Conceptualization to Development of a Decision Support Tool to Manage Building Water Quality

Opportunistic premise plumbing pathogens (OPPPs) such as Pseudomonas aeruginosa and Legionella pneumophila, are microbial inhabitants of premise plumbing which can pose a serious risk to human health, and even cause death, mainly but not exclusively in elderly and immunocompromised individuals. Guidance on appropriate measures to control these OPPPs comes from many different scattered sources that are at times inconsistent and conditioned on various characteristics of the plumbing systems. Furthermore, such guidance is usually difficult to implement in practice because of the varying conditions that exist in buildings. Therefore, there is a need of developing a tool that can bring together knowledge from these different sources for building specific requirements and are free from inconsistencies. To address this problem, we have developed a web-based premise plumbing water quality management tool, herein called "plumbing information and performance evaluation (PIPE) decision support tool (DST)." The PIPE tool provides a free resource for water quality management in buildings that takes input from building facility managers and outputs guidance specific to their buildings. The PIPE requires simple user inputs related to the building and its plumbing system's operational and design characteristics. In response, PIPE will help them assess if a water quality management plan is required for their building and identify those features that need the management most. The output recommendations of the PIPE tool are based on an inbuilt knowledge database on building water quality management guidelines. The database was developed based on summarizing the guidance from 15 important guidance documents that were systematically screened from a large pool of 54 guidance documents from worldwide organizations. The information summarized in the database included reconciling knowledge gaps/inconsistencies, management actions (e.g., use of chloramine rather than chlorine, temperature control, etc.), and water quality metrics with their appropriate levels that ensure water quality in building plumbing systems. Being at the early stage of development, the PIPE DST can be enhanced by beta-testing among the targeted users (i.e., building owners, engineers, facility managers) to identify management approaches customized for specific building types such as hospitals, hotels, and long-term care facilities.