More can be done to reduce Legionnaires’ disease risk in Australia, according to study

Flinders University researchers have identified opportunities to strengthen Legionella risk management across Australia by introducing uniform best practices across all states and territories.

Published in BMC Public Health, the study is the first comprehensive comparison of Legionella-related legislation, regulations, codes of practice and policy frameworks across Australia, with New Zealand included as an international comparison.

The experts in environmental health argue that greater national coordination could support more consistent Legionella prevention strategies across Australia—with no single state or territory better than another.

“Some jurisdictions were found to apply more structured and comprehensive regulatory frameworks, including detailed risk management requirements, routine monitoring programs and clear notification processes,” says lead author Crystal Kennett, a Ph.D. candidate.

“Other jurisdictions adopt alternative approaches, often incorporating guidance documents, localized registers or risk-informed approaches.”

Inconsistencies in the management of recognized Legionella risk factors included thermostatic mixing valves, stagnant pipework (“dead legs”) and other aerosol-generating water systems.

Legionella is the bacterium that causes Legionnaires’ disease, a potentially serious form of pneumonia. People can become infected by breathing in tiny water droplets (aerosols) containing the bacteria from sources such as cooling towers, building water systems, spas, decorative fountains and other engineered water systems.

Symptoms of Legionnaires’ disease can include fever, chills, cough, shortness of breath, muscle aches, headaches and fatigue. In severe cases, the infection can lead to pneumonia that requires hospitalization and can be life-threatening, particularly for older adults, smokers and people with weakened immune systems.

The research examined legislative and policy frameworks governing Legionella control in cooling towers, warm-water systems and other engineered water systems. Differences in approaches to system registration, risk assessment and microbiological monitoring were evaluated.

“All jurisdictions are working to manage Legionella risks, but the tools and methods used vary in scope and application,” Kennett says.

While Australia has a “strong foundation” for Legionella management, she says regulatory variations were identified in cooling tower registration requirements, risk assessment processes, monitoring frequencies, notification thresholds and the actions required when Legionella was detected.

The review examined New Zealand’s framework, which integrates public health guidance, building controls and workplace safety requirements within a coordinated national system.

Senior author Harriet Whiley says, “This model demonstrates the value of alignment across regulatory domains while still allowing flexibility in implementation.”

“Legionnaires’ disease remains a serious infection with potentially severe consequences, particularly for vulnerable populations,” Whiley says.

“Understanding where regulatory gaps and inconsistencies exist is an important first step in ensuring that prevention measures are evidence-based, proportionate and effective.”

The authors, including Professor in Environmental Health Kirstin Ross, say future research should evaluate whether differences in regulatory approaches influence Legionella risk management outcomes and disease prevention.

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Gaby Clark

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Andrew Zinin

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