I appreciate that sticking one’s neck above the parapet to challenge accepted practice may be committing professional suicide, but here goes. I observe elaborate and costly risk assessments and control systems (including flushing of cold taps) for standard hot and cold water systems within Local Authorities who are already under significant financial pressures, all of which is advocated by the professional contractors they engage. Yet the national annual incidence of Legionnaires disease appears to be limited to around 300 to 600 cases. This does not appear to represent a hugely significant proportion of the population, even if we narrow it down to the cohort of middle aged male, smokers or those susceptible to chest infections. So surely, the incidence should be significantly higher, if this risk is significant. Yet, outbreaks of the disease still appear to be largely associated with water cooling and spa and shower systems. Is it the case that perhaps the attention needs to be better focused to tackling those high risk areas, which may at present be obscured by a general smoke-screen caused by risk aversion? Or is it the case that a higher number of smaller scale (e.g. individual) outbreaks is under reported?

Hi Liddell Taps probably are a low risk but most LA's will have systems that contain showers and sometimes spa pools as well as cooling towers in some cases all in the one building or complex. If an FM company is in to do all the other stuff then flushing a few sentinel taps as part of the control plan is not making the contract any bigger or more costly in my experience. Low incidence of cases, 300-600 a year. Maybe that is due to all the sterling efforts flushing those sentinel taps? This is from a Legionella course I was on a few years back-one hospital discovered that all braded hoses in the hospital sinks contained rubber instead of man made materials (counterfeitid BS parts) and were the source of the huge CFU counts they were getting from the water system. -If the Low risk HCWS had not been included in the plan that would have been a disaster. You put forward a logical point but it does not really effect the outcome in practice. The inclusion of the HCWS assessments and checks do not add any great extra expense to the total contract for an LA and can turn up unsafe conditions that need to be controlled. Of course this may be different in other LA's I can only speak from the one I worked in. Kind regards Jeff