Each commercial organisation in the UK has the same duties under the Health & Safety at Work Act 1974, Management of Health & Safety at Work Regulations 1999, Control of Substances Hazardous to Health Regulations 2002 and the HSE’s Approved Code of Practice ‘L8’.
These can be summarised as:
- Conduct a risk assessment
- Appoint someone to be managerially responsible for controlling the risk
- Ensure that a plan for controlling the risk is formulated and documented
- The plan must be implemented and the required checks be completed
- Keep records of all those checks
- Make sure that all involved are competent
This is often an easy task when considering the domestic water systems we find in most modern dental practices, which are often very small and simple in design. We do however come across the additional issue of the dental specific equipment, including the dental unit water lines, which is often missed by many risk assessment companies and is mitigated in their terms and conditions.
Whilst recorded cases of Legionnaires’ disease are few and far between associated with dental practices there are a number of general recommendations for the decontamination of dental unit water lines laid down in the Health Technical Memorandum 01:05:
- To reduce microbial accumulation, run water through the water lines for 2 – 3 minutes at the start of each session and 20 – 30 seconds between every patient. Checklists are useful to ensure compliance and provide auditable evidence.
- At the end of the day, the bottle should be disconnected, emptied, rinsed and stored inverted clean and dry overnight.
- Isolate the water supply from the mains water by using an independent bottled water system on the unit.
- Fill the bottle with freshly distilled / reverse osmosis water at the start of each day (if bottled water is used this must be from a previously unopened bottle).
- Do not fill bottles with tap water as this will introduce opportunistic respiratory bacteria into the waterline and rapidly lead to biofilm formation.
Duncan completed the risk assessment at our dental practice in a good timeframe, was pleasant and courteous with staff and readily available to discuss queries. We would be happy to use him again for Legionella consultancy.
Mansi Patel, St Mary’s Dental Practice
