Risk assessments for dental decontamination
The Department of Health publication Decontamination Health Technical Memorandum 01-05: Decontamination in Primary Care Dental Practices provides comprehensive advice and guidance on the design, installation and operation of specialised building and engineering technology used in the delivery of healthcare and is applicable to new and existing sites.
Registered Managers of dental practices have an overriding general duty of care to ensure that the water supply, storage and distribution services at their practice complies with the best practice guidance given. This includes the following publications:
- Health and Safety Executive's ACoP The Control of Legionella Bacteria in Water Systems (L8) which has special legal status.
- Health Technical Memorandum 04-01, The Control of Legionella, hygiene "Safe" hot water, cold water systems.
What does this mean for your dental practice?
Essentially, all premises are required to have a written scheme and a legionella risk assessment for controlling any identified risks in accordance with L8. This must be carried out by "competent persons" who are members of the Legionella Control Association.
How TSS can help
TSS are longstanding category 1 members of the LCA. We will visit your site and, working closely with the Registered Manager and staff, undertake the following tasks:
- Provide a full Legionella risk assessment with schematic drawings, and identify and grade any risks
- Take samples of suspect water to test specifically for legionella and other bacteria
- Provide a full report which advises on how to control or eliminate the risk(s) identified
- Provide all remedial work necessary
- Establish with the client an ongoing Legionella Risk Management programme with testing and monitoring schedules as per ACoP (L8)
- Provide log books and training courses for the nominated site personnel, so that they can interpret information, record and act on it at regular stages
- Back up and audit the records.
Decontamination and cleaning procedures - Water Quality Considerations
The L8 Risk Assessment will pick up any legionella risks and provide a method of control. There is a strong correlation between reducing the risk of legionella and decontamination of instruments and systems as in either case we are aiming at complete water hygiene.
The decontamination tasks referred to in DHTM 01-05 consider these criteria:
- Manual Cleaning Procedures
- Steam Cleaning (if used)
- Stored Water Condition
- Quality of water used
- Flushing and cleaning of dental unit water lines (DUWLS)
- Disinfection Procedures
- Record Keeping.
The quality of the water used is specifically described in chapter 17 of HTM 01-05. For instance water used for manual or automated cleaning must contain less than 50 parts per million of calcium hardness (CaCO3). In water, hardness is commonly between 2 - 300ppm which means that water softening is expressly advised. In other cases rinse water may be required to be exceptionally pure i.e. distilled water or reverse osmosis quality water. There are specific requirements for the types of disinfectants to be used - some types are forbidden. In addition it is important that levels of endotoxins in the water are known in addition to the actual chemical characteristics of the water.
How TSS Facilities can help
TSS are able to provide full consultancy for all aspects of contamination. We have mobile analysis test kits and can carry out an instant analysis of the water. We provide a sampling service for bacteria and other micro-organisms using an UKAS accredited laboratory.
We can advise on disinfectants and decontamination procedures and supply the necessary chemicals. Where specific water quality is required, we are able to supply build and install our own treatment and equipment (custom made to your requirements), such as water softeners and reverse osmosis equipment.
To summarise we are in a unique position to offer a complete, integrated service and consultancy for all your water quality requirements so contact us today to book your risk assessment.