7_DHA Water Chemestry Database Application_Jaclyn Kiehl_24UG23.pdf

Medically Ready Force… Ready Medical Force

UNCLASSIFIED/CUI

DHA Water Treatment Program

DHA Water Treatment Program

Agenda

1) Case Studies and Key Issues

2) Lesson’s Learned

3) Recommendations for Softening Equipment

4) Dental Equipment Recommendation’s

5) Sterile Processing Department (SPD) Equipment

Recommendations and Layout

6) Water Management Plan & ASHRAE 188

7) DHA Policy Guidelines vs. Contractor Guidelines

DHA Water Treatment Program

Who is on the Team

Kelly Mollenkopf PE (FPE/ME) Chief, Engineering and Design

Joey Bass Senior Program Manager

Miro Uhrik Quality Control Specialist

Jaclyn Kiehl Mechanical Engineer/Water SME

Paul Cherry PE (ME) Deputy, Engineering and Design

Alok Kumar PE, EMP Sr. Director, Energy Services

Chris Bosch

VP, IT

Kenneth Cruz Program Manager

DHA Water Treatment Program

Case Studies and Key Issues

Site

Legionella Outbreak

Residual Chlorine

Levels Low after softener

Iron Reducing Bacteria/ Positive

Total Coliform

Reverse Osmosis system is considered a dead leg

Salt Not

NSF

compliant

Zero Hardness

Soft Water System has no Blending

Water quality TDS needs to be between 50-

150ppm

AAMI

TIR34

Complia nt

Water Quality is

Highly Corrosive

Lead Count over the 90th percentile

Long Pipe Run's

Lack of Pipe insulation on Cold Pipes

HW

System was 93°F- 111°F

Fort Bliss X X X X X X X X Camp Pendleton X X X X X X X X

Pensacola/ Minot X X

DHA Water Treatment Program

Lessons Learned (Fort Bliss)

• Potable water system showed corrosion due to zero hardness and no proper bypass system installed

• Site did not have a constant chlorine disinfectant residual

• Corrosion inhibitor needed to be installed due to elevated levels of lead in domestic water system

• Not all water quality parameters have been tested

• Operation wastes salt and regenerates each softener before it is exhausted of salt

• Galvanized Pipe fittings were installed

• CSI system was not piped properly

• No operators where properly licensed under TCEQ

• Salt in Brine tank was not NSF compliant

DHA Water Treatment Program

Lessons Learned (Camp Pendleton)

• Water Softening System removed over

50% of free chlorine coming from the water utility

• Long pipe runs that reduce in pipe diameter along route

• The infrequent use of the RO system effectively creates a dead leg

• Legionella was found in low-use taps.

• Lack of pipe insulation on cold pipes

• Hot Water System were found between

93°F and 111 °F

• The CSI system at NHCP was demonstrated to be ineffective in controlling Legionella in the hospital water supply, with 45% of POU taps positive

• POU filtration may be effective at retaining bacteria from water piped to a water tap

DHA Water Treatment Program

Lessons Learned (NAS Pensacola/Minot AFB )

• Sterile Processing Department water not up to AAMI TIR 34 Standard

• Blending TDS level’s must be within

50-150 ppm for certain type of equipment

• Process water must be either “Utility” or “Critical”

• Feedwater Quality is different for Carbon-Steel and Stainless Steam Generators

DHA Water Treatment Program

Potable Water

Condenser Water System

(Cooling Towers)

Steam System (Steam Boilers)

Chilled Water System (Chillers)

Heating Hot Water System

(Hot Water Boilers)

Heat Pump System (Process Cooling)

Domestic Hot and Cold water, RO/DI (Sterilizer, Dental, Special Medical Use, Plumbing Fixtures (Sink, Toilet, Drinking Fountain

Cooling Tower, Condensers Open Loop.

Make-Up Water System

Steam for Boiler Make-up Water System

Chillers Closed Loop Water

Heating Hot Water Boiler Closed Loop Water

Process Cooling Closed Loop Water

DHA Water Treatment Program

Recommendations for Softening Equipment

• Provide a minimum hardness of 51.3 mg/L. Typical softener’s produce water hardness between 0-30 mg/L

• The water softening system must include a hard water bypass and blending system consisting of a proportioning valve and a bypass meter

• Any treatment additives used for potable water should follow NSF certification and approval for use in drinking water

• 10% of cross-linked resin has high performances with a chlorine environment. Few chances are available to break down the beads with chlorine

• When installing Copper/Silver Ionization; Install after softener

DHA Water Treatment Program

Dental Equipment Recommendations

• Dental water purification systems may be direct feed or bottle-fill systems

• A source water bypass should be installed

• Manufacturer’s may recommend any required pre-filters, booster pumps, water storage tanks, and dental water faucets

• A pre-filter is preferred if the source water quality is >250 PPM TDS

DHA Water Treatment Program

Sterile Processing Department (SPD) Equipment Recommendations and Layout

• Will need a softener system if Stainless-Steel Steam Generators are installed in equipment

• If a Large system is required, a recirculating loop must be installed with tank and booster pump that flows at 3 to 5 feet per Second

• Both Large and Small system need bacterial and endotoxin treatment

• Blending Valve must be installed on Reverse Osmosis system that need Total

Dissolved Solid levels between 50-150 ppm

• Small volume system’s have be installed without recirculation loop however must still comply with AAMI TIR34 quality

DHA Water Treatment Program

Typical Layout of Water Treatment System for Critical Water

DHA Water Treatment Program

Water Management Plan & ASHRAE 188 Water Management Plan

• Create a Team

• Map the Water System

• Identify Risk and Create a

Plan

• Develop Standard

Operating Procedures

Monitoring Control Measure Example

DHA Water Treatment Program

DHA Policy Guidelines vs. Contractor Guidelines

DHA Water Treatment Program

Questions?