Bridging the Gap: Plumbing Engineering and Health Care for Safer, Sustainable Facilities 

Christoph Lohr

Recent discussions in healthcare facility design have highlighted a critical challenge: the widespread adoption of low-flow fixtures, intended for water conservation, can unintentionally increase water age in piping systems. This creates conditions that foster the growth of Legionella and other waterborne pathogens – posing a significant risk to patient safety and infection control. 

Data collected from a range of health care buildings show that measured peak flow rates are consistently much lower than those projected by traditional standards such as Hunter’s curve. However, simply reducing pipe sizes to match these lower flows is not a viable solution in health care environments. There is no approved alternative for downsizing water piping systems that safely accommodates low-flow fixtures, and the technical nuances of water system design are often unfamiliar to health care professionals. 

This situation underscores the importance of interdisciplinary collaboration. Scientific insights are essential to inform health care leaders about the risks and realities of plumbing design. Evidence-based updates to plumbing codes and guidelines are needed to ensure that sustainability efforts do not compromise safety. 

By advocating for data-driven approaches and open dialogue between technical and clinical stakeholders, the industry can advance plumbing innovation while protecting public health and supporting sustainability goals.