{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"490 From Plans to Prevention: Water Management Insights with Dr. Abe Cullom","description":" A water management plan protects people only when the facility uses it to guide decisions. Dr. Abe Cullom, Director of Water Safety & Management at Pace Analytical, joins Trace Blackmore, CWT, to examine why Legionella programs break down\u2014and how testing, communication, and consistent implementation can strengthen them.  Implementation Is the Bottleneck  Five decades after Legionella was identified, researchers understand much more about the organism, its ecology, the conditions that support its growth, and the interventions available to control it. However, Dr. Cullom identifies implementation\u2014not a lack of science\u2014as the primary bottleneck.  Many plans remain in filing cabinets or operate on autopilot. Teams collect measurements and samples, yet no one connects the results into a complete picture of the building water system. Process failures, limited follow-up, budget constraints, and unclear communication can allow a developing problem to remain hidden behind repeated low-level corrective actions.  Testing Must Inform Risk  Culture remains a dominant testing method, although the typical wait for results can complicate decisions during an investigation or operational change. qPCR provides faster results but may detect genetic material from both living and dead cells. Dr. Cullom also explains viable but non-culturable cells and why recent heat treatment, supplemental disinfection, oxidative stress, or prolonged stagnation can affect culture results.  The goal is not automatically to drive every Legionella result to zero. Instead, teams should interpret findings using the species detected, distal site positivity, the facility\u2019s population, and the limitations of the testing method. Dr. Cullom explains why testing only for Legionella pneumophila may make sense in some systems, while healthcare facilities may require a broader view because highly immunocompromised patients can develop infections from other Legionella species.  Ownership, Communication, and Continuous Review  Water management plans often fail when responsibility for corrective action has not been assigned. Dr. Cullom calls one version of this breakdown the \u201cmilkman approach\u201d: a consultant or water treater delivers results, but the facility expects that outside party to organize a response that was never included in the scope.  Effective programs clearly define authority, assign actions, and give engineers, infection prevention professionals, facility leaders, consultants, and water treaters a shared vocabulary. When reviewing a program, examine its records, verification and validation activities, corrective-action documentation, and long-term data trends.  Dr. Cullom recommends giving someone at least 30 minutes each month to consider what the results reveal and whether the plan needs to change. He closes with a direct priority: validate every plan through testing\u2014at least once and, ideally, routinely.  Listen to the full conversation above. Explore related episodes below. Stay engaged, keep learning, and continue scaling up your knowledge!    Timestamps  08:40 \u2014 Trace introduces Dr. Abe Cullom and begins a practical examination of water safety, risk assessment, and Legionella outbreak prevention. 11:30 \u2014 Dr. Cullom defines opportunistic premise plumbing pathogens and explains why vulnerable building occupants face greater infection risks. 13:10 \u2014 Building water systems emerge as complex microbial environments shaped by chemistry, hydraulics, construction materials, pathogens, and antibiotic resistance. 14:40 \u2014 Fifty years of Legionella research have produced strong scientific guidance, but inconsistent implementation remains the central bottleneck. 16:40 \u2014 Process failures, poor communication, limited follow-up, and plans running on autopilot can undermine otherwise sound water management programs. 18:50 \u2014 Dr. Cullom compares culture and qPCR testing, including turnaround time, sensitivity, and the challenge of detecting DNA from dead cells. 20:50 \u2014 Testing only for Legionella pneumophila may reduce unnecessary responses in some systems, but healthcare facilities may need broader species testing. 22:30 \u2014 Viable but non-culturable cells can complicate sampling after heat, disinfection, oxidative stress, starvation, or prolonged stagnation. 24:10 \u2014 \u201cZero Legionella\u201d and \u201czero cases\u201d represent different goals, requiring teams to manage health risk instead of reacting identically to every positive result. 26:10 \u2014 Distal site positivity measures the percentage of sampled outlets testing positive and helps teams interpret building-level risk. 27:50 \u2014 Corrective actions can stall when authority, responsibilities, and expectations between facilities, consultants, and water treaters remain unclear. 30:00 \u2014 Plans, diagrams, and training should give multidisciplinary program teams a shared vocabulary for productive water-management decisions. 33:10 \u2014 Pseudomonas aeruginosa and nontuberculous mycobacteria deserve greater attention as additional building water pathogens. 34:20 \u2014 Public health, regulatory responsibilities, and the cost of outbreak mitigation can help professionals make the case for proactive water management. 36:50 \u2014 A program review should examine documentation, verification, validation, corrective actions, data trends, and how facility leaders interpret the results. 38:00 \u2014 Dr. Cullom previews \u201cClinical Crossroads: The Risk Burden of ST-108,\u201d addressing water quality, sterile processing, and new areas of liability. 39:40 \u2014 Program teams should dedicate time each month to reviewing data, challenging assumptions, and updating their understanding of the system. 41:30 \u2014 The Legionella Awareness Month lightning round covers essential resources, common communication failures, and routine testing as a driver of improvement.   Connect with Dr. Abe Cullom Phone: 913-948-3948  Email: abe.cullom@pacelabs.com  Website: People Advancing Science\u00ae: Transforming Environment & Health   LinkedIn: https:\/\/www.linkedin.com\/in\/abraham-cullom-46b04385\/   https:\/\/www.linkedin.com\/company\/paceanalyticalservices\/     Words of Water with James McDonald  Today's definition is a horizontal pressure vessel located at the bottom of a water tube boiler. Its primary functions are to facilitate water circulation and to provide a collection point for sludge, sediment, and other suspended solids that settle out of the boiler water. Can you guess the word or phrase?    2026 Events for Water Professionals  Check out our Scaling UP! H2O Events Calendar where we\u2019ve listed every event Water Treaters should be aware of by clicking HERE.    This episode made possible through our valued partners at:   ","author_name":"Scaling UP! H2O","author_url":"http:\/\/scalinguph2o.com","html":"