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Yes, under some conditions. Lower water use can increase water age and weaken disinfectant residuals in parts of a building’s plumbing, potentially creating conditions that support Legionella growth. That is a plumbing-management risk—not evidence that green buildings or certification inherently cause illness.
How water conservation can affect building water quality
Premise plumbing is the building-side system that carries water from the service connection to taps and other outlets. When fixtures use less water, outlets are rarely used, or occupancy falls, water can stay in pipes and equipment longer. Large or oversized plumbing volumes, dead ends, unused outlets, and poorly managed storage can add to that water age.
As water sits, disinfectant residual can decline and temperatures can shift. Stagnant hot water may cool into conditions more favorable to Legionella, while other parts of the system may also experience changes in water quality. The EPA explains that stagnant water can change temperature and lower disinfectant levels, creating opportunities for Legionella growth (EPA: Legionella in the Indoor Environment). CDC similarly notes that slowly moving or stagnant water increases water age and provides opportunities for Legionella growth (CDC: Monitoring Building Water, updated March 15, 2024).
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What the evidence says—and does not say
The evidence supports a conditional engineering concern, not a blanket claim that low-flow fixtures, water conservation, or green certification cause illness. Risk depends on interacting factors such as plumbing layout, stagnation, hot-water temperatures, disinfectant residual, storage and treatment equipment, occupancy, and maintenance. NIST says lower water and water-related energy use in modern buildings have presented challenges to maintaining chemical and microbial water quality, and identifies a need for more technical knowledge to meet health and efficiency goals (NIST: Premise Plumbing Systems for High-Performance Buildings).
EPA also identifies the effects of low-flow fixtures and flow changes on premise-plumbing water quality as topics needing further research (EPA: National Priorities on Water Conservation and Water Quality). The reviewed evidence does not establish a reliable headline statistic for how much water conservation in green buildings increases illness incidence.
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What a LEED-building investigation found
A 2023 peer-reviewed case study investigated widespread Legionella pneumophila colonization in one LEED building. The authors identified several possible contributors: a low water-heater setting associated with temperatures favorable to growth, reduced occupancy and stagnation, colonized water-saving fixtures, a water-softening system that could remove chlorine residual, and a colonized expansion tank (Joshi et al., Frontiers in Water, 2023).
Flushing and thermal disinfection alone did not resolve the problem in that building; replacing the expansion tank ultimately did. The case illustrates why a building’s whole system matters: it does not isolate water-saving fixtures as the sole cause, nor does one building establish a population-wide effect.
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What risk models can—and cannot—tell building owners
A quantitative microbial risk assessment published in Environmental Science & Technology in April 2024 modeled Legionella risk across specified scenarios. Its results are model outputs based on the study’s assumptions, not observed illness rates or predictions for every building (Clements et al., 2024).
| Modeled result | What it means |
|---|---|
| Median annual modeled probability of clinically severe illness was 1–3 orders of magnitude below 10-4 across all scenarios examined. | This describes the study’s modeled scenarios, not a measured population rate or a guarantee of safety in a particular building. |
| Scheduled purging once or twice per day reduced modeled probability for one-occupant homes by 39–43%. | This reduction applied to those modeled one-occupant-home scenarios; it is not a universal field result or a recommended schedule for every building. |
| Smart purging maintained the modeled lower probabilities while using 45–62% less additional water than scheduled purging. | This was a modeled comparison of water consumption, not a demonstrated performance claim for all buildings. |
These results help illustrate the water-use trade-off involved in purging, but they do not establish a building-specific intervention. EPA notes that control approaches depend on the plumbing system and does not recommend one universal technology or treatment (EPA: Technologies for Legionella Control in Premise Plumbing Systems).
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How building teams can manage water efficiency and health together
CDC’s guidance for potable-water systems emphasizes a building-level water management program rather than reliance on a fixture label or a single corrective measure (CDC: Controlling Legionella in Potable Water Systems). For owners, facility managers, and design teams, the relevant checks include:
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- Flow and water age: identify remote outlets, dead ends, low-use fixtures, and areas where water can remain for long periods. CDC advises eliminating dead legs and considering monitoring locations as part of a water management program.
- Temperature: monitor hot- and cold-water temperatures through the system, not only at the heater. CDC advises placing thermostatic mixing valves close to fixtures and sizing storage tanks appropriately.
- Residual and treatment equipment: assess disinfectant residual and how softeners or other treatment devices may affect it; account for tanks and other equipment that can become part of the problem.
- Fixture design: include low-flow and mechanically complex fixtures, such as electronic sensor faucets, in the risk assessment and maintenance plan.
- Occupancy and operations: plan for seasonal use, low occupancy, shutdowns, and reopening; specify who will monitor conditions and carry out maintenance.
- Water and energy trade-offs: consider efficiency goals alongside microbial and chemical water-quality monitoring, and account for the water and labor burden of flushing or other interventions.
CDC’s considerations for water in healthcare facilities provide additional context for facilities where water management is part of infection prevention (CDC: Considerations for Reducing Risk—Water in Healthcare Facilities).
What to do after a shutdown or major reduction in use
Before reopening a building after prolonged closure or reduced occupancy, owners should assess building-water hazards and follow applicable public-health and drinking-water guidance. A flushing or purging plan should be based on the building’s system and handled with qualified facility expertise; it should not be copied from a modeled scenario or applied as a universal schedule. Flushing also consumes water, and it can generate aerosols, so the method and scope matter.
For a suspected Legionella or metals issue, facility teams should use a building-specific assessment and appropriate public-health or drinking-water guidance rather than assuming that one fixture, one treatment, or one flushing event will resolve the problem.
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