Elevated bacteria levels have prompted the Columbus VA to stop using the plumbing system in its dental clinic. Bottled water has been used exclusively since August, said Laura Ruzick, the associate director of the Chalmers P. Wylie VA Ambulatory Care Center. Officials hope to flush the system and retest the water in the next month or two, she said.
Elevated bacteria levels have prompted the Columbus VA to stop using the plumbing system in its dental clinic.
Bottled water has been used exclusively since August, said Laura Ruzick, the associate director of the Chalmers P. Wylie VA Ambulatory Care Center. Officials hope to flush the system and retest the water in the next month or two, she said.
“Our goal is to be better than the community standard,” Ruzick said. “That’s what these proactive measures are for.”
VA documents mailed anonymously to The Dispatch show that spikes in bacteria in the waterlines have persisted since the U.S. Department of Veterans Affairs’ health-care center opened in Whitehall in 2008.
Officials said they don’t think the elevated bacteria levels have placed patients at risk. The officials have turned to bottled water to rinse patients’ mouths and for other nonsurgical uses whenever bacteria levels are too high. During dental surgery, sterile water is used.
But some patients might have been exposed to higher levels of bacteria before VA officials learned of the contamination through testing.
“I have no evidence to suggest that any of our patients treated here ever got an infection from dental-unit water,” said Dr. Michael Jung, the chief of dental service. “I think we do a terrific job of taking care of our veterans.”
The dental clinic saw 2,204 patients during its most-recent fiscal year, which ended on Sept. 30.
Like other VA centers, the Columbus VA recently began testing its water quarterly.
The American Dental Association updated its recommendations on dental-unit waterlines after a paper was published this year about the 2011 death of an otherwise-healthy 82-year-old woman in Italy who developed Legionnaires’ disease after a dental visit. The disease is caused by bacteria often found in water.
The association said “regular maintenance” of dental clinics’ water supplies would be needed to keep bacteria counts below the maximum concentration recommended by the U.S. Environmental Protection Agency: 500 colony-forming units per milliliter (cfu/mL).
The small diameter of dental waterline tubing is a good environment for bacteria to gain a foothold, the dental association said. Bacteria and other microorganisms can coat the interior of the tubing.
“As the water travels through the waterlines, the microorganisms slough off, resulting in contamination of the water,” the association said.
The Columbus VA removed a “dogleg” in the dental clinic’s plumbing system in late October, which officials hope will lower the bacteria levels.
A water test on April 19 found that bacteria levels exceeded the maximum threshold in two lines, measuring 870 cfu/mL in one line and 560 cfu/mL in another.
In March 2010, a testing company found “severe levels” of pseudomonas bacteria in waterlines. VA officials said the waterlines that had high bacteria counts weren’t being used at the time.
“The assistant side of the dental chair ... is still showing bacteria growth,” one VA official wrote in a May 2011 email. “This has been an ongoing problem.”
Elevated levels of bacteria also have been found at other VA dental clinics in Ohio, including in Cleveland, Dayton, Cincinnati and Chillicothe. The Chillicothe VA said its readings have never exceeded 500 cfu/mL, while readings spiked above 500 cfu/mL twice in Dayton and Cincinnati and three times in Cleveland.
As a precaution, the VA centers treat water when bacteria counts rise above 200 cfu/mL, officials said.
When the Columbus outpatient center was built, the VA had a contractor install a system to further purify the municipal water used during dental cleanings. Officials note that many private dental practices don’t use such a system.
But the system was installed improperly, and waterlines that supply the dental assistants’ side of the clinic’s 13 chairs were never routed through the purifying system. The VA recently paid $23,000 to fix that problem.Jung said the VA’s senior leadership has been aware of the waterline problem since the center opened.
VA officials were “not feeling it was a critical issue because, in general, our counts have been below the accepted EPA standard,” Ruzick said. The city of Columbus said it regularly tests its water to make sure that chlorine residual levels are high enough to keep bacteria from growing. Of 801 tests this year across the city, 39 found bacteria levels exceeding 500 cfu/mL.
“When a higher number becomes a regular pattern, we investigate further, but often times it’s from a dirty faucet or something simple that does not indicate a regular problem in the water-distribution system,” a city spokeswoman said in a statement.