Legionnaire's symptoms and treatment

What are the symptoms? The symptoms of legionnaires' disease are very similar to the symptoms of the flu:

• high temperature, fever and chills;
• coughs;
• muscle pains;
• headaches; and leading on to
• pneumonia, and very occasionally
• diarrhoea and signs of mental confusion

How is it treated?
The illness is usually treated with an antibiotic called erythromycin or a similar antibiotic.

What to do

• If you start to develop the above symptoms and you are worried that it might be legionnaires' disease, see your GP.
• Because it's similar to the flu, it's not always easy to diagnose. A blood or urine test will be helpful in deciding whether it is or is not legionnaires' disease. When doctors become aware that the illness is present in the local community, they have a better chance of diagnosing it earlier.
• If you suspect that you have got the illness as a consequence of your work then you must report this to your manager, as well as your health and safety representative and occupational health department. There is a legal requirement for employers to report all cases of legionnaires' disease that may have been acquired at their premises to the HSE. 

The Barrow incident

In 2002, 7 members of the public died and 180 people suffered ill health as a result of an outbreak of legionella at a council-owned arts and leisure facility in the town centre of Barrow-in-Furness, Cumbria.

Following the court case, two public meetings were held to allow the public, and those affected, to learn more about the circumstances and the causes of the  legionella outbreak. The Barrow Legionnaires’ Outbreak Public Meetings were held in December 2006 in Barrow. They were chaired by former West Lancashire MP Colin Pickthall.

The purpose of the report (available from hse.gov.uk) is to record the content of those meetings and to enable others to learn what caused the outbreak and what changes have been made since.

It has been produced to allow dutyholders with similar responsibilities to benefit from the findings and be able to apply the recommendations identified as a result of the tragedy. The full report explains both the technical steps, and the essentials of good health and safety management that can ensure that a similar tragedy never happens again.

How safe is your workplace?

The regulations give a detailed definition of what a ‘dangerous substance’ is, and you should refer to the regulations for more information. It includes any substance or preparation, which because of its properties or the way it is used could potentially cause harm to people from fires and explosions.

Dangerous substances include: petrol; liquefied petroleum gas (LPG); paints; varnishes; various solvents; and dusts which when mixed with air could cause an explosive atmosphere eg dusts from milling and sanding operations. Dangerous substances can be found, in varying quantities, in most work situations.

What's an explosive atmosphere?

An explosive atmosphere is an accumulation of gas, mist, dust or vapour, mixed in with air, which has the potential to catch fire or explode. An explosive atmosphere does not always cause an explosion, but if it caught fire the flames would quickly travel and if this happened in a confined space (eg in a plant or manufacturing equipment) the rapid spread of the flames or rise in pressure could also cause an explosion.

Where does DSEAR apply? DSEAR applies to most workplaces where a dangerous substance is present or could potentially be present.

What are the main requirements of DSEAR for employers and the self-employed? You must:

• carry out a risk assessment of work activities involving dangerous substances;
• provide policies to eliminate or reduce risks as far as is practicable;
• provide suitable equipment and procedures to deal with accidents and emergencies;
• provide full information and training to employees;
• classify places where explosive atmospheres may occur into specific zones and mark the zones where necessary (This duty is being gradually phased in).

DSEAR clarifies the existing requirements to manage potential fire and explosion risks which are set out in the Management of Health and Safety at Work Regulations 1999 (Management Regulations), and it also expands those requirements in a few areas.

What does the risk assessment involve?

The risk assessment is an identification and careful examination of the potential dangerous substances present or liable to be present in the workplace; the acual work activities involving them; and how they might fail and cause a fire or explosion or similar event that could harm staff and the public. Its purpose is to help you to decide what you need to do to eliminate or reduce the safety risks

Risk assessments look at the risk from dangerous substances as far as is reasonably practicable. It should take account of such matters as:

• the hazardous properties of the various substances;
• the way they are used and stored;
• the possibility of explosive atmospheres occurring;
• all potential ignition sources.

You must carry out a risk assessment regardless of the actual quantity of dangerous substance present, as it will help you to decide whether existing measures are sufficient or whether there are any additional controls or precautions are necessary.

Working with asbestos

Do:
• Stop and ask if you are suspicious that something may be asbestos or if you think the specific work might need to be carried out by a licensed contractor
• Follow the plan of work and the specific task guidance sheets; and make sure you use the right sheet for the job
• Take account of other risks such as work at height
• Use protective equipment, including a suitable face mask, fitted properly
• Clean up as you go to stop waste building up
• Make sure that waste is double-bagged and is disposed of properly at a licensed tip
• Wash before breaks and before going home

Don't:
• Use methods that create lots of dust, like using power tools
• Sweep up dust and debris - use a Type H vacuum or wet rags
• Take home overalls that have been used for asbestos work
• Reuse disposable clothing and masks
• Smoke
• Eat or drink in the area

What should those in charge of the job do? They must:
• Find out if asbestos-containing materials are present and plan the work to avoid disturbing these materials if at all possible
• Ensure that anyone working on asbestos material is trained properly and is supervised
• Know what type of work can be carried out on asbestos-containing materials, ie does this work need to be carried out by a contractor licensed by HSE?
• Take account of all other risks as well as asbestos, eg work at height, and take all the precautions necessary to do the job safely
• Use the equipment and method sheets and the right task sheet to make sure that the job is always carried out properly and that exposure to asbestos is kept as low as humanly possible
• Prepare a plan of work, and explain what the job involves, the work procedures, and what controls to use
• Provide the right equipment, which is clean, in good working order, and protects against asbestos
• Train workers in using this equipment
• Make sure the work area is inspected visually at the end of the job, and check if it’s fit for reoccupation
• Make arrangements for the safe disposal of any asbestos waste
• Consult the health and safety representative (if there is one to contact)

What does the law require?

There are a number of regulations, which cover work with all types of asbestos-containing material; they place duties on 'dutyholders’, employers and self-employed workers. A summary of these regulations can be found in the asbestos regulations section of the hse.gov.uk website.