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United Way of Lancaster County


Proposed bill aims to reduce risk of Legionnaires’ Disease

Flanked by board member Dr. Hung Cheung and Executive Director Tonya Winders of the Alliance to Prevent Legionnairs’ Disease, state Rep. Ismail Smith-Wade-El, D-Lancaster, speaks about proposed legislation in Reservoir Park outside the Lancaster County Prison on Thursday, May 17, 2024. (Photo: Tim Stuhldreher)

State government needs to do more to protect Pennsylvanians from legionella contamination in their drinking water, state Rep. Ismail Smith-Wade-El said Thursday.

Smith-Wade-El and representatives from the Alliance to Prevent Legionnaires’ Disease held a news conference Thursday to discuss House Bill 2145, for which the Lancaster Democrat is prime sponsor. It seeks to reduce the threat from legionella by strengthening the minimum chlorination standard for public water systems; by requiring the prompt reporting of any incident that could lead to contamination; and by increasing public awareness.

Legionella is a bacterium that spreads in water. It is the cause of Legionnaires’ Disease, a potentially fatal illness akin to pneumonia. Up to 10% of reported Legionnaires’ Disease cases lead to death, according to federal health data. People who are older or who have other illnesses are at higher risk of complications and death.

Close to 9,000 confirmed cases of Legionnaires’ Disease were reported nationwide in 2019, including 638 in Pennsylvania, according to the Centers for Disease Control & Prevention. There were 512 confirmed U.S. deaths that year; the CDC did not break down deaths by state.

The prevention alliance says the actual number of cases is likely 10 to 15 times higher. Many mild cases go undiagnosed and unreported, and public health officials focus their attention on outbreaks involving multiple patients, not isolated cases.

State Rep. Carol Hill-Evans, D-York, a co-sponsor of House Bill 2145, speaks in support of it. (Photo: Tim Stuhldreher)

Thursday’s news conference took place across the street from the Lancaster County Prison, where an inmate tested positive for legionella last fall following the transfer of a state inmate with Legionnaires’ Disease. A number of water sources in the prison subsequently tested positive as well.

That necessitated an intensive decontamination and testing process. The prison installed additional water decontamination equipment in November; It has continued to test monthly since then, with all results coming back negative, officials have said.

About 80% of legionella outbreaks stem from public water systems, the alliance says, citing a Centers for Disease Control study. Increasing preventive measures “upstream” at those source points will reduce the chance of contamination across the board, whether at institutions like the prison or in residential neighborhoods, Smith-Wade-El and alliance representatives said.

House Bill 2145 is “model legislation,” said Tonya Winders, the alliance’s executive director.

Smith-Wade-El described the bill as a “structural solution” that reduces the burden of prevention on institutions and homeowners.

“This is an easy thing that we can do to make life safer for all impacted Pennsylvanians,” he said.

A coalition of trade groups, the Pennsylvania Water Utility Council, strongly opposes the bill. In a letter (PDF) to the state House Health Committee, it said legionella “is a premise plumbing issue,” with contamination originating in end users’ water infrastructure, not at utilities’ treatment plants. Universally raising chlorination levels “is not the appropriate means” of addressing the issue, the council said, and would not be effective.

Moreover, chlorination yields byproducts that are carcinogenic. They must be minimized to stay within U.S. Environmental Protection Agency guidelines, the council said, and increasing chlorination would make it more difficult to keep those byproducts down.

Dr. Hung Cheung, a board member of the prevention alliance and former Maryland state medical director, disputed that. Mandating prevention measures “as upstream as possible” is the most effective and efficient approach, he said. As for chlorination byproducts, he said, there are ways to design systems to keep them to a minimum.

“At the end of the day, you can do it,” he said.

Gary Lobaugh, a spokesman for Pennsylvania American Water, a subsidiary of publicly traded utility American Water Works, said microbe control is a shared responsibility between utilities and their customers.

“We will continue to work with our regulators and other stakeholders to advocate for best practices related to legionella risk reduction,” he said.

Cheung said increasing chlorination will help mitigate the risk involved in the upcoming removal of lead water service lines, which the federal government is mandating. The concern, he said, is the potential for shaking loose contaminants when water lines that have lain untouched for decades are disturbed.

House Bill 2145 is awaiting action by the House Health Committee. Smith-Wade-El said he’s optimistic about its chances of passage.

There is no estimate of the bill’s cost yet, he said, but that analysis will be done. “I guarantee you,” he said, that whatever it is, it’s less than the cost imposed on the health system by preventable cases of Legionnaires’ Disease.

Pennsylvania’s drinking water regulations are enforced by the state Department of Environmental Protection. It would have up to two years to develop and implement the regulatory provisions of House Bill 2145 if it passes.

The bill would also require DEP, in conjunction with the Department of Health, Bureau of Consumer Protection and health organizations, to develop a “best practices guide” for the public on how to reduce legionella risk.