by Morgan Sagely, Product Manager — WMP, Phigenics
On August 28, I teamed up with my colleagues, Phigenics CEO, Mark Crockett, MD and Epidemiologist Consultant, Angela Tonozzi, MD, MS, CIC to host a webinar that explored the implications of newly published ANSI/ASHRAE Standard 514 for water safety and patient risk in healthcare environments. Our attendees learned why expanding their scope beyond Legionella is critical, as Standard 514 highlights 13 clinically significant microbial hazards—such as Pseudomonas aeruginosa and non-tuberculous mycobacteria (NTM) —that are often implicated in hospital-acquired infections (HAIs).
Waterborne Pathogen Case Report
Our discussion covered some key points about ANSI/ASHRAE Standard 514:
- Expands on Standard 188 by addressing microbial, chemical, and physical hazards. This covers the full building lifecycle — from design through renovation.
- Aligns with regulatory standards like: Joint Commission’s EC.02.05.02 and CMS directives
- Promotes proactive strategies, including surveillance and flexible response plans and the use se of Appendix G for program development and validation
- Encourages facilities to map patient vulnerability and regularly update contingency plans for emerging pathogens
Angela and Mark presented two clinical case reports focused on Pseudomonas to help illustrate the risks and financial burdens posed by waterborne pathogen outbreaks in healthcare settings. In both cases, expansion of water testing beyond Legionella proved vital in resolving their respective disease investigations. These two stores were included to make sure that our audience understood that water management is not merely a regulatory checkbox but an ever-evolving practice essential for patient safety.
I would like to share a few notable questions that came up during the Q&A portion of the webinar are highlighted below:
Question: “Is testing of microbial hazards required with Standard 514?”
Answer: “Environmental testing of the water system is not a requirement of this standard. However, Appendix D of this standard does state that testing water for the presence of microorganisms is a common way to that a WMP is effective at controlling hazards. And as stated earlier, that appendix is a great resource overall if you are doing water testing.”
Question: “I’m currently using a monochloramine system at my facility. You mentioned some disinfectant types may promote the growth of pathogens. Are there limitations to controlling Legionella with this system?”
Answer: While Appendix G (G4.1.5) mentions some pathogens can metabolize from the disinfection byproducts of monochloramine, it’s noted that Legionella cannot. However, monochloramine can cause Viable but nonculturable (VBNC) Legionella so that may be a limitation for sure. The standard does not recommend one disinfectant over the other. It DOES, however, recognize supplemental disinfection as a potential control measure, notes that benefits and unintended consequences must be evaluated (Appendix B) and directs teams to validate effectiveness in their own system.”
“Water safety isn’t just about compliance – it’s about protecting our most vulnerable patients. ASHRAE 514 gives us the tools to do that better.” — Dr. Angela Tonozzi.
What was our key takeaway?
Infection preventionists and epidemiologists know their facilities best. We hope they feel empowered to lead water safety initiatives, using ANSI/ASHRAE Std. 514 as a guiding roadmap to help expand their program scope and evolve their water safety practices to protect vulnerable patient populations and to stay in line with modern risks and regulatory expectations.
To watch the full presentation and Q&A, please go to the page for this webinar and register to view.
