Dr Tom Makin, a highly experienced microbiologist and former Directorate manager at the Department of Medical Microbiology at the Royal Liverpool University Hospital, and Ken Tench, compliance manager, Estates and Facilities Directorate, at Central Manchester University Hospitals NHS Foundation Trust.
Who has worked in operational estate functions since 1984, examine the widespread use of thermostatic mixing valves, or TMVs, in healthcare premises. They argue that such devices have, in recent years especially, been overspecified, particularly given the potential for increased contamination of the outlets, and the resulting heightened risk of spread of potentially life-threatening nosocomial waterborne diseases.
There is a recognised increased risk of scalding at hot water outlets in healthcare premises, arising in part as a result of compliance with Health and Safety Executive1 and Department of Health2 guidance requiring hot water to be produced at no less than 60°C to control Legionella and other opportunistic pathogens that cause waterborne nosocomial infection.
To reduce scalding risk, thermostatic mixing valves (TMVs), which blend water to a safe temperature for bathing, are recommended. In healthcare premises TMVs are required to rapidly close down the hot water supply to the mixer unit should interruption to the flow of cold water to the outlet occur. TMV3 valves represent the highest specification of such valves, and should ensure that the hot water flow at the outlet ceases virtually immediately the cold water supply stops.
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