I would like to share how we, at The Dudley Group of Hospitals, manage the Legionella risk from our shower heads, particularly as regards regular de-scaling and disinfection.
All shower heads and hoses are removed quarterly and sent away for descaling and disinfecting. Shower heads previously de-scaled and disinfected are then fitted to the showers. Heads and hoses are not separated, but handled as an assembly. Inevitably there is a risk that dirty heads and hoses will be accidentally mixed up with used, clean ones. A red cable tie is therefore fitted to the assembly before it is removed for de-scaling and cleaning, and removed by the contractor after de-scaling and disinfecting. We always replace the shower heads and hoses in our cancer ward, where we have immune-deficient patients, using new heads and hoses. The ones removed are sent with all the other heads and hoses for disinfecting and cleaning for use in other departments. This influx of new heads and hoses in our cancer department makes up for any damaged heads and hoses discarded elsewhere. More recently we have started using low volume shower heads – which aerate the water, and therefore consume around half that of a normal head. There is an excellent payback from the water and energy savings. However, even more important than this is the reduced risk of Legionella. Normal shower heads can be adjusted to provide two or three different types of spray. If these shower heads are dismantled the different “channels” for achieving a choice of sprays can be seen, only one being open to the water at any time. De-scaling and disinfection is compromised, since the chemicals will only reach the channel last selected. The new, low volume shower heads do not offer a choice of spray, and therefore do not have different channels, meaning that all inside surfaces are totally open and accessible to any chemicals used for de-scaling and disinfecting. These heads are also made from bacterialresistant material, and their use is an important part of our control of Legionella bacteria in our showers.
Phil Kinsella I Eng IHEEM (retired)
