Water distribution system of health institutions: prevention and control of waterborne infectious risks.

Degradation of the microbiological quality of water within the water supply system of health-care institutions is linked to the proliferation of micro organisms which can be naturally found in water, and to exogenous contamina tion. The water in distribution networks is used for various purposes (cooking, s anitary, medical, or technical) which, besides meeting potable drinking wat er requirements, require a constant monitoring of possible contamination by opportunist pathogen microorganisms, in risk areas. "Quality" management, based on the principles of risk analysis and monitoring of critical points, must be set up by a multidisciplinary team created and maintained in order to control the microbiological quality of water. Monitoring water supply contamination consists in identifying contamination factors, analyzing waterborne infectious risks for patients according to w ater uses, and setting up adapted preventive measures (technical measures, antimicrobiological treatment). Through observation or regular measurement in critical points of the water distribution system, the monitoring system allows ensuring that preventive measures are carried out and that correctiv e actions are taken if target standards are not met, thus warranting microb iological control. A periodic checking of the control plan allows guarantee ing that it meets the standards for the control of waterborne infectious ri sks. Registering and documenting the implemented actions allows for traceab ility in the long run. (C) 2000 Editions scientifiques et medicales Elsevie r SAS.