Search Results (27)

Between April and May 2025, an outbreak of travel-associated Legionnaires’ disease (TALD) occurred, involving six cases at a hotel in Crete, Greece. Including two cases reported in 2023 and two additional cases from 2016 to 2017, ten cases were associated with this accommodation site. All TALD cases were reported by the European Legionnaires’ Disease Surveillance Network (ELDSNet). In compliance with the European Centre for Disease Prevention and Control (ECDC) surveillance and investigation protocols for hotels associated with the patient’s stay, local public health authorities conducted on-site inspections at the hotel by collecting water samples and performing risk assessments, while simultaneously recording the required epidemiological, environmental, and physicochemical data. A total of 181 statistically analyzed water samples showed positive rates for L. pneumophila of 12.71% (95% CI: 7.86–17.56) for (≥50 CFU/L) and 6.08% (95% CI: 2.60–9.56) for (≥1000 CFU/L). Risk assessments identified 18 stagnation points, systemic maintenance deficiencies, and high cumulative structural (30/52) and water (36/71) system risk scores. Low microbiological positivity of water samples does not necessarily equate to low risk, thus necessitating continuous risk assessment, implementation of Water Safety Plans (WSPs), and integrated monitoring by accommodation facilities to prevent LD cases. Full article

In 2020, Directive (EU) 2020/2184 was published and subsequently transposed into Italian legislation via Legislative Decree 18/23 (Lgs.D. 18/23). The Directive aims to protect public health through a proactive approach based on a site-specific risk analysis along the entire water supply chain (Water Safety Plan, WSP). Between February and November 2024, a survey was conducted in Italy to assess both hospitals’ knowledge of Lgs.D. 18/23 and the application of the WSP in these facilities. A total of 300 hospitals were asked to complete an anonymous questionnaire containing 60 questions about the characteristics of the facility and the management of the water network, including the chemical–physical and microbiological monitoring of Legionella and other microbiological parameters. A total of 102 questionnaires were sent out (response rate: 34%), but only 72 were properly completed and analyzed. The results of the chemical–physical monitoring are not presented in this manuscript. Overall, 52.8% of the hospitals were built before 2000, and most are aware of Directive (EU) 2020/2184, Lgs.D.18/23 (80.6%), in particular, Article 9 on the risk assessment and management of internal water systems and the guidelines for its implementation (77.8%). All hospitals perform annual microbiological water testing, including Legionella analysis, with a detection rate of <50%. National guidelines for the implementation of WSPs are known in 75% of the hospitals, but only 38.9% have started planning to implement them, and 13.9% organize staff training on the subject. The questionnaire responses highlight the need to train hospital staff in water system risk management and WSP planning, which will be mandatory by 2029. Full article

Drinking Water Safety Plans (DWSP) in buildings serve to identify health hazards associated with the drinking water system. Sanitation Safety Plans (SSP) fulfill the same purpose for the sewage system. Water Safety Plans (WSP) include DWSPs, SSPs, and water systems like gray water and firefighting water. WSPs are based on a high-quality description of the water systems. This paper presents a new methodology for describing water systems. In contrast to previous approaches, the system description begins at the point where the water is consumed. These points of use are described using ecomaps, which are then supplemented with information about the pipe network. This approach makes it possible to fulfill four relevant premises: (1) the system description includes all essential parts of the drinking water installation, (2) the system description is possible with usual equipment, (3) the system description can be carried out with the least possible additional personnel costs, and (4) the system description is controllable, versionable, changeable, and forgery-proof. The ecomaps created in this way are suitable for the next step within the WSP framework, namely hazard and risk assessment. In addition, the ecomaps can be integrated into a quality, occupational safety, or environmental management system. Aspects of water security can be added to enable the ecomaps to be used as the basis for a total integrated water management system. Full article

Groundwater is a critical freshwater resource in Italy’s Po plain, which includes Milan (northern Italy), one of Europe’s most industrialized and urbanized areas. This region relies heavily on groundwater for both industrial and public water supplies. However, the quantity and quality of this resource are vulnerable to both natural and human-induced factors, such as climate change, industrial activities, and changing water use practices. This study investigates and addresses the complex management challenges of groundwater resources of Milan in the framework of the EU directives. A steady-state groundwater flow model was developed as part of the broader project MODEL-MI to aid in the creation of a Water Safety Plan (WSP). This study highlights the importance of accurate stratigraphic data to constructing a reliable hydrogeological conceptual model. The model, calibrated using extensive data, successfully reproduces groundwater flow patterns and will be used both to support decision-making for sustainable groundwater management and to predict future impacts of climate change on water resources. Full article

The World Health Organization (WHO) recommends the introduction of a water safety plan (WSP) approach on drinking water, in all types of settings. This study represents the first WSP developed on the Neptune Fountain, in Bologna (Italy), based on an interdisciplinary approach, integrating hydraulic and microbiological features, in a Building Information Modeling (BIM). The aim was to develop a dynamic and digital platform to update and share the maintenance program, promoting collaboration among microbiologists, engineers, and municipal staff. Water samples were collected along fountain water distribution systems (WDS) from 2016 to 2021 to monitor water quality through the heterotrophic bacteria at 22 °C and 37 °C, as well as to conduct an Enterococci, Coliform bacteria, Escherichia coli, Pseudomonas aeruginosa, Clostridium perfringens, and Staphylococcus aureus assessment. Simultaneously, hydraulic measures were performed, and advanced geomatics techniques were used to detect the WDS structural components, with a focus on the water treatment system (WTS). The WTS consisted of 10 modules corresponding to specific treatments: descaling, carbon–sand filtration, reverse osmosis, and ultraviolet disinfection. Fecal indicators, heterotrophic bacteria, and P. aeruginosa exceeded the reference limits in most of the modules. Several disinfections and washing treatments, other than changing the maintenance procedure scheduling, were performed, improving the WTS and controlling the contamination. The developed microbiological results, hydraulic measurements, and maintenance procedures were integrated in the BIM model to optimize the data storage, updating procedures and the real-time data sharing. This approach improved the fountain management, operation, and material conservation, ultimately preserving the health of daily visitors. Full article

Legionella contamination control is crucial in healthcare settings where patients suffer an increased risk of disease and fatal outcome. To ensure an effective management of this health hazard, the accurate application of a hospital-specific Water Safety Plan (WSP), the choice of a suitable water disinfection system and an extensive monitoring program are required. Here, the ten-year experience of an Italian hospital is reported: since its commissioning, Legionellosis risk management has been entrusted to a multi-disciplinary Working Group, applying the principles of the World Health Organization’s WSP. The disinfection strategy to prevent Legionella and other waterborne pathogens relies on the treatment of domestic hot water with a system ensuring the in situ production and dosage of monochloramine. An average of 250 samples/year were collected and analyzed to allow an accurate assessment of the microbiological status of water network. With the aim of increasing the monitoring sensitivity, in addition to the standard culture method, an optimized MALDI-ToF MS-based strategy was applied, allowing the identification of Legionella species and other relevant opportunistic pathogens. Data collected so far confirmed the effectiveness of this multidisciplinary approach: the fraction of positive samples never overcame 1% on a yearly basis and Legionnaires’ Disease cases never occurred. Full article

The World Health Organization promotes risk assessment and risk management through Water Safety Plans (WSPs) as the most effective way to manage drinking-water supplies. Despite proven advantages of this approach in other regions, WSPs are still not widely used across small drinking-water supplies in Sub Saharan Africa. The aim of this research is to identify good practices and related gaps which may assist with formal uptake of WSPs for small drinking-water supplies in Rwanda. Through semi-structured interviews with the key stakeholders involved in small drinking-water supply management across Rwanda, the aim is achieved through the investigation of the following: (i) current drinking-water management challenges; (ii) stakeholder collaboration and data management activities including reporting of information; and (iii) the regulatory and policy environment. The use and awareness of WSPs in Rwanda was confirmed as low. However certain drinking-water management activities which align with the WSP methodology are being carried out. These include catchment management and stakeholder collaboration. Although legislation and policy are in place in Rwanda, communication and training of methods to implement WSPs are required to sustainably embed WSPs into practice. Several elements, including community engagement, systematic review of risks and data management, require greater focus to align with the WSP methodology. Respondents highlighted key drinking-water management challenges, including reactive budgeting and lack of sector prioritization, which could benefit from formal WSP implementation. Full article

A water safety plan (WSP) is a tool proposed by the World Health Organization (WHO) for the mitigation of risks in water consumption, and little is known about the challenges of its implementation stage. The goal of this work was to identify the facilitating factors and challenges regarding WSP implementation from a case study in Brazil. Semi-structured interviews were conducted with water supply public service providers who already have implemented such policy and with supporting institutions that helped with the process implementation. As a result, it has been identified that the WSP implementation is strongly influenced by the quality of WSP preparation process, which means that this process is the foundation of the WSP implementation; through internal management of the organization, whose administrative discontinuities thwart the actions’ implementation; and through the relationship of the service provider with the external actors, which can interfere be it in the data collection or the WSP implementation scope’s entirety. Lastly, it was possible to conclude that the WSP preparation process, the organization’s internal management, and its relationship with external actors are the specific factors that impact the WSP implementation. The conduction and deepening of studies aiming to improve the tools of support for WSP implementation are thus recommended. Full article

The present work provides an insight into the emergency preparedness and coping capacity of Italian water utilities, based on the results of two ongoing research projects. Specific attention is given to the role that Water Safety Plans (WSPs) may have in this framework. The results of an online survey completed with a wide sample of Italian water utilities have been integrated with the evidence from targeted in-depth interviews, with the aim of: (i) characterizing the state of implementation of WSPs in Italy; (ii) identifying the main challenges, barriers and opportunities; (iii) describing the key issues related to the interactions among different institutions. A critical summary of the main evidence was structured in the form of a SWOT analysis. Full article

Recent regulatory developments (DM 14.06.2017) have introduced the concept of Water Safety Plans (WSP) into the Italian legislative framework, a new, challenging paradigm of risk assessment, prevention, and control covering the entire drinking water supply chain. When applied to the water abstraction step, it requires complex data collection and processing, field survey, monitoring, and research in order to develop a robust and scientifically sound hydrogeological conceptual model, being the core of groundwater flow models and vulnerability assessments. A successful experience in identifying and characterizing the wellhead protection areas, as well as the vulnerability pattern, has been achieved for the wide and complex hydrogeological system belonging to the Vicenza water production area. Full article

The use of water safety plans (WSPs) has been recommended by the World Health Organization (WHO) since 2004 as a highly effective means of improving water safety management. Experience with the implementation of WSPs is increasing worldwide, but there is no unified or standardized methodology for how the verification of a WSP should be conducted. In this article, we present a thorough evaluation of a specific WSP five years after its initial implementation. We reviewed the risk assessment methodology used by a water utility in Salta, Argentina, and assessed the implementation of control measures. To objectively evaluate the effectiveness of the WSP, we evaluated water quality parameters and customer complaints using a time-series analysis. We show that although some control measures were implemented, and a reduction in risk values was observed, it was not possible to improve long-standing problems in the water supply of the city of Salta, such as the number of consumer complaints or high turbidity levels in the water during the rainy season. We discuss the role of rigorous scientific assessments and the importance of legislation and regulatory bodies in implementing the WSP. Full article

The use of Microfiltered Water Dispensers (MWDs) is increasing in offices, companies, or commercial facilities, as a response to plastic pollution. Despite their widespread use, poor data are available about the water quality and pathogens developed. Starting from a high contamination found in MWDs, a Water Safety Plan (WSP) was implemented on 57 MWDs to improve the water quality. To assess the effectiveness of WSP during the period 2017–2021, the environmental monitoring of heterotrophic plate counts (HPCs) at 36 °C and 22 °C, Enterococcus spp., Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, and Clostridium perfringens, as prescribed by Italian regulation for drinking water, was conducted. A high level of HPCs at both temperatures was observed, over the regulation limit; contrarily, the pathogenic bacteria were absent. The contamination found was studied with respect to the temperature threshold of 25 °C, suggested by directives. No significant differences were found between samples above and below the threshold, while a significant decrease over the years was observed for HPCs at 36 °C (p = 0.0000000001) and 22 °C (p = 0.000006). The WSP implementation resulted in a 43.09% decrease for HPCs at 36 °C and a 24.26% decrease for HPCs at 22 °C. Moreover, during the SARS-CoV-2 pandemic, the WSP contributed to limit the microbial contamination, preserving the MWDs’ functionality and hygienic conditions and the drinking water quality. Full article

Climate-resilient water safety plans (CR-WSPs) have been developed as a risk-based approach to ensure a safe drinking-water supply while addressing the increasing stress on water resources resulting from climate change. Current examples of the application of CR-WSPs show a strong sectoral approach that fails to explore the potential synergies between other climate-sensitive sectors related to water, such as food and energy. This can increase the vulnerability or decrease the overall resilience of urban systems when planning climate change adaptation measures. In this work, the Water–Energy–Food (WEF) Nexus approach was applied in the formulation of a CR-WSP in Leh Town, India, a city with rapid development and population growth located in the Himalayas—one of the most sensitive ecosystems to climate change. The WEF Nexus approach was applied in the system description using a critical infrastructure approach and in the formulation of scenarios for risk management which exploited intersectoral synergies through water reclamation with resource recovery using constructed wetlands. The improvements in WEF security and risk reduction were demonstrated through indicators and risk mapping with geographical information systems (GISs). The methods for integrating the WEF Nexus approach in CR-WSPs provided through this work can serve as a base for a trans-sectoral, resilient approach within risk-based approaches for water security. Full article

Background: The quality of water for human consumption is an objective of fundamental importance for the defense of public health. Since the management of networks involves many problems of control and efficiency of distribution, the Water Safety Plan (WSP) was introduced to address these growing problems. Methods: WSP was applied to three companies in which the water resource assumes central importance: five water kiosks, a third-range vegetable processing company, and a residence and care institution. In drafting the plan, the terms and procedures designed and tested for the management of urban distribution systems were applied to safeguard the resource over time. Results: The case studies demonstrated the reliability of the application of the model even to small drinking-water systems, even though it involved a greater effort in analyzing the incoming water, the local intended use, and the possibilities for managing the containment of the dangers to which it is exposed. This approach demonstrates concrete effectiveness in identifying and mitigating the dangers of altering the quality of water. Conclusions: Thanks to the WSP applied to small drinking-water systems, we can move from management that is focused mainly on verifying the conformity of the finished product to the creation of a global risk assessment and management system that covers the entire water supply chain. Full article

Water management plans (WMPs), sometimes referred to as risk management plans (RMPs) or water safety plans (WSPs), are not mandatory for hotels in many countries of the world, including the US. As such, many hotel personnel are uninformed of WMPs and the precautions to take if their hotel water system is compromised. The purpose of this study was to identify hotel personnel’s knowledge and practices of WMPs through a survey incorporating the Health Belief Model (HBM). Data were collected from 59 hotels within Fulton County, Georgia, USA, through a questionnaire, and questions were developed tailored to the HBM. Significant associations were found between the perceived susceptibility of contracting a waterborne illness and WMP for hotel personnel as well as between cues to action and having a WMP in general linear models (p ≤ 0.05). The study concludes that many key personnel are not aware of WMPs. Many hotel facilities do not have a plan in place, and some facilities are unaware of a current plan is in place. The study findings provide insight into the importance of WMPs and the risk factors associated with microbial contamination in a hotel building’s plumbing system. Future research and potential law change should be emphasized to increase hotel employees’ and owner’s WMP knowledge. Full article