Guidelines, Standards, and Laws
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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, 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]