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Like most industrial hygienists, Megan Canright Racicot, MPH, CIH, didn’t intend to work in waterborne disease prevention. As a younger professional, she had been more comfortable assessing risks and exposures for traditional occupational and environmental health and safety hazards, despite her background in microbiology. When a mentor figure asked her to work on a Legionella inquiry, she told him she felt unprepared for the task. “Megan,” the mentor said, “it’s the same kind of risk assessment process as it is with any other agent that you’ve worked with.”

Reassured, Canright took the Legionella case. She’s now the executive director of water services for Forensic Analytical Consulting Services Inc. (FACS) and credits her mentor’s guidance for helping change the direction of her career.

But OEHS professionals sometimes must take on work related to Legionella or other waterborne pathogens without experienced mentors to guide them. Cases of Legionnaires' disease in the United States are increasing, yet many OEHS professionals have not been trained to collect water quality data or support waterborne disease outbreak response efforts. For this reason, Canright joined a team of OEHS professionals to create a technician-level certification program for assessing Legionella and other waterborne pathogens.

Who Are Competent Technicians?

The “competent technician” role is qualified to monitor building water systems and perform associated field work. They may also assist in implementing water management programs or conducting risk assessments in response to outbreaks under the guidance of a competent “program professional,” who manages preventative water management programs, or a “responder professional,” who controls outbreaks.

“The competent technician is working very closely with those responder and program professionals to do that work,” Canright told SynergistNOW staff. “They are in the field gathering information. They may be looking at the water system, inventorying the water system, or assisting with the inventorying and characterization of the water system.” With respect to water management, the competent technician’s primary duties include collecting water samples for laboratory analysis and measuring parameters such as temperature, disinfectant levels, and pH levels. This information helps the more experienced program and responder professionals fulfill their roles.

The term “competent technician” doesn’t correspond to a single job title. The person playing this role may be employed as a facilities professional, infection prevention professional, environmental health and safety professional, water management team operative, or a consultant for a healthcare, governmental, commercial, educational, or other facility. “Really, any building that needs to have a water management plan in any industry could have site operatives or personnel who would get value out of taking this course,” Canright said. “It’s intended for the everyday person who is supporting water management program implementation.”

Although the competent technician is not expected to make final decisions on Legionella controls, their role is important to the success of the program. Canright noted that industrial hygienists prefer to prevent illnesses and injuries before they occur, when possible. The competent technician assists preventative efforts by collecting the data needed by the water management program professional to proactively identify hazards and implement controls. In some situations, however, the team must respond to a disease outbreak. Then the competent technician’s data helps the responder professional implement interim control measures, identify the cause of the disease, and develop permanent controls to stop more people from getting sick. “They’re really the eyes and ears and the boots on the ground who are helping to move these processes along,” Canright said.

Accordingly, the waterborne pathogen certificate program provides an overview of waterborne pathogen control measures, as well as training on data collection. “While they may not be the ultimate decision maker in identifying what those control measures are,” Canright said, “the data that they’re collecting and the work that they’re doing in the field is critical to providing the responder and program professionals with the information they need.”

What To Expect from the Program

The certificate program comprises 10 modules and roughly 20 hours of content. The first module is free, so participants can sample the course before they commit to it. The modules cover water system management, sampling methods, risk assessment, and control strategies. Although the primary focus is Legionella, the material can be applied to other waterborne pathogens, such as Pseudomonas and mycobacteria.

Canright described how she and her colleagues drew on their own professional backgrounds to create the program. “Each of us has at least 10 to 20 years of experience working in Legionella prevention and response. We really wanted to leverage that experience, to put that into the training to make it digestible for the attendees.” Program content includes photos and scenarios taken from the field experiences of the program development team. “By using those real-life scenarios and demonstrative photographs and other materials, we’re hoping that really translates to competent technicians,” Canright said. “So that when they do go into the field, they will have some sense of what to expect.”

The certification program development team also worked to make the content interactive and efficient. Information is presented through narrative and diagrams, and every module concludes with a questionnaire that helps participants check their knowledge. The material has been independently peer-reviewed to ensure its accuracy.

On completion, participants receive a certificate confirming they have the skills, training, education, and background to perform the technician role effectively. “It’s important to have a baseline confidence in the professionals who are being retained or involved in this type of work to make sure that it’s done correctly,” Canright said. “The certificate is designed to provide that level of assurance for building owners and operators to have staff who can do that work.”

She urged other OEHS professionals to consider water as another exposure pathway and educate themselves accordingly. Legionella may be found in the water system of any sort of building, she noted, including office buildings, healthcare facilities, schools, and industrial facilities. “Wherever there’s water, there can be a risk for Legionella to be present. And we know that immunocompromised people, people who are susceptible to getting Legionnaires' disease, can be anywhere in the community at any time.”

“I certainly encourage my colleagues and members of the industrial hygiene community not only to take the course themselves—to increase their knowledge, to increase the repertoire of their areas of practice—but also to encourage their clients, their colleagues, and other industry professionals to take the course as well,” Canright said.

To register for or learn more about the certificate program Legionella and Other Waterborne Pathogens: Fundamentals for Technicians, visit the AIHA website. Accompanying courses for responder and program professionals are forthcoming.