated health related diseases.

Where Does The Risk Come From?

One of the key risks identified for Legionella contamination in Dental Practices is related to the biofilms that are prone to forming on dental unit waterlines. The majority of organisms which can be present on this film are generally harmless, however they have the potential to harbour harmful organisms such as Legionella bacteria.

It is also known that Legionella bacteria can be amplified in the biofilm present on dental units. This can then lead to escalation levels with the potential for inhalation or direct contamination of surgical wounds.

The Dental unit water lines have the most potential and obvious route of exposure for both patient and dentist. However, it is also important to confirm that the standard hot and cold water systems within the building are of low risk. This can include domestic hot and cold water taps, reception areas, practice and any showers, storage tanks or other water outlets or storage mediums within the demise. The Legionella Risk Assessment will assess all of these factors.

How Can EMS Water Help?

Our Qualified Water Consultants are able to provide a comprehensive Legionella Risk Assessment which will include priority risk assessments and schematic drawings. Our Legionella Risk Assessments for dental practices are also designed with compliance to the relevant Department of Health Technical memorandums in mind.

EMS Water will also work with you to ensure your understanding of the findings and any associated risks which are discovered to assist with your ongoing compliance.

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