14 September 2004
By Sophie Blakemore

Health experts raised serious concerns yesterday about the risks of legionnaires' disease being spread by poorly maintained hot tubs and spa pools.

A year-long study by the Health Protection Agency (HPA) and environmental health officers found tubs containing the legionella bacteria even after routine microbiological checks had taken place.

Last year there were 27 cases of legionnaires' disease in England and three deaths where spa pools were identified as the source of the infection.

The HPA, currently holding its scientific conference at Warwick University, said poorly managed or maintained pools were a cause for serious concern.

It said the study raised the question of whether routine legionella testing should be included within new Health and Safety Executive and HPA guidelines.

The HPA study surveyed more than 100 tubs and pools and found that out of 88 premises, 23 pools contained legionella bacteria.

Of these, 16 had passed current accepted levels for routine microbiological parameters.

Lead researcher Dr Susanne Surman-Lee said in every legionnaires' outbreak related to a pool that they had investigated, the pool had not been managed or designed according to guidelines or had poorlytrained staff.

Under current rules, testing for legionella is not mandatory for spa pools.

"Because spa pools are increasing in popularity we need greater recognition and understanding of the risks associated with their use and misuse," she said.

"They have the potential to cause infection because the water systems become contaminated with bacteria and the high temperatures of the water make considerable demands upon the

disinfection and filtration systems making it easy for the bacteria to develop and spread if not adequately maintained.

"The jets from spa pools then produce aerosols containing legionella which can then be inhaled and cause illness."

Dr Surman-Lee said it had been assumed that if the pool water was satisfactory for routine microbiological checks then growth and spread of legionella would also be under control.

"But we discovered the legionella bacterium may be present in high numbers in both privately owned and public facilities even when routine microbiological and safety checks appear satisfactory," she added. So far this year there had only been one case of legion-naires' reported to officials where a spa pool has been found to be the cause.

Symptoms of the disease include a flu-like illness with muscle aches, tiredness, headaches, dry cough and fever.

The infection can be treated with antibiotics and cannot be spread from person to person.

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