Audit, Compliance and Risk Blog

Although Environmental Health and Safety (EH&S) requirements target hundreds of micro-organisms (primarily viruses and bacteria), regulation of important hazards remain on the drawing boards, awaiting appropriate testing and control methodologies, sufficient resources … and high enough political priorities. Until recently, one of these unregulated pathogens has been the legionella bacterium, first identified in 1976 as the cause of “Legionnaire’s disease” – named after an outbreak at an American Legion convention in Philadelphia traced to the hotel’s air conditioning system. This summer, however, an outbreak in New York has led state and local health agencies to adopt extremely ambitious testing and disinfection programs.

What Happened in New York?

Over four weeks during July and August, an outbreak of Legionnaire’s disease in the South Bronx eventually sickened over 100 people and killed 12. As the infections progressed, New York City and State escalated their responses, eventually imposing important new testing and cleanup requirements on tens of thousands of cooling towers statewide.

• Mid-July—health officials notice a spike in Legionnaire’s cases, concentrated in the South Bronx.

• August 6—the NYC Health Commissioner issued an order to all owners of buildings with cooling towers, requiring them to:

• Disinfect their cooling towers within 14 days (unless this had already been done within the preceding 30 days), using a qualified consultant applying an industry-approved protocol.

• Keep inspection and disinfection records, available for City review.

• August 13—NYC City Council passes ordinance to:

• Require owners to register cooling towers with NYC Buildings Department.

• Require owners to develop maintenance plans (meet American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE) standards and manufacturer’s instructions) by “qualified persons” (effective 3/1/16).

• Require quarterly inspections, testing and disinfection of any towers found with microbial levels above standards to be set by Health Department, or after system has been shut in for more than 5 days (effective once Health Department issues regulations).

• Provide penalties for noncompliance.

• Require Health Department to submit reports to the Council.

• August 17—NY State Department of Health adopts (statewide) emergency regulations applicable to all owners of cooling towers, and all general hospitals and residential health care facilities.

• Require owners to register cooling towers with DOH within 30 days.

• Require quarterly inspections, testing and disinfection of any towers found with microbial levels above standards (contained in the regulations), or after system has been shut in for more than 5 days (begin within 30 days).

• Require owners to develop maintenance plans (meeting ASHRAE standards and manufacturer’s instructions) by “qualified persons” (effective 3/1/16).

• Require general hospitals and residential health care facilities to develop sampling plans, as required by DOH.

• Provide penalties for noncompliance.

• August 20—NYC declares the emergency over, after source cooling tower identified and disinfected, and no new infections during previous 2 weeks (incubation period)

What’s Next?

As of this writing, nobody knows how many cooling towers are in New York City, let alone New York state. Estimates run into the tens of thousands—as systems are registered more accurate information will become available. Commentators also offer differing views on how quickly and effectively all these systems can be inspected, disinfected if necessary, and subjected to appropriate management plans. The voluntary ASHRAE standards already exist, and health and safety entities provide (non-mandatory) protocols for Legionella testing (weblinks below), but it seems fair to say that these will be entirely new activities at many locations.

I can’t think of any environmental health and safety (EH&S) program of this scale that has become effective so quickly, but expect that systems will develop over the next year or so to accomplish the city and state program goals to a substantial degree—and that the agencies will spend years tracking down laggards and scofflaws.

More generally, as of this writing it’s not clear whether New York’s actions will prompt other jurisdictions to adopt enforceable rules governing legionella. It seems safe to assume that health agencies will monitor New York’s accomplishments. Environmental service providers have expanded their advertising. In addition, readers should note that the US Environmental Protection Agency (EPA) administers a non-enforceable Maximum Contaminant Level Goal (MCLG) under the Safe Drinking Water Act (SDWA), and that the Department of Veterans Affairs (VA) issued standards for potable water systems in 2014.

Self-Evaluation Checklist

Does the organization operate any facilities that use cooling towers as part of heating, ventilation and air conditioning (HVAC) systems?

• If so, do these facilities have ongoing system management programs?

• If so, do these programs include monitoring of towers and systems for biological contaminants such as legionella?

• If so, can the organization document that these programs are effectively implemented, including whether any incidents of contamination and disinfection have taken place?

Where Can I Go For More Information?

• New York City initiatives:

• NYC Health Commissioner’s Legionnaire’s Disease webpage  

• Commissioner’s Order (8/6/15)  

• NYC ordinance regulating cooling towers (8/13/15)  

• NYC Buildings Department Cooling Tower Registration webpage 

• NY State Environmental Health Regulations (8/17/15)  

• ASHRAE Standard 188-2015 (Legionellosis: Risk Management for Building Water Systems) (available for online review and/or purchase) 

• Agency webpages:

• Centers for Disease Control and Prevention (CDC) Legionella webpage 

• Occupational Safety and Health Administration (OSHA) eTool for evaluating Legionnaire’s in cooling towers  

• Environmental Protection Agency (EPA), Safe Drinking Water Act Drinking Water Contaminants  

• European Union, European Centre for Disease Prevention and Control, European Legionnaires’ Disease Surveillance Network (ELDSNet)  

Specialty Technical Publishers (STP) provides a variety of single-law and multi-law services, intended to facilitate clients’ understanding of and compliance with requirements. These include:

• OSHA Auditing - Federal Compliance Guide: Facilities: The Complete Safety & Health Audit Checklist 

• OSHA Compliance: A Simplified National Guide

• OSHA State Differences Summaries and Checklists

• OSHA Auditing - California Occupational Health and Safety Audit Guide

• Cal/OSHA: Compliance and Auditing

• Federal Toxics Program Commentary

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