Defining water safety in healthcare premises

Abstract

The term 'water safety' originated in a time when the risk emanating from the wastewater system was not appreciated. Water and wastewater systems are uniquely intertwined. Each may impact on the other to have an adverse effect on patient safety. Risk to patient safety may be introduced at any point from mains water entering a site right through to wastewater exiting the site to join the municipal sewers. These risks begin at inception of a new-build project, through every stage of the life cycle of a building, through to decommissioning. The term 'water safety' is outdated as it does not consider the different structural areas of the water/wastewater system which may give rise to unique risks. This, in turn, hinders the development of expertise, necessary training, guidelines, research, etc. specific to the area. It is therefore proposed that water/wastewater systems should be divided into three zones: (A) main body of the water system; (B) periphery of the water/wastewater system; and (C) main body of in-premise wastewater system. It is recommended that the term 'water safety' should be used to refer to the main body of the in-premise water system. It is recommended that the term 'clinically integrated water/wastewater safety' should be used to refer to the periphery of the water/wastewater system. It is recommended that the term 'wastewater safety' should be used to refer to the main body of the wastewater system. It is recommended that both the periphery of the water/wastewater system and the main body of the wastewater system should be recognized in their own right, necessitating development of specific training and expertise in each area. The water safety group should accordingly change their title to the 'water/wastewater safety group'. The range of stakeholders and knowledge base required to ensure water/wastewater safety needs to be expanded, delineated and recognized. Depending on the nature of the stakeholder, this could require improved exchange of information, development of training and expertise, etc.

Keywords: Antimicrobial resistance; built environment; infection prevention and control; sanitation; water / wastewater safety.