Common Objections to Point-of-Use Water Filters
October 14, 2021
If you want to learn more about Point-of-Use Water (POU) Filters and how they work, see our earlier blog posts:
Objection 1: Point-of-Use Water Filters are too costly.
Except in an outbreak situation, POU filters are intended to help reduce risk in the most critical patient applications. Those at-risk patients are typically more susceptible to a waterborne infection than the average person.
Depending on the organism, even one waterborne infection in a particular unit can cost a hospital thousands of dollars or more. Preventing that infection may both pay for the entire case of POU filters, and save the hospital additional money on top of that. For more information on the potential return-on-investment, see our blog here.
Objection 2: I have a disinfection system, so I don’t need Point-of-Use Water Filters.
Any good water management program incorporates many different control measures to reduce risk. Since no one measure is a guarantee, these measures are often used in conjunction in the most high-risk areas of the hospital.
Secondary disinfections systems, like monochloramine, chlorine dioxide, and copper silver ionization can help to reduce risk. However, none of these systems can completely eradicate waterborne organisms and further, disinfection can work well on some organisms and poorly on others. This is why waterborne outbreaks have been known to occur even with a functioning secondary disinfection system1,2.
Therefore, for those critical patients, it is important to consider additional measures. Sterilizing-grade POU filters can effectively and immediately retain waterborne organisms and thus are a simple control measure.
Objection 3: We don’t have a problem.
Many healthcare facilities are looking only for Legionella pneumophila in their water sampling, if at all. If the samples are negative for Legionella then the facility sometimes concludes that there is no problem with their water, especially if there has never been a known outbreak in their facility.
Water samples give great information over time to let a facility know how well it is managing the water. However, water samples are a snapshot in time and don’t give all the information on the health of a water system. Further, if Legionella samples are being taken and are negative, this does not mean that other harmful waterborne organisms are also under control – what works well for the control of Legionella does not necessarily work well for the control of other waterborne pathogens, like Non-tuberculous mycobacteria.
It is important to remember that many facilities that experience an outbreak have never had one in the past. To avoid having false confidence, it is important to design a robust water management plan no matter the history of the facility.
Objection 4: My facility is brand new so I don’t need Point-of-Use Water Filters.
It is true that many known outbreaks have been linked to old buildings with old pipework that is complex and filled with “dead legs”. However, there are also outbreaks that have been documented in brand new buildings as well3. Construction and commissioning a building for opening can contribute to waterborne pathogen risk in several ways, contaminating a system before the building is even open4.
Objection 5: I already have a filter under the sink.
A POU filter is best used at the point of use. This is because waterborne organisms can exist in the water line downstream of an in-line filter and at the point of use outlet. In fact, some organisms, like Pseudomonas aeruginosaare known to colonize right at the end of a faucet or shower5. Putting a POU filter right at the point of use means that all water that comes into contact with a patient or healthcare worker will have been filtered immediately before use.
In addition to the concerns of the downstream line, many in-line filters are not suitable to reduce risk of waterborne organisms. To be sure, check to see if the filter is sterilizing-grade or microbially rated according to ASTM F838. Separately, also consider that even if the filter is rated to 0.2 microns, if it has not been tested to ASTM F838 then the user cannot be sure it will help reduce waterborne risk. This is because micron size only tells part of the story – a 0.2 micron filter that is nominal, for example, maybe less than 90% efficient and 10% of particles will flow through.
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