Gurnari G., Ottaviani M.

Leader technical-scientific commission of the FEMTEC, Manager of «Hygiene of inland water» Dep., Istituto Superiore Sanità, Italy

In our society rarely the common environments can claim to be free from bacteria contamination. The problem exists and it’s complex and articulated even if the natural immune defences of most people reduce the risk to contract infections by pathogens in common environments.

In order to limit such risk, some technologies of contrast have been debugged and the surveillance level has been increased.

Both techniques and means of intervention are largely regulated by rules, prescriptions and hints that don’t always meet the needs. Besides the sharing of juridical tools is complex to apply in a crucial environment as public health care can be, most of all when the rules have to be internationally sustainable and the users are heterogeneous.

The diffuse contamination of water and water-sanitary plants, evaporative cooling towers and air conditioning plants by pathogens as (Legionella sp.), has involved the need to adopt appropriate criterions of intervention in order to reduce risk factors, most of all in the sanitary structures and in the common environments (hospitality, gyms and swimming pools, thermal establishments, means of transport, et). Progressive risk levels have been also identified according to the amount of microorganism — CFU (Colons making units) — existing in the water or in the moistened air and relative techniques of contrast have been suggested.

On the other hand, the methods indicated don’t always meet the needs because of the extreme variety of the reference structures and don’t always consider the large number of national and international rules that regulate both water and air conditioning plants. Besides, the contrast through chemical or physical or chemical-physical methods doesn’t always allow obtaining the expected results. The guidelines issued in the recent past contained suggestions and indications that haven’t always reached the expected results during the experimentation and sometimes even counterproductive; in some cases, especially in medical spa environment, the techniques of intervention used have shown to be inappropriate and will shortly require a revision.

As we know there is a large number of procedures that must be considered (such as choice of materials, ways of installation, hygienic-sanitary compatibility, managing) and the attention cannot be focused only on the treatment method; in that way the problems became complicated.

In this case the different institutional subjects involved seems to be politically (is it sustainable such an action?) and economically (which are the extra costs needed for a low-risk issue and that only a restricted social class could benefit from?) perplexed. It has to be pointed out that if the technical-scientific shared supports were not used, this would represent a real obstacle to the possibility to regulate with rules all the aspects of a wide and interdisciplinary question as the bacteria contamination in a diffuse environment.

This happens in a context in which the industrial and applied research tries to find solutions that can also lead to a commercial evolution. New techniques and criterions of intervention and new materials are quickly developed; on the other hand the biological research sector is not able to provide rapidly the outcome of a microbiological investigation or the environmental compatibility of air and water manipulations. However, this timing difference doesn’t justify the approximation in facing hygienic—sanitary problems only supported by commercial needs.

The hygienic prevention represents, first of all, an aim to be achieved at a cultural level. Once the aspects of the different and complex bacteriological problems and the dynamics that characterize them will be clear, then in a short time-span, the experimental processes — real and pursuable — will have to be implemented, with low costs involved and with results that can be validated. Therefore, it is necessary to confirm the reference situation: the cooperation between private and public subjects, between interdisciplinary professionals and specialized industry are to be considered to identify criterions and methods in order to obtain a more effective hygienic prevention on all the components of structural and managing systems.

A support by the law could be quickly developed only through a remarkable and effective cooperation between Institutions and Services, in order to avoid speculations and alarmism (not always justified) and to improve the quality offered in tourism & hospitality, sanitary, sport and medical spa structures.

The jurisdiction is actually deficient, because the informative are not completed yet. New purposes, to be shared by all the subjects involved, have to be pursued in order to fill this gap.