In the absence of a cohesive national approach to prevention, health organizations and professional associations have produced guidelines due to increasing cases of Legionnaires' disease. The table includes both national and international guidelines that exist for Legionella prevention today.  Click on table row to view PDF. (See Terms of Use)

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Organization Guideline Focus Year
Allegheny County Health Department (ACHD)

Approaches to prevention and control of Legionella infection in Allegheny county healthcare facilities         (Proactive approach)

Healthcare 1993
ACHD, Pittsburgh Regional Health Initiative, RAND Updated Guidelines for the Control of Legionella in Western Pennsylvania Healthcare 2014
The American Industrial Hygiene Association (AIHA)

Recognition, Evaluation, and Control of Legionella in Building Water Systems
(purchase standard on AIHA website)

Healthcare 2015
ASHRAE ANSI/ASHRAE Standard 188-2015  Legionellosis: Risk Management for Building Water Systems 
(purchase standard on ASHRAE website)
HVAC & Healthcare 2015
ASHRAE Minimizing the risk of Legionellosis associated with building water systems 
(located on Baltimore Aircoil website)
HVAC & Healthcare 2000
Association of Water Technologies (AWT) Legionella 2003: An update and statement by the Association of Water Technologies HVAC 2003  
Australia/ New Zealand Air-handling and water systems of buildings-Microbial control. Part 3: Performance-based maintenance of cooling water systems HVAC 1998
Centers for Disease Control and Prevention (CDC) Developing a Water Management Program to Reduce Legionella Growth & Spread in Buildings All 2017
Centers for Disease Control and Prevention (CDC) Guidelines for preventing health-care associated pneumonia Healthcare 2003
Centers for Disease Control and Prevention (CDC) Guidelines for prevention of nosocomial pneumonia Healthcare 1997  
Centers for Medicare & Medicaid Services (CMS)

Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease

Healthcare 2017
Cooling Technology Institute (CTI) Guideline: Best Practices for Control of Legionella HVAC 2008  
EPA Technologies for Legionella Control in Premise Plumbing Systems: Scientific Literature Review EPA 2016
Health & Safety Executive (HSE) Legionnaires’ disease. The control of Legionella bacteria in water systems. Approve code of practice and guidance. All 2000  
Joint Commission Environment of Care: Standard EC.02.05.01  Healthcare 2009  
New York City Department of Health and Mental Hygiene Notice of Adoption of Chapter 8 (Cooling Towers) of Title 24 of the Rules of the City of New York All 2016
New York State Cooling Tower Regulation: Protection Against Legionella All 2015
New York
State Advisory / Dept. of Health 
Advisory: Prevention and Control of Legionellosis (Legionnaires' disease) in Healthcare Facilities & NY State DOH Prevention and Control of Legionnaires' Guidance for Clinicians: Background and Diagnosis


Queensland Health, Australia Preliminary Guidelines for Managing Microbial Water Quality in Health Facilities Healthcare 2013
State of New York Dept. of Health Guidance for infection control activities for prevention, surveillance, investigation, and control. Guidance for routine environmental care and maintenance within a facility, and response to possible or confirmed healthcare facility-associated Legionnaires' disease cases Healthcare 2005  
Veterans Health Administration (VHA) VHA Guidance Document (GD-2016-001) Risk Assessment for Prevention of Healthcare-Associated Legionella Disease Healthcare 2016
Veterans Health Administration (VHA) VHA Directive 1061: Prevention of Healthcare-Associated Legionella Disease and Scald Injury from Potable Water DIistribution Systems Healthcare 2014
Veterans Health Administration (VHA) VHA directive 2008-010: Prevention of Legionella Disease Healthcare 2008  
World Health Organization (WHO) Legionella and the prevention of Legionellosis HVAC & Healthcare 2007