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Information for Health Care Institutions During a Boil Water Advisory

Water for drinking

  • Post “Do Not Drink” signs at all water taps including drinking faucets, kitchen areas, and washrooms.
  • Take special measures to prevent unsafe water consumption in private rooms and wards where cognitive development or function is an issue (for example pediatric wards, or Alzheimer wards).
  • Only boiled or bottled water should be used for drinking. Boiled water is water that has been brought to a rolling boil for at least one (1) minute and then cooled and stored in clean, covered containers until served. 

Handwashing and personal hygiene

  • Enforce frequent, thorough handwashing with disinfected water for all staff. Follow handwashing guidelines and use sanitizing gels. (If there is a known agent, special handwashing procedures may need to be followed).
  • Post signs and guidelines about proper handwashing at all hand sinks.
  • Take special measures to ensure that patients comply with guidelines for handwashing and personal care. Patients with cognitive deficits will require assistance.
  • Follow teeth brushing guidelines and ensure appropriate care of dentures in wards and in private rooms. 

Medical/nursing procedures

  • Monitor patients closely for signs and symptoms of gastrointestinal illness
  • Use only disinfected water to treat skin wounds
  • Institute special practices in units where water is used as part of the treatment regimen (for example renal dialysis units) 

Food preparation and dishwashing

  • Review and follow guidelines for food premises
  • Discard all foods and beverages made with untreated or potentially contaminated water.
  • Do not serve water, ice or drinks made with untreated water, or raw foods rinsed with untreated water.
  • Commercial dishwashers that use hot water at 60C (or 140F) with a hot water sanitizing rinse of 82C (or 180F) for 10 seconds would be considered satisfactory.  Where parasitic contamination is suspected, "low" temperature dishwashers using chemical sanitizers may not be effective.  Beverage glass washers that use a cold water rinse must not be used. Consider the use of single use, disposable dishes where applicable.
  • Ensure satellite kitchens/food service areas receive and follow the same strict guidelines. 

When the boil water advisory is rescinded 

  • Restart, flush and sanitize any water-using fixture or piece of equipment in accordance with the manufacturer's specifications. This may vary depending on the type of fixture. Consult the facility engineer and/or the manufacturer when restarting the equipment.
  • Drain water-holding reservoirs (in large buildings) in consultation with the facility engineer and health unit.
  • Run cold faucets for one minute before using the water.
  • Run drinking fountains for one minute before using the water.
  • Backwash pool filters and change media or water.
  • Drain and refill hot water heaters set below 45°C (113°F).

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