Guidelines, Standards, and Laws

Standard

• Legionellosis: Risk management for building water systems. ANSI/ASHRAE standard 188–2018. Atlanta, GA: ASHRAE; 2018.

General Guidelines

• Centers for Disease Control and Prevention. Preventing occupational exposure to Legionella. National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2019-131.
• Managing the risk of legionellosis associated with building water systems. ASHRAE Guideline 12-2020. Atlanta, GA: ASHRAE; 2020.
• Cooling Technology Institute. Legionellosis guideline: Best practices for control of Legionella. 2008
• Cooling Technology Institute, 2020. Guideline (GDL) 159 – Practices to Reduce the Risk of Legionellosis from Evaporative Heat Rejection Equipment Systems. 2020.
• Centers for Disease Control and Prevention. Model aquatic health code.
• Centers for Disease Control and Prevention. Disinfection of hot tubs that Contain Legionella.
• Centers for Disease Control and Prevention. Guidance for Reopening Buildings After Prolonged Shutdown or Reduced Operation.

Get practical guidance on how to implement these guidelines and standard.

Healthcare-specific Guidelines and Requirements

• Department of Veterans Affairs. Prevention of healthcare-associated Legionella disease and scald injury from water systems. VHA Directive 1061. 2021.
• Centers for Medicare & Medicaid Services. Requirement to reduce Legionella risk in healthcare facility water systems to prevent cases and outbreaks of Legionnaires’ disease [4 pages]. 2017.
• Centers for Disease Control and Prevention. Guidelines for environmental infection control in health-care facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. 2003;52(RR-10):1–42.
• Centers for Disease Control and Prevention. Guidelines for preventing health-care-associated pneumonia, 2003: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. 2004;53(RR-3):1–36.
• Centers for Disease Control and Prevention. Guidelines for infection control in dental health-care settings, 2003. MMWR. 2003;52(RR-17).
• Infectious Diseases Society of America/American Thoracic Society. Diagnosis and Treatment of Adults with Community-acquired Pneumonia, 2019.
• Infectious Diseases Society of America/American Thoracic Society. Management of adults with hospital-acquired and ventilator-associated pneumonia: Clinical practice guidelines, 2016.

Laws

• Environmental Protection Agency. Safe drinking water act.
• Environmental Protection Agency. Federal insecticide, fungicide, and rodenticide act.

Literature Reviews

• Environmental Protection Agency. Technologies for Legionella Control in Premise Plumbing [139 pages, 1.67 MB]