In this section

Terry Stange, Ph.D.

CEO, Trusted Water

Water Age Mapping in Premise Plumbing for Infection Prevention and Compliance

Abstract: Periodic water outlet flushing is a common method of remediation in water management programs to reduce the risk of bacterial growth in stagnant plumbing. However, there is no simple way to verify flushing protocols are being followed and/or how often water outlets are used. New technology is required to identify stagnant water outlets, because direct observation is impractical. The objective of this study was to implement novel water outlet flushing monitors as a usage and water age mapping tool. The question was whether these monitors are useful for verifying flushing protocols, managing water age within a health care facility and ultimately reducing bacteria levels at high-risk water outlets. We provide recommendations for facility leaders on how to implement flushing monitors and usage mapping tools in water management programs to reduce water age and the risk of growth and spread of waterborne pathogens.

Conclusions and Recommendations

Flushing monitors work well as a surveillance and reminder tool on high visibility outlets, but are less effective on low visibility outlets where there is less traffic. ATP results confirm reduced bacteria levels on outlets with monitors and high flushing compliance. The monitors enable an evidence-based approach to manage water age and bacteria levels in premise plumbing. Water outlet usage can be mapped based on different stagnation timer thresholds to identify under-used outlets. Monitors support water conservation by identifying only outlets needing flushing. Results for monitored-outlets in low-traffic areas indicate the need for wireless, remote monitoring solutions to track usage.

In this presentation, we will:

  • Review some of the history of epidemiological outbreaks (cholera, Cryptosporidium, Legionella, etc.) and material issue outbreaks (e.g. lead issues throughout the U.S.) through a plumbing perspective
  • Identify the issues that the push for low-flow has caused in domestic water systems and some of the proposed solutions, as well as showing calculations for initial model of velocity and flow, and temperature considerations
  • Evaluate drain carry issues inside facilities due to low flow in the sanitary/sewer systems
  • Cover the compatibility of supplemental disinfectant with various piping materials and other disinfection strategies
  • Explain and discuss proper hot water recirculation sizing and strategies

Terry Strange Dr. Terry Stange, Ph.D. is the CEO of Trusted Water, which specializes in helping facilities with Legionella management programs by combining water age mapping with water quality data. Using novel sensor technology with water quality data and analytics, Trusted Water is building a cloud-based ecosystem to manage waterborne pathogens in complex plumbing systems. Dr. Stange received his Ph.D. in chemical engineering and materials science from the University of Minnesota and an MBA from Denver University’s Daniels College of Business. He has over 15 years of experience in water quality instrumentation and testing.