scholarly journals Blackwater Event: Water Management and Remediation at a Major Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s140-s140
Author(s):  
Priya Sampathkumar ◽  
Debra Apenhorst ◽  
Al Kubly ◽  
Mark Keller ◽  
Alan Wright
Keyword(s):  
Water Management ◽  
Water Supply ◽  
Potable Water ◽  
Water System ◽  
Bottled Water ◽  
Alternative Methods ◽  
Infection Prevention And Control ◽  
Water Testing ◽  
Municipal Water ◽  
The Impact

Background: The CMS and the CDC recommend that all healthcare facilities have an effective water management program (WMP). Our WMP has been in place since 2010; it includes members from facilities operations, infection prevention and control, environmental services, and industrial hygiene. The team meets regularly to discuss current water issues, reviews validation data and water testing reports. Description of event: In April 2018, we suddenly experienced discolored water and sediment at multiple water fixtures throughout the 3.3 million square-foot hospital campus. The hospital incident command structure (HICS) was activated to assist in investigating and managing the situation. Immediate response: Water was deemed unsafe while the cause was being investigated. Bottled water was distributed to 950 hospital patients, and >8,000 staff and visitors. The impact included alternative methods for hand hygiene, the use of bottled water for food preparation and drinking, and the elimination of showers for patients and staff. The dialysis unit used an independent water supply that was not affected. Investigation and remediation: The hospital had 2 sources of domestic cold water: municipal water and a private well that had been in use since 1912. An investigation revealed that the well pump had malfunctioned, drawing gravel into the potable water supply. This overwhelmed the plumbing, blocked toilets and likely dislodged biofilm from the pipes. Early testing showed high levels of corrosion byproducts (ie, iron, copper, and lead) and bacterial contamination in the water, including presence of Legionella. Remediation involved isolating the well, switching to municipal water as the sole source of potable water, flushing the system, and retesting. Overall, 105 technicians flushed the water system including 6,000 water fixtures, 125 drinking fountains, and 95 emergency showers and eyewashes; they sanitized and cleaned 130 ice machines and tested 240 backflow preventers. We retested 437 water samples after remediation; all parameters had returned to the normal range. The existing water process flow diagrams were used to guide sampling for water testing. Conclusions: The hospital’s water system was brought back on line in 78 hours after the first report of “black water.” An active, mature WMP with multiple facilities technicians trained in water sampling enabled a quick response. Coordination through the HICS structure streamlined the response and enabled clear communication throughout the process.Funding: NoneDisclosures: None

Managing the risks and responsibilities of resource companies providing potable water

2013 ◽  
Vol 53 (1) ◽  
pp. 407
Author(s):  
Chris Hewitson ◽  
Eva Dec ◽  
Tony Lines
Keyword(s):  
Water Quality ◽  
Drinking Water ◽  
Water Supply ◽  
Potable Water ◽  
Quality Management System ◽  
Water Quality Management ◽  
Water Source ◽  
Aquifer Recharge ◽  
Beneficial Use ◽  
The Impact

This peer-reviewed paper examines the risks and responsibilities of water providers and the process resource companies should undertake to document how they will deliver a safe and secure water supply to their employees and contractors, and the communities in which they operate, thereby reducing the risks of water quality incidents and managing the impact to the organisation should an incident occur. Water quality incidents can have major impacts to human health and the brand perception of the resource company supplying the water, and can potentially shutdown resource abstraction. Resource companies have a duty of care to provide a secure and safe drinking water supply. This is reinforced by state health departments directing resource organisations to comply with the Australian Drinking Water Guidelines (ADWG), which were updated in 2011 (National Health and Medical Research Council, 2011). Organisations in the CSG industry experience an additional challenge—managing water by-product from gas extraction. There are drivers for the beneficial use of this water—including irrigation, aquifer recharge and municipal supply—resulting in changes to legislation in Queensland (DERM, 2010) that require a process similar to ADWG recommendations, where beneficial use or disposal may impact potable supplies. The ADWG provides clear guidance to potable water providers—whether they are supplying a few consumers or major towns requiring a Drinking Water Quality Management System (DWQM System). This guidance includes documenting a clear process to securing a clean water source, making the water safe to consume and proving it is safe. Developing a DWQM System enables resource companies to understand issues in supplying drinking water through regular review and improvement, while minimising and managing the health risks to consumers.

scholarly journals Introduction of Monochloramine into a Municipal Water System: Impact on Colonization of Buildings by Legionella spp

2006 ◽  
Vol 72 (1) ◽  
pp. 378-383 ◽  
Author(s):  
Matthew R. Moore ◽  
Marsha Pryor ◽  
Barry Fields ◽  
Claressa Lucas ◽  
Maureen Phelan ◽  
...  
Keyword(s):  
Potable Water ◽  
Sampling Site ◽  
Water System ◽  
Water Source ◽  
Water Systems ◽  
Hot Water ◽  
County Government ◽  
Single Family ◽  
Pinellas County ◽  
Municipal Water

ABSTRACT Legionnaires' disease (LD) outbreaks are often traced to colonized potable water systems. We collected water samples from potable water systems of 96 buildings in Pinellas County, Florida, between January and April 2002, during a time when chlorine was the primary residual disinfectant, and from the same buildings between June and September 2002, immediately after monochloramine was introduced into the municipal water system. Samples were cultured for legionellae and amoebae using standard methods. We determined predictors of Legionella colonization of individual buildings and of individual sampling sites. During the chlorine phase, 19 (19.8%) buildings were colonized with legionellae in at least one sampling site. During the monochloramine phase, six (6.2%) buildings were colonized. In the chlorine phase, predictors of Legionella colonization included water source (source B compared to all others, adjusted odds ratio [aOR], 6.7; 95% confidence interval [CI], 2.0 to 23) and the presence of a system with continuously circulating hot water (aOR, 9.8; 95% CI, 1.9 to 51). In the monochloramine phase, there were no predictors of individual building colonization, although we observed a trend toward greater effectiveness of monochloramine in hotels and single-family homes than in county government buildings. The presence of amoebae predicted Legionella colonization at individual sampling sites in both phases (OR ranged from 15 to 46, depending on the phase and sampling site). The routine introduction of monochloramine into a municipal drinking water system appears to have reduced colonization by Legionella spp. in buildings served by the system. Monochloramine may hold promise as community-wide intervention for the prevention of LD.

Comparison of two molecular methods used for subtyping of Legionella pneumophila 1 strains isolated from a hospital water supply

2008 ◽  
Vol 58 (3) ◽  
pp. 683-688 ◽  
Author(s):  
B. Casini ◽  
P. Valentini ◽  
A. Baggiani ◽  
F. Torracca ◽  
C. Lorenzini ◽  
...  
Keyword(s):  
Water Supply ◽  
Legionella Pneumophila ◽  
Potable Water ◽  
Water System ◽  
Epidemiological Studies ◽  
Molecular Methods ◽  
Pfge Analysis ◽  
Typing Method ◽  
Electrophoretic Patterns ◽  
Low Degree

The results of the pulsed-field gel electrophoresis and the sequence-based typing (using the loci flaA, pilE, asd, mip, mompS and proA) were compared for subtyping of Legionella pneumophila 1 strains isolated from a hospital water supply. Molecular typing was carried out on 61 isolates (38% of the positive samples) selected on space and temporal criteria in order to follow the evolution of the water-system colonization. For all the 61 isolates, the sequence of the amplified mip gene fragment identified Legionella pneumophila strain Wadsworth. Genotype testing by PFGE analysis showed three different patterns, correspondent to three SBT types according to the allelic profiles. Both PFGE and SBT indicated the circulation and the persistence in the hospital potable water-system of three types randomly distributed in space and time. The two molecular methods adopted showed a 100% concordance, although a low degree of genetic heterogeneity characterized the isolates. The electrophoretic patterns were sufficiently unambiguous to consider PFGE a highly discriminatory typing method, but the SBT technique besides accurately characterizing isolates, was able to identify Legionella strains through analysis of the mip gene. A typing method with this level of discriminatory power has great potential for assisting in epidemiological studies.

scholarly journals Bottled water selection and health considerations from multi-element analysis of products sold in New York state

2008 ◽  
Vol 6 (4) ◽  
pp. 505-512 ◽  
Author(s):  
Jeffrey Chiarenzelli ◽  
Christina Pominville
Keyword(s):  
New York ◽  
Environmental Protection Agency ◽  
Inductively Coupled Plasma ◽  
New York State ◽  
Water System ◽  
Bottled Water ◽  
Element Analysis ◽  
Treatment Comparison ◽  
Municipal Water ◽  
Wide Range

Nineteen bottled water products were purchased from stores in Potsdam and Wappingers Falls, New York and analyzed for 71 inorganic elements by inductively coupled plasma – mass spectrometry (ICP-MS). The wide range in elemental concentrations observed suggests considerable variation in source water composition, processing, and treatment. Comparison with samples from a typical small municipal water system (Potsdam, New York) was made to evaluate the differences between bottled and municipal water and in many cases little difference is apparent. With the exception of one sample of tonic water and one mineral water, all bottled waters tested meet United States Environmental Protection Agency (USEPA) primary standards for drinking water supplies. Ingestion of some of the waters could provide significant percentages of the reference daily intakes (RDI) of key trace elements. Knowledge of the inorganic chemistry of bottled water can help consumers select the brands best suited to their individual health needs or preferences.

Point-of-Use Membrane Filtration and Hyperchlorination to Prevent Patient Exposure to Rapidly Growing Mycobacteria in the Potable Water Supply of a Skilled Nursing Facility

2011 ◽  
Vol 32 (9) ◽  
pp. 837-844 ◽  
Author(s):  
Margaret M. Williams ◽  
Tai-Ho Chen ◽  
Tim Keane ◽  
Nadege Toney ◽  
Sean Toney ◽  
...  
Keyword(s):  
Water Supply ◽  
Potable Water ◽  
Skilled Nursing Facility ◽  
Water System ◽  
Nursing Facility ◽  
Mycobacterium Chelonae ◽  
Skilled Nursing ◽  
Rapidly Growing Mycobacteria ◽  
Membrane Filters ◽  
Point Of Use

Background.Healthcare-associated outbreaks and pseudo-outbreaks of rapidly growing mycobacteria (RGM) are frequently associated with contaminated tap water. A pseudo-outbreak ofMycobacterium chelonae–M. abscessusin patients undergoing bronchoscopy was identified by 2 acute care hospitals. RGM was identified in bronchoscopy specimens of 28 patients, 25 of whom resided in the same skilled nursing facility (SNF). An investigation ruled out bronchoscopy procedures, specimen collection, and scope reprocessing at the hospitals as sources of transmission.Objective.To identify the reservoir for RGM within the SNF and evaluate 2 water system treatments, hyperchlorination and point-of-use (POU) membrane filters, to reduce RGM.Design.A comparative in situ study of 2 water system treatments to prevent RGM transmission.Setting.An SNF specializing in care of patients requiring ventilator support.Methods.RGM and heterotrophic plate count (HPC) bacteria were examined in facility water before and after hyperchlorination and in a subsequent 24-week assessment of filtered water by colony enumeration on Middlebrook and R2A media.Results.Mycobacterium chelonaewas consistently isolated from the SNF water supply. Hyperchlorination reduced RGM by 1.5 log10initially, but the population returned to original levels within 90 days. Concentration of HPC bacteria also decreased temporarily. RGM were reduced below detection level in filtered water, a 3-log10reduction. HPC bacteria were not recovered from newly installed filters, although low quantities were found in water from 2-week-old filters.Conclusion.POU membrane filters may be a feasible prevention measure for healthcare facilities to limit exposure of sensitive individuals to RGM in potable water systems.

Effects of interforest grazing on forest ecosystem and water environment of basin-Interforest grazing and ecosystem service

Impact ◽  
2020 ◽  
Vol 2020 (3) ◽  
pp. 36-38
Author(s):  
Yuri Yamazaki
Keyword(s):  
Water Environment ◽  
Water System ◽  
Agricultural Practices ◽  
Meat Consumption ◽  
Alternative Methods ◽  
Regional Environment ◽  
Agricultural Industry ◽  
Run Off ◽  
Cattle Rearing ◽  
The Impact

There is a myriad of issues that form our global crisis of climate change and the destruction of the environment. If we are to develop sustainable practices that can help reverse the destructive trends, we need revolutions across a range of industries. The agricultural industry is huge, globally essential activity that will always be with us. It is intimately tied to the environment and has multiple direct impacts on it. Naturally, the world will always require food, whether that be from livestock or crops. Therefore, we need to continue improving our agricultural practices if we are to sustain the global population. Livestock pose a particular set of questions as to how best maintain them. They take up significant space, consume a lot of vegetation and produce a lot of waste. Whilst avoiding and reducing meat consumption is a growing social movement, this will never eliminate meat consumption and only further emphasises how we should rear livestock in a sustainable and non-destructive manner. Typically, livestock such as cattle are raised on large areas of meadows and grasslands. The more cattle you are looking to raise, the greater the amount of land needed. Where they feed has a profound impact on the environment around them. They can alter the vegetation growing and their waste can affect the water system. When it rains, their waste seeps into the soil and then into streams and rivers. Rivers are basins for large areas of grassland and likely multiple cattle farms. This means a huge multiplication of waste run off from livestock rearing. Dr Yuri Yamazaki of the Faculty of Regional Environment Science, Tokyo University of Agriculture is investigating alternative methods of cattle rearing. This work has developed directly from her doctoral studies which were aimed at evaluating the impact of dairy farming and upland farming on river water quality. This work led her to exploring the forest grazing of cattle as a potential alternate way of maintaining livestock. She is now working hard to evaluate this proposition.

scholarly journals A Model-Based Engineering Methodology and Architecture for Resilience in Systems-of-Systems: A Case of Water Supply Resilience to Flooding

Water ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 496 ◽  
Author(s):  
Demetrios Joannou ◽  
Roy Kalawsky ◽  
Sara Saravi ◽  
Monica Rivas Casado ◽  
Guangtao Fu ◽  
...  
Keyword(s):  
Water Supply ◽  
Water System ◽  
Water Sector ◽  
Systems Architecture ◽  
Systems Of Systems ◽  
Supply Networks ◽  
Model Based ◽  
Wide Range ◽  
The Uk ◽  
The Impact

There is a clear and evident requirement for a conscious effort to be made towards a resilient water system-of-systems (SoS) within the UK, in terms of both supply and flooding. The impact of flooding goes beyond the immediately obvious socio-aspects of disruption, cascading and affecting a wide range of connected systems. The issues caused by flooding need to be treated in a fashion which adopts an SoS approach to evaluate the risks associated with interconnected systems and to assess resilience against flooding from various perspectives. Changes in climate result in deviations in frequency and intensity of precipitation; variations in annual patterns make planning and management for resilience more challenging. This article presents a verified model-based system engineering methodology for decision-makers in the water sector to holistically, and systematically implement resilience within the water context, specifically focusing on effects of flooding on water supply. A novel resilience viewpoint has been created which is solely focused on the resilience aspects of architecture that is presented within this paper. Systems architecture modelling forms the basis of the methodology and includes an innovative resilience viewpoint to help evaluate current SoS resilience, and to design for future resilient states. Architecting for resilience, and subsequently simulating designs, is seen as the solution to successfully ensuring system performance does not suffer, and systems continue to function at the desired levels of operability. The case study presented within this paper demonstrates the application of the SoS resilience methodology on water supply networks in times of flooding, highlighting how such a methodology can be used for approaching resilience in the water sector from an SoS perspective. The methodology highlights where resilience improvements are necessary and also provides a process where architecture solutions can be proposed and tested.

The impact of water resource planning on water issues in Beijing, China

Water Policy ◽  
2014 ◽  
Vol 17 (4) ◽  
pp. 612-629 ◽  
Author(s):  
Wei Fu ◽  
Dihua Li
Keyword(s):  
Water Supply ◽  
Water Resource ◽  
Water Conservation ◽  
Water System ◽  
Resource Planning ◽  
Water Diversion ◽  
Systematic Analysis ◽  
Water Resource Planning ◽  
The Impact ◽  
Water Issues

Water has become a critically important resource in Beijing. In this study, a systematic analysis of changes in conditions related to water resources in Beijing since 1949 was performed. These include changes in water quantity and quality, water disasters, as well as an analysis of the evolution of water resource planning in Beijing over this period of time. Also, past approaches to urbanization have been looked at to see whether they exacerbated Beijing's water issues. The aggravating water issues were found to be associated with water resource planning in five ways. Water supply and flood protection projects have failed to control the complex water system and have exacerbated water shortages. Excessive project-oriented water diversion efforts and a lack of resource-oriented water conservation have allowed aquatic environments to deteriorate. Water supply planning has been based on demand that has intensified a lowering of the groundwater table. Improper measures that allowed wastewater to be used for irrigation of agricultural soils have aggravated water pollution. In general, water resource planning has not necessarily been conducive to solving water problems; it has even exacerbated Beijing's water crisis. The results and recommendations of this study may serve as a reference for future water resource planning in Beijing.

Net-zero water management: achieving energy-positive municipal water supply

2016 ◽  
Vol 2 (2) ◽  
pp. 250-260 ◽  
Author(s):  
James D. Englehardt ◽  
Tingting Wu ◽  
Frederick Bloetscher ◽  
Yang Deng ◽  
Piet du Pisani ◽  
...  
Keyword(s):  
Water Management ◽  
Water Supply ◽  
Water Recycling ◽  
Total Water ◽  
Municipal Water Supply ◽  
Municipal Water ◽  
Net Zero

Municipal water management can now be energy-positive and economical, through total water recycling.

scholarly journals Examining the Relative Impact of Drivers on Energy Input for Municipal Water Supply in Africa

2021 ◽  
Vol 13 (15) ◽  
pp. 8480
Author(s):  
Pauline Macharia ◽  
Maria Wirth ◽  
Paul Yillia ◽  
Norbert Kreuzinger
Keyword(s):  
Cluster Analysis ◽  
Water Supply ◽  
Energy Input ◽  
Analytical Framework ◽  
Sub Saharan Africa ◽  
Relative Impact ◽  
Water Abstraction ◽  
Municipal Water Supply ◽  
Municipal Water ◽  
The Impact

This study examines supply-side and demand-side drivers of municipal water supply and describes how they interact to impact energy input for municipal water supply in Africa. Several key compound indicators were parameterized to generate cluster centers using k-means cluster analysis for 52 countries in Africa to show the impact of water supply–demand drivers on municipal water supply and associated energy input. The cluster analysis produced impact scores with five cluster centers that grouped countries with similar key compound indicators and impact scores. Three countries (Gambia, Libya, & Mauritius) were classified as outliers. Libya presented a unique case with the highest impact score on energy input for raw water abstraction, associated with largescale pumping from deep groundwater aquifers. Multivariate analysis of the key indicators for 20 countries in sub-Saharan Africa that are either water-secure or water-stressed illustrate the relative impact of drivers on energy input for municipal water supply. The analytical framework developed presents an approach to assessing the impact of drivers on energy input for municipal water supply, and the findings could be used to support planning processes to build resilient drinking water infrastructure in developing countries with data challenges.

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