Leaked HSE report by inspectors before 2012 Olympics highlights danger of poor management of cooling towers

London could experience an outbreak of legionnaires’ disease with potentially “catastrophic consequences” for people’s health because of poor management of cooling towers and evaporative condensers near busy transport hubs and Olympic venues, according to a leaked Health and Safety Executive (HSE) report.

The stark warning is contained in a report by the HSE detailing the results of inspections for the presence of the legionella bacteria, which causes the disease, at 62 sites around the capital, carried out by its inspectors as part of the safety preparations for this summer’s Olympic Games.

Inspectors visited sites “within two kilometres of London-based Olympic venues and certain major travel hubs, namely Heathrow airport, London City airport, London Bridge station and St Pancras train station”, as well as all sites under the HSE’s remit in the central London borough of Westminster, according to the report entitled Olympic Legionella Project, dated “spring/summer 2012”.

It reveals that compliance with health and safety requirements was inadequate at almost three-quarters of the sites. “The headline to arise from this project is the poor level of compliance. In percentage terms 73% of sites were in receipt of enforcement notices or written/verbal advice,” it says.

Noting that “there appears to be no logical reason why compliance is poor”, it then refers to the previous outbreaks of legionella and the relevance of the Corporate Manslaughter and Corporate Homicide Act for management of risk. It then states: “The potential of any outbreak in terms of numbers of people infected and potential for prosecution on both an individual or corporate basis is well known.”

Then, noting the problems inspectors uncovered and potentially poor management of cooling towers and evaporative condensers by facilities management companies, it adds: “Taken together with the increased turnover of FM companies leading to management responsibilities changing, it could be speculated that scenarios are occuring where an outbreak could happen [in London]. This will have catastrophic consequences compared to Edinburgh given it is the area with the most footfall within the country.”

Three people died and almost 100 others fell ill, with several ending up in intensive care in hospital, in the Scottish capital in June this year in an outbreak of legionnaires’ disease linked to cooling towers in the south-west of the city.

The HSE’s report, obtained by Environmental Health News (EHN) magazine, appears to be warning that London could experience a much greater loss of life than Edinburgh because of the large number of people who use the transport hubs inspected in the capital.

An outbreak of legionnaires’ disease in Stoke-on-Trent in July, which was linked to a hot tub display, led to 21 people becoming infected and two deaths. The disease is an uncommon but severe form of pneumonia. Smokers and anyone with a weakened immune system is at higher risk.

Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen, told EHN that the still unpublished HSE report showed that urgent action was needed to minimise the risk to Londoners.

“A great pity that the HSE Olympic Project Report has not yet been published. It is a powerful wake-up call for action to rectify the long list of deficiencies found regarding the management of the legionella risk from cooling towers, particularly in the public sector. But for the grace of God there hasn’t been an outbreak in London – yet. Urgent action is needed. Legionella kills – but it is preventable,” Pennington said.

The HSE initially identified 106 sites for inspection. Of those, 62 were HSE-enforced sites which had active wet cooling towers and evaporative condensers, 31 were decommisisoned or not in use, four were embassies “where enforcement was a grey area” and the other nine were due to be inspected by local council officials.

Of the 62 sites its staff visited, 11 were issued with improvement notices over issues such as access problems, insufficient risk assessment and poor monitoring or management. It issued written advice in relation to another 30 sites and verbal advice to eight others. But only one site was being considered for prosecution, the report says.

Compliance was “poorer” among the 43 sites it visited that were owned by the public sector than among the 19 private sector sites, the report notes.

The HSE told EHN that the warning of a catastrophic outbreak was unfounded. “This was a comment made by the inspector who drafted the report, based on speculation and personal opinion. It is not one that is backed up by research or evidence,” a spokesperson said.

Formal enforcement action in the form of notices was needed at fewer than 10% of the sites visited, the HSE added.

“Most of this enforcement related to the provision of safe means of access for staff and contractors involved in the monitoring and maintenance of the cooling towers and evaporative condensers, rather than being related directly to legionella management. Verbal and written advice is generally given where it has been identified that improvements can be made and standards raised, but where people are not being put at serious risk,” said the spokesperson.

A “final version” of the report would be published, the HSE said.

Proactive checks on potential legionella breeding grounds have halved in three years, says UK health and safety watchdog

Inspections of sites identified as potential breeding grounds for legionnaires’ disease have almost halved over the last three years.

The sharp decline has resulted in warnings that cutbacks are having a damaging effect on public health and comes as officials continue to investigate several outbreaks of the disease, including one last month in Stoke-on-Trent in which two people died.

There has been a 44% fall in the number of inspections into legionella – the bacterium that causes the disease – carried out by the Health and Safety Executive since 2009. The total level of proactive inspections fell from 833 in 2009 to 464 in 2011.

Proactive inspections are carried out at sites that are considered to be at high risk of causing an outbreak of the disease, which is spread through infected water sources, particularly industrial cooling towers and air-conditioning systems. According to the HSE, 90% of outbreaks in the past 10 years were caused by businesses failing to identify risks and implement effective control measures.

There are around 5,800 cooling sites in the UK, of which 2,900 undergo inspections by the HSE. The number of legionella inspections at cooling towers carried out by the HSE fell from 237 in 2010 to 134 in 2011, according to the figures released to Environmental Health News.

Graham Jukes, chief executive of the Chartered Institute of Environmental Health, warned of a “ticking time bomb”. He said: “My concern is that, over time, we will see increases in the number of accidental deaths or outbreaks of disease that could be prevented from proactive actions.”

In June more than 100 people in Edinburgh contracted legionnaires’ disease in an outbreak believed to have stemmed from a cooling tower. Three people died. A leading bacteriologist, Professor Hugh Pennington, has called for a public inquiry into the outbreak and a “root-and-branch” review of regulatory policy.

He described the fall in inspections as “highly unsatisfactory”. He added: “The great majority of cooling towers can only be having inspections once every 10 years, some probably less.”

The number of deaths from legionnaires’ disease has halved over the past three years but Pennington said this had been achieved through improvements in intensive care.

A spokeswoman for the HSE said it was the responsibility of operators of cooling sites to ensure they did not pose a risk to public health and that inspections were only one of a number of measures deployed in combating disease. She said the figures related only to legionella-focused inspections and did not include general inspections that might also reveal the bacteria.

Proactive checks on potential legionella breeding grounds have halved in three years, says UK health and safety watchdog

Inspections of sites identified as potential breeding grounds for legionnaires’ disease have almost halved over the last three years.

The sharp decline has resulted in warnings that cutbacks are having a damaging effect on public health and comes as officials continue to investigate several outbreaks of the disease, including one last month in Stoke-on-Trent in which two people died.

There has been a 44% fall in the number of inspections into legionella – the bacterium that causes the disease – carried out by the Health and Safety Executive since 2009. The total level of proactive inspections fell from 833 in 2009 to 464 in 2011.

Proactive inspections are carried out at sites that are considered to be at high risk of causing an outbreak of the disease, which is spread through infected water sources, particularly industrial cooling towers and air-conditioning systems. According to the HSE, 90% of outbreaks in the past 10 years were caused by businesses failing to identify risks and implement effective control measures.

There are around 5,800 cooling sites in the UK, of which 2,900 undergo inspections by the HSE. The number of legionella inspections at cooling towers carried out by the HSE fell from 237 in 2010 to 134 in 2011, according to the figures released to Environmental Health News.

Graham Jukes, chief executive of the Chartered Institute of Environmental Health, warned of a “ticking time bomb”. He said: “My concern is that, over time, we will see increases in the number of accidental deaths or outbreaks of disease that could be prevented from proactive actions.”

In June more than 100 people in Edinburgh contracted legionnaires’ disease in an outbreak believed to have stemmed from a cooling tower. Three people died. A leading bacteriologist, Professor Hugh Pennington, has called for a public inquiry into the outbreak and a “root-and-branch” review of regulatory policy.

He described the fall in inspections as “highly unsatisfactory”. He added: “The great majority of cooling towers can only be having inspections once every 10 years, some probably less.”

The number of deaths from legionnaires’ disease has halved over the past three years but Pennington said this had been achieved through improvements in intensive care.

A spokeswoman for the HSE said it was the responsibility of operators of cooling sites to ensure they did not pose a risk to public health and that inspections were only one of a number of measures deployed in combating disease. She said the figures related only to legionella-focused inspections and did not include general inspections that might also reveal the bacteria.

Samples taken from tub at JTF Mega Discount Warehouse in Stoke-on-Trent match those from patients

Health authorities say a hot tub is the “probable” source of an outbreak of legionnaires’ disease in Staffordshire.

Samples taken from a tub at the Stoke-on-Trent branch of the JTF Mega Discount Warehouse match those taken from patients with an unusual strain of the bacteria responsible for the disease. There have been 18 cases linked to the outbreak. One person has died.

A statement from the firm, which has 11 branches across the Midlands and north of England, said it was “extremely concerned by this incident”, and had worked closely with authorities to eliminate any further risk. The product has been withdrawn from all stores.

Seven people are in hospital in Stoke-on-Trent and another is in a stable condition in hospital in Leicester, health agencies said on Monday. The tub was “decommissioned” on Tuesday as investigations were launched across the city to identify the possible source of the outbreak. Cooling towers, air conditioning systems and other potential sites of infection have also been checked.

Specialists from the Health and Safety Executive and Stoke-on-Trent council are continuing to take samples from sites across the city.

The probable link with the spa tub was established by the specialist laboratory of the Health Protection Agency (HPA), the NHS’s main public health body, late on Sunday. Sue Ibbotson, the agency’s regional director, said: “We have the evidence from DNA fingerprinting of samples from the hot tub and the patients being caused by the same previously unseen strain of legionella.

“The HPA also took detailed histories from the confirmed cases and we know that 17 of the 18 confirmed cases visited this warehouse in the two weeks before they fell ill. Added to that we know that spa pools are known to be effective mechanisms for spreading legionella infection.

“We may still expect to see new cases of legionnaires’ disease related to this outbreak. JTF Warehouse decommissioned the hot tub on 24 July. It can take up to two weeks following exposure for people to develop symptoms of legionnaires’ disease and a further few days before they go to see their GP.”

Zafar Iqbal, director of public health for the NHS in Stoke, said: “It’s good news that we have a probable source, especially as we know that it has been dealt with through precautionary measures last week.”

Those in hospital are all said to be in a “stable and improving” condition.

Samples taken from tub at JTF Mega Discount Warehouse in Stoke-on-Trent match those from patients

Health authorities say a hot tub is the “probable” source of an outbreak of legionnaires’ disease in Staffordshire.

Samples taken from a tub at the Stoke-on-Trent branch of the JTF Mega Discount Warehouse match those taken from patients with an unusual strain of the bacteria responsible for the disease. There have been 18 cases linked to the outbreak. One person has died.

A statement from the firm, which has 11 branches across the Midlands and north of England, said it was “extremely concerned by this incident”, and had worked closely with authorities to eliminate any further risk. The product has been withdrawn from all stores.

Seven people are in hospital in Stoke-on-Trent and another is in a stable condition in hospital in Leicester, health agencies said on Monday. The tub was “decommissioned” on Tuesday as investigations were launched across the city to identify the possible source of the outbreak. Cooling towers, air conditioning systems and other potential sites of infection have also been checked.

Specialists from the Health and Safety Executive and Stoke-on-Trent council are continuing to take samples from sites across the city.

The probable link with the spa tub was established by the specialist laboratory of the Health Protection Agency (HPA), the NHS’s main public health body, late on Sunday. Sue Ibbotson, the agency’s regional director, said: “We have the evidence from DNA fingerprinting of samples from the hot tub and the patients being caused by the same previously unseen strain of legionella.

“The HPA also took detailed histories from the confirmed cases and we know that 17 of the 18 confirmed cases visited this warehouse in the two weeks before they fell ill. Added to that we know that spa pools are known to be effective mechanisms for spreading legionella infection.

“We may still expect to see new cases of legionnaires’ disease related to this outbreak. JTF Warehouse decommissioned the hot tub on 24 July. It can take up to two weeks following exposure for people to develop symptoms of legionnaires’ disease and a further few days before they go to see their GP.”

Zafar Iqbal, director of public health for the NHS in Stoke, said: “It’s good news that we have a probable source, especially as we know that it has been dealt with through precautionary measures last week.”

Those in hospital are all said to be in a “stable and improving” condition.

Eight people remain in hospital as cooling towers are treated with chlorine and spas and air-conditioning systems tested

Efforts to identify the source of legionnaires’ disease in Stoke-on-Trent are continuing, after the outbreak which has so far which has killed one person and infected at least 15 others.

Eight people, aged between their late-40s and mid-70s, remain in hospital. The first cases were confirmed six days ago and cooling towers in the city have been treated with chlorine although no source has yet been identified.

Other potential sites of infection, including spas and air-conditioning systems, have also been tested. No cause of death has yet been given for the patient who died on Saturday although an update on the outbreak is expected on Monday afternoon.

One patient at Glenfield hospital, Leicester, was said to be in a critical but stable condition on Sunday night, while the others at the University of North Staffordshire hospital, Stoke, were stable or improving.

Eight people remain in hospital as cooling towers are treated with chlorine and spas and air-conditioning systems tested

Efforts to identify the source of legionnaires’ disease in Stoke-on-Trent are continuing, after the outbreak which has so far which has killed one person and infected at least 15 others.

Eight people, aged between their late-40s and mid-70s, remain in hospital. The first cases were confirmed six days ago and cooling towers in the city have been treated with chlorine although no source has yet been identified.

Other potential sites of infection, including spas and air-conditioning systems, have also been tested. No cause of death has yet been given for the patient who died on Saturday although an update on the outbreak is expected on Monday afternoon.

One patient at Glenfield hospital, Leicester, was said to be in a critical but stable condition on Sunday night, while the others at the University of North Staffordshire hospital, Stoke, were stable or improving.

One of 16 patients confirmed as having contracted Legionnaires’ disease in Staffordshire has died, says health agency

Eight patients remain in hospital after an outbreak of Legionnaires’ disease.

Sixteen people have been confirmed as having contracted the disease in Stoke-on-Trent, Staffordshire, since Tuesday.

No details have yet been released of a patient who died on Saturday. The cause of death has also not been revealed.

The Health Protection Agency (HPA) said on Sunday that no new cases of the disease had been reported. All those infected had been aged between their late 40s and mid-70s.

The disease was not hospital-related and the premises were safe for patients and visitors, the HPA added.

A spokesman for the University Hospital of North Staffordshire in Stoke said: “Eight patients remain in hospital and all are in a stable or improving condition. Three patients were well enough to go home today and have been discharged.”

A spokesman for Glenfield hospital, Leicester, said: “We are treating a patient transferred from the University Hospital of North Staffordshire confirmed with Legionnaires’ disease who is in a critical but stable condition.”

One of 16 patients confirmed as having contracted Legionnaires’ disease in Staffordshire has died, says health agency

Eight patients remain in hospital after an outbreak of Legionnaires’ disease.

Sixteen people have been confirmed as having contracted the disease in Stoke-on-Trent, Staffordshire, since Tuesday.

No details have yet been released of a patient who died on Saturday. The cause of death has also not been revealed.

The Health Protection Agency (HPA) said on Sunday that no new cases of the disease had been reported. All those infected had been aged between their late 40s and mid-70s.

The disease was not hospital-related and the premises were safe for patients and visitors, the HPA added.

A spokesman for the University Hospital of North Staffordshire in Stoke said: “Eight patients remain in hospital and all are in a stable or improving condition. Three patients were well enough to go home today and have been discharged.”

A spokesman for Glenfield hospital, Leicester, said: “We are treating a patient transferred from the University Hospital of North Staffordshire confirmed with Legionnaires’ disease who is in a critical but stable condition.”

Deceased was one of 16 in Stoke-on-Trent to contract disease, although exact cause of death remains unknown

Health officials are awaiting details of the cause of death of a patient affected by a legionnaires’ disease outbreak.

The patient was among 16 people suffering from the disease in Stoke-on-Trent, Staffordshire. The group have all been confirmed as having legionnaires’ disease, with the number of confirmed cases rising steadily since news of the outbreak emerged last Tuesday.

The Health Protection Agency (HPA) said one of the patients in hospital had died. No further details were released about the victim and officials are waiting for a cause of death from the coroner.

The HPA said there had been one further case confirmed in Stoke, bringing the total to 16. All those affected are aged between their late 40s and mid-70s.

A spokesman for university hospital of North Staffordshire (UNHS) said: “The trust is currently treating 11 patients confirmed with legionnaires’ disease who are all in a stable or improving condition.

“One patient has sadly died. Three patients are well enough to go home and have been discharged.”

A spokesman for Glenfield hospital, Leicester, said: “We are treating a patient transferred from the UNHS confirmed with Legionnaires’ disease who is in a critical but stable condition.”