East Hills, NY (April 12, 2005) - - The current goal to reduce sickness and death from infections that patients acquire in hospitals has created a renewed focus on identifying ways to reduce the problem at its source. Hospital water for drinking, bathing, showering, to make ice cubes or to rinse medical equipment is increasingly being recognized as a significant source of microbes that may contribute to many of these life-threatening infections. Infection control practitioners, scientists and epidemiologists convened to review this problem at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA) in Los Angeles. Joseph Cervia MD, a leading infectious disease expert, professor of Clinical Medicine and Pediatrics at Albert Einstein College of Medicine and Medical Director of Pall Corporation (NYSE: PLL) presented the latest information on water as an emerging threat in the healthcare environment.
"Infections acquired in hospitals and healthcare institutions affect approximately two million people resulting in about 98,000 deaths at a cost of $29 billion in the United States each year," said Dr. Cervia. "We know that tap water, previously unrecognized as a source of many of these infections, harbors pathogenic microorganisms that can pose a significant health threat to patients, especially those with weakened immune systems. By all accounts the prevalence of infections caused by some of the most potentially lethal waterborne microbes, such as legionella and pseudomonas, are underestimated."
He explained that waterborne microbes- -bacteria, viruses, fungi and parasites --can enter into the healthcare environment in several ways: direct contact with or ingestion of drinking water or ice, breathing aerosols from showers and faucets and even from improperly reprocessed medical devices. As hospitals increasingly recognize the risks to patient health, they are employing a variety of treatment technologies to attempt to eradicate microbes from incoming water. Dr. Cervia described the different types of systemic disinfection methods used and the advantages and disadvantages of each.
"Despite the range of technologies being applied, the problem of waterborne microbes in the healthcare setting continues to persist," explained Dr. Cervia. "Each of the systemic methods are limited in their ability to prevent patient exposure to waterborne pathogens because they cannot completely reach and permanently destroy biofilm."
Biofilm is a Key Culprit Biofilm is a community of numerous types of microbes that attach to internal pipe surfaces, faucets and showerheads where they thrive and multiply. The force of water passing through the pipes or tap can break off fragments of the biofilm transferring it to different parts of the water distribution system and seeding formation of new biofilm colonies.
When water enters a hospital room from a faucet or shower, tiny water droplets containing the biofilm contaminants separate from the main water stream and spread by air currents in all directions. Some of these contaminants are inhaled as aerosols (tiny water droplets containing microbes) or condensed on surfaces where they can be touched.
Many of the bacteria found in biofilm, such as legionella pneumophila, are exhibiting resistance to commonly used water treatment methods as well as to the antibiotics used for treating infected patients. Further complicating the problem, some of these harmful pathogens are also protected by amoeba that are resistant to chlorination, temperature and osmotic pressure. The amoeba acts as a "Trojan Horse" harboring and transporting the microbes. Amoebas with waterborne resistant microorganisms have been recovered from drinking water, cooling towers and water distribution networks in hospitals.
Dr. Cervia presented data on the efficacy of point-of-use 0.2 micron filters to provide a barrier to Legionella and other pathogens to reduce the risks from hospital water. Unlike systemic technologies, filtration can significantly reduce the release of pathogens, biofilm and the aerosols they create. He explained that several European nations already recommend point-of-use 0.2 micron filters as a simple and effective solution to prevent waterborne microbe transmission to patients. He reviewed the results of studies conducted with Pall-AquasafeTM filters, which are specifically designed to prevent patient exposure to waterborne microbes. The filters provide an absolute barrier between the microorganisms and patients.
"Point-of-use filtration is a effective solution that can be easily applied to all types of water systems -- showers, faucets, and even ice machines -- especially in hospitals areas where the most vulnerable patients reside," he said.
Taking Action to Help Protect Patients Dr. Cervia said hospitals throughout North America are increasingly turning their attention to water as a source of nosocomial (hospital-acquired) infection as a result of recognition of the prevalence and risks posed by waterborne pathogens. However, he noted, there is a great deal more to be done.
He stated that the infectious disease community can take the lead in solving the problem and that they can also look to the experience and success in Europe to ensure that patients are protected from dangerous waterborne pathogens.
Health and government agencies continue to stress the need for more stringent approaches to dealing with nosocomial infections, such as the new infection control standards mandated by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), as part of their 2005 National Patient Safety Goal. State legislative initiatives across the U.S. in addition to public education campaigns by several organizations are also pushing for hospitals to alert the public to their infection rates.
About Pall Corporation Pall Corporation is the global leader in the rapidly growing field of filtration, separations and purification. Pall's business is organized around two broad markets: Life Sciences and Industrial. The Company provides leading-edge products to meet the demanding needs of customers in biotechnology, pharmaceutical, transfusion medicine, semiconductor, water purification, aerospace and broad industrial markets. Total revenues for fiscal 2004 were $1.8 billion. The Company headquarters are in East Hills, New York with extensive operations throughout the world. Visit Pall at http://www.pall.com/.
This release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995. These statements are based on current Company expectations and are subject to risks and uncertainties which could cause actual results to differ materially. Such risks and uncertainties include, but are not limited to: fluctuations in foreign currency exchange rates; regulatory approval and market acceptance of new technologies; changes in product mix and product pricing and in interest rates and cost of raw materials; the Company's success in enforcing its patents and protecting its proprietary products and manufacturing techniques and its ability to achieve the savings anticipated from its cost reduction initiatives; global and regional economic conditions and legislative, regulatory and political developments; and domestic and international competition in the Company's global markets. Additional information regarding these and other factors is available on the Web at www.pall.com and is included in the Company's reports filed with the U.S. Securities and Exchange Commission. Copies of such reports can be obtained, without charge, at www.sec.gov.
The following reprints can be ordered from Marcia Katz:
Marcia Katz Director of Public Relations 516-801-9851 firstname.lastname@example.org
The Hospital Water Supply as a Source of Nosocomial Infections, Elias J. Anaissie, MD; Scott R. Penzak, PharmD; M. Cecilia Dignani, MD, July 8, 2002
Waterborne Nosocomial Infections, Cheryl Squier, RN, BSN, Victor L. Yu, MD, and Janet E. Stout, PhD, 2000
Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study and clinical implications for patients with hematologic malignancies, Elias J. Anaissie, Shawna L. Stratton, M. Cecilia Dignani, Choon-kee Lee, Richard C. Summerbell, John H. Rex, Thomas P. Monson, and Thomas J. Walsh, April 1, 2003
Goal #7: Reduce the risk of health-care-associated infections.
Requirement #7B: Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health-care-associated infection.
Full compliance required as of January 1, 2005
Centers for Disease Control (CDC) Guidelines
Controlling the Spread of Waterborne Microorganisms
"Eliminate contaminated water or fluid environmental reservoirs (e.g. in equipment or solutions) wherever possible"
Preventing Legionnaires Disease in Protective Environments and Transplant Units
"If Legionella spp. are determined to be present in the water of a transplant unit, implement certain measures until Legionella spp. are no longer detected by culture.
Decontaminate the water supply.
Do not use water from the faucets in patient-care rooms to avoid creating infectious aerosols.
Restrict severely immunocompromised patients from taking showers?"
Prevention and Control of Health-Care-Associated Legionnaires Disease
"Health-care facilities with hematopoietic stem cell or solid-organ transplantation programs. If Legionellae are detected in the potable water supply of a transplant unit, and until Legionellae are no longer detected by culture:
Restrict severely immunocompromised patients from taking showers. Do not use water from faucets with Legionella-contaminated water in patients? rooms to avoid creating infectious aerosols."
Control of Specific Nosocomial Infections/Recommendations Regarding Legionella Species:
"?conduct a thorough epidemiologic and environmental investigation to determine the likely environmental source(s) of Legionella species (e.g. showers, tap water faucets, cooling towers and hot water tanks.)"
Control of Specific Nosocomial Infections/Recommendations Regarding Legionella Species:
"The source of Legionella infection should be identified and decontaminated or removed."
"?the goal, if environmental surveillance for Legionellae is undertaken, should be to maintain water systems with no detectable organisms."
World Health Organization (WHO) Guidelines
Proposed protection measures to prevent drinking waterborne infections in immunocompromised patients
Protection Level I ? Mild Immunosuppression: "Avoid any circumstance with elevated infection risk (like drinking water from uncontrolled sources)"
Protection Level II - Moderate Immunosuppression: "Drinking water should have an additional antimicrobial barrier to tap water Bathroom installations should be controlled for bacterial reservoirs"
Protection Level III - Severe Immunosuppression: "Any water for human use should have very low bacterial count (use water filters/controlled carbonated water) Strict control of bath installation and water for showering (showering to be avoided if no control possible)"
Protection Level IV - Extreme Immunosuppression: "Only sterile fluids for drinking, mouth care and washing allowed"