Determinants of Legionella pneumophila Contamination of Water Distribution Systems: 15-Hospital Prospective Study

1987 ◽  
Vol 8 (9) ◽  
pp. 357-363 ◽  
Author(s):  
Richard M. Vickers ◽  
Victor L. Yu ◽  
S. Sue Hanna ◽  
Paul Muraca ◽  
Warren Diven ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Distribution System ◽  
Distribution Systems ◽  
Water Distribution ◽  
Cold Water ◽  
Physicochemical Characteristics ◽  
Hot Water ◽  
Environmental Study ◽  
Water Tank ◽  
One Year

AbstractWe conducted a prospective environmental study for Legionella pneumophila in 15 hospitals in Pennsylvania. Hot water tanks, cold water sites, faucets, and show-erheads were surveyed four times over a one-year period. Sixty percent (9/15) of hospitals surveyed were contaminated with L pneumophila. Although contamination could not be linked to a specific municipal water supplier, most of the contaminated supplies came from rivers. Parameters found to be significantly associated with contamination included elevated hot water temperature, vertical configuration of the hot water tank, older tanks, and elevated calcium and magnesium concentrations of the water (P < 0.05). This study suggests that L pneumophila contamination could be predicted based on design of the distribution system, as well as physicochemical characteristics of the water.

Isolation of Legionella pneumophila from the Cold Water of Hospital Ice Machines: Implications for Origin and Transmission of the Organism

1985 ◽  
Vol 6 (4) ◽  
pp. 141-146 ◽  
Author(s):  
Janet E. Stout ◽  
Victor L. Yu ◽  
Paul Muraca
Keyword(s):  
Legionella Pneumophila ◽  
Distribution System ◽  
Water Distribution ◽  
Water Distribution System ◽  
Cold Water ◽  
Water System ◽  
Primary Source ◽  
Hot Water ◽  
Hospital Environment ◽  
Water Storage Tank

AbstractAlthough the mode of transmission of L. pneumophila is as yet unclear, the hot water distribution system has been shown to be the reservoir for Legionella within the hospital environment. In this report we identify a previously unrecognized reservoir for L. pneumophila within the hospital environment, ie, the cold water dispensers of hospital ice machines. The cold water dispensers of 14 ice machines were cultured monthly over a 1-year period. Positive cultures were obtained from 8 of 14 dispensers, yielding from 1 to 300 CFU/plate. We were able to link the positivity of these cold water sites to the incoming cold water supply by recovering L. pneumophila from the cold water storage tank, which is directly supplied by the incoming municipal water line. This was accomplished by a novel enrichment experiment designed to duplicate the conditions (temperature, sediment, stagnation, and continuous seeding) of the hot water system. Our data indicate that significant contamination of cold water outlets with L. pneumophila can occur. Although no epidemiologic link to disease was made, the fact that the primary source of a patient's drinking water is from the ice machines warrants further investigation of these water sources as possible reservoirs.

scholarly journals Saving cold drinking water in residential hot water distribution systems

2020 ◽  
Vol 24 ◽  
pp. e4
Author(s):  
Marcelo Dalmédico Ioris ◽  
Enedir Ghisi
Keyword(s):  
Drinking Water ◽  
Distribution Systems ◽  
Water Distribution ◽  
Cold Water ◽  
Solenoid Valve ◽  
Hot Water ◽  
Water Tank ◽  
Vertical Pipe ◽  
Plumbing Systems ◽  
Approximate Amount

In homes that have instantaneous gas heaters to heat water, cold water is wasted in the first seconds of using hot water fixtures. This waste is caused due to the large lengths of piping between the hot water fixtures and the heater that feeds them. The water in such pipes suffers thermal losses over time. When turning on the fixtures, this drinking water, because it is cold, is rejected by users, especially when using showers. This work deals with the conformation of a system that avoids wasting water in residential hot water services. To establish this conformation, a usual plumbing design was analysed to verify the changes proposed in order to optimise the operation of the system. The gas-heated hot water pipes are currently installed so that the pipes start at the heater and run through the entire house to the hot water fixtures furthest from the heater. It was found that the waste of water in a water fixture decreases if there is the consumption of hot water previously in one of the water fixtures of the house. To avoid this waste, according to the configuration of the current plumbing systems, it is necessary to install an additional set of electronic equipment that automatically redirects the cold water − that would be wasted − to a water tank for later use. The system proposed is composed of a solenoid valve located at the end of the hot water pipe. This valve has the function of letting flow to the water tank the approximate amount of cold water that would be wasted. Through a radio frequency signal sent when a button located near the hot water fixtures is pressed, the system recognises which water fixture was turned on and the approximate amount of cold water that must be released through the valve until the arrival of hot water from the heater. Then, there must be a pipe that collects the water that flows through the solenoid valve. Such pipe will be connected to a vertical pipe, responsible for collecting water from all flats and directing the water to the water tank. The installation of the system is based on the recommendations of the standards used in Brazil and the most frequent configuration found in homes. This work also serves as a guide for installing the system in homes other than the example shown herein.

scholarly journals How Molecular Typing Can Support Legionella Environmental Surveillance in Hot Water Distribution Systems: A Hospital Experience

2020 ◽  
Vol 17 (22) ◽  
pp. 8662
Author(s):  
Luna Girolamini ◽  
Silvano Salaris ◽  
Jessica Lizzadro ◽  
Marta Mazzotta ◽  
Maria Rosaria Pascale ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Molecular Typing ◽  
Distribution Systems ◽  
Water Distribution ◽  
Water Distribution Systems ◽  
Gene Sequencing ◽  
Culture Technique ◽  
Hot Water ◽  
Environmental Surveillance ◽  
Risk Map

In this study, we aimed to associate the molecular typing of Legionella isolates with a culture technique during routine Legionella hospital environmental surveillance in hot water distribution systems (HWDSs) to develop a risk map able to be used to prevent nosocomial infections and formulate appropriate preventive measures. Hot water samples were cultured according to ISO 11731:2017. The isolates were serotyped using an agglutination test and genotyped by sequence-based typing (SBT) for Legionella pneumophila or macrophage infectivity potentiator (mip) gene sequencing for non-pneumophila Legionella species. The isolates’ relationship was phylogenetically analyzed. The Legionella distribution and level of contamination were studied in relation to temperature and disinfectant residues. The culture technique detected 62.21% of Legionella positive samples, characterized by L. pneumophila serogroup 1, Legionella non-pneumophila, or both simultaneously. The SBT assigned two sequence types (STs): ST1, the most prevalent in Italy, and ST104, which had never been isolated before. The mip gene sequencing detected L. anisa and L. rubrilucens. The phylogenetic analysis showed distinct clusters for each species. The distribution of Legionella isolates showed significant differences between buildings, with a negative correlation between the measured level of contamination, disinfectant, and temperature. The Legionella molecular approach introduced in HWDSs environmental surveillance permits (i) a risk map to be outlined that can help formulate appropriate disinfection strategies and (ii) rapid epidemiological investigations to quickly identify the source of Legionella infections.

scholarly journals Analysis of building plumbing system flushing practices and communications

2019 ◽  
Vol 17 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Lisa Ragain ◽  
Sheldon Masters ◽  
Timothy A. Bartrand ◽  
Jennifer L. Clancy ◽  
Andrew J. Whelton
Keyword(s):  
Drinking Water ◽  
Distribution System ◽  
Grade Level ◽  
Water Distribution ◽  
Cold Water ◽  
Expert Elicitation ◽  
Hot Water ◽  
Single Family ◽  
Point Of Entry ◽  
12Th Grade

Abstract Drinking water distribution system contamination incidents can prompt public agencies and drinking water utilities to issue do-not-drink and do-not-use advisories. After the contaminant is cleared from distribution mains, consumers are often directed to flush their plumbing. However, little validated guidance and few evaluated communications strategies are available on using flushing to decontaminate building water systems. Additionally, limited data support the effectiveness of current practices and recommendations. In this study, expert elicitation was used to assess existing flushing guidance and develop validated flushing guidance and communications for single-family residences. The resulting guidance recommends progressively opening all cold-water taps from the closest to point of entry to the furthest and allowing the water to run for at least 20 minutes. Hot-water taps should be opened progressively and run for at least 75 minutes. The guidance language and format conformed to grade-level and readability scores within recommended health communication ranges. The readability of eight other flushing guidance documents was also evaluated for contamination incidents from 2008–2015. Seven were written at a 10th–12th grade level, above the 6th–7th grade level recommended for health communications.

Long-Term Effects of Hospital Water Network Disinfection onLegionellaand Other Waterborne Bacteria in an Italian University Hospital

2014 ◽  
Vol 35 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Beatrice Casini ◽  
Andrea Buzzigoli ◽  
Maria Luisa Cristina ◽  
Anna Maria Spagnolo ◽  
Pietro Del Giudice ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Distribution Systems ◽  
Water Distribution ◽  
Hot Water ◽  
Control Measures ◽  
University Hospital ◽  
Long Term Effects ◽  
Water Safety ◽  
Safety Plan ◽  
Water Safety Plan

Objective and Design.Legionellacontrol still remains a critical issue in healthcare settings where the preferred approach to health risk assessment and management is to develop a water safety plan. We report the experience of a university hospital, where a water safety plan has been applied since 2002, and the results obtained with the application of different methods for disinfecting hot water distribution systems in order to provide guidance for the management of water risk.Interventions.The disinfection procedures included continuous chlorination with chlorine dioxide (0.4–0.6 mg/L in recirculation loops) reinforced by endpoint filtration in critical areas and a water treatment based on monochloramine (2-3 mg/L). Real-time polymerase chain reaction and a new immunoseparation and adenosine triphosphate bioluminescence analysis were applied in environmental monitoring.Results.After 9 years, the integrated disinfection-filtration strategy significantly reduced positive sites by 55% and the mean count by 78% (P< .05); however, the high costs and the occurrence of a chlorine-tolerant clone belonging toLegionella pneumophilaST269 prompted us to test a new disinfectant. The shift to monochloramine allowed us to eliminate planktonicLegionellaand did not require additional endpoint filtration; however, nontuberculous mycobacteria were isolated more frequently as long as the monochloramine concentration was 2 mg/L; their cultivability was never regained by increasing the concentration up to 3 mg/L.Conclusions.Any disinfection method needs to be adjusted/fine-tuned in individual hospitals in order to maintain satisfactory results over time, and only a locally adapted evidence-based approach allows assessment of the efficacy and disadvantages of the control measures.

scholarly journals THE ANALYSIS OF WATER SPEED INFLUENCE IN HOT-WATER DISTRIBUTION SYSTEM ON THE AMOUNT OF HEAT LOSS

2021 ◽  
Vol 2021 (1) ◽  
pp. 23-28
Author(s):  
Peter Kapalo ◽  
◽  
Khrystyna Kozak ◽  
Khrystyna Myroniuk ◽  
◽  
...  
Keyword(s):  
Energy Consumption ◽  
Heat Loss ◽  
Distribution System ◽  
Distribution Systems ◽  
Water Distribution ◽  
Water Distribution System ◽  
Ventilation System ◽  
Hot Water ◽  
Graphical Form ◽  
Hot Water Supply System

One of the main tasks around the world is to reduce energy consumption with constant consumer comfort. The hot water supply system uses a significant part of thermal energy and requires no less attention than the heating or ventilation system. The amount of heat loss from hot water distribution systems is of great importance for the energy consumption of buildings. In winter, part of this heat is used for space heating, in summer they are unused and is considered as lost heat. For this reason, this paper considers the influence of water velocity in the pipe, pipe size, and water temperature on the total heat losses in the insulated hot-water distribution system. The data are presented in tabular and graphical form. A graph of the dependence of the amount of heat loss on the temperature and velocity of hot water is obtained.

scholarly journals Temperature diagnostic to identify high risk areas and optimize Legionella pneumophila surveillance in hot water distribution systems

2015 ◽  
Vol 71 ◽  
pp. 244-256 ◽  
Author(s):  
Emilie Bédard ◽  
Stéphanie Fey ◽  
Dominique Charron ◽  
Cindy Lalancette ◽  
Philippe Cantin ◽  
...  
Keyword(s):  
High Risk ◽  
Legionella Pneumophila ◽  
Distribution Systems ◽  
Water Distribution ◽  
Water Distribution Systems ◽  
Hot Water ◽  
Risk Areas ◽  
Temperature Diagnostic

Treatment of aLegionella pneumophila-Colonized Water Distribution System Using Copper-Silver Ionization and Continuous Chlorination

1999 ◽  
Vol 20 (6) ◽  
pp. 426-428 ◽  
Author(s):  
Amaya Biurrun ◽  
Luis Caballero ◽  
Carmen Pelaz ◽  
Elena León ◽  
Alberto Gago
Keyword(s):  
Legionella Pneumophila ◽  
Distribution System ◽  
Water Distribution ◽  
Water Distribution System ◽  
Cold Water ◽  
Conventional Methods

AbstractThe detection in April 1997 of a case of nosocomial legionellosis in our hospital led to the discovery that both our hot- and cold-water circuits were heavily colonized withLegionella pneumophila. Conventional methods for eradication of the organisms were unsuccessful, so a copper-silver (Cu-Ag) ionization system and a continuous chlorination system were installed. Five months later, the number of colonized sites decreased from an initial 58.3% to 16.7%.

scholarly journals Persistence of Nontuberculous Mycobacteria in a Drinking Water System after Addition of Filtration Treatment

2006 ◽  
Vol 72 (9) ◽  
pp. 5864-5869 ◽  
Author(s):  
Elizabeth D. Hilborn ◽  
Terry C. Covert ◽  
Mitchell A. Yakrus ◽  
Stephanie I. Harris ◽  
Sandra F. Donnelly ◽  
...  
Keyword(s):  
Drinking Water ◽  
Distribution System ◽  
Distribution Systems ◽  
Water Distribution ◽  
Cold Water ◽  
Nontuberculous Mycobacteria ◽  
Treatment Plant ◽  
Water System ◽  
Drinking Water Treatment ◽  
Drinking Water System

ABSTRACT There is evidence that drinking water may be a source of infections with pathogenic nontuberculous mycobacteria (NTM) in humans. One method by which NTM are believed to enter drinking water distribution systems is by their intracellular colonization of protozoa. Our goal was to determine whether we could detect a reduction in the prevalence of NTM recovered from an unfiltered surface drinking water system after the addition of ozonation and filtration treatment and to characterize NTM isolates by using molecular methods. We sampled water from two initially unfiltered surface drinking water treatment plants over a 29-month period. One plant received the addition of filtration and ozonation after 6 months of sampling. Sample sites included those at treatment plant effluents, distributed water, and cold water taps (point-of-use [POU] sites) in public or commercial buildings located within each distribution system. NTM were recovered from 27% of the sites. POU sites yielded the majority of NTM, with >50% recovery despite the addition of ozonation and filtration. Closely related electrophoretic groups of Mycobacterium avium were found to persist at POU sites for up to 26 months. Water collected from POU cold water outlets was persistently colonized with NTM despite the addition of ozonation and filtration to a drinking water system. This suggests that cold water POU outlets need to be considered as a potential source of chronic human exposure to NTM.

Energy Analysis of Hot Water Distribution System - Interrupted Operation

2013 ◽  
Vol 437 ◽  
pp. 1062-1065 ◽  
Author(s):  
Peter Kapalo ◽  
Ladislav Böszörmenyi
Keyword(s):  
Distribution System ◽  
Distribution Systems ◽  
Water Distribution ◽  
Energy Analysis ◽  
Water Distribution System ◽  
Energy Requirement ◽  
Hot Water ◽  
Energy Price ◽  
Actual Increase

At an actual increase energy price it is has impact cut-down energy requirement for preparation and distribution of hot water (HW). In the paper are presented results of exploration, where been evaluation effect interrupted operations distribution systems HW flat building. From presented analyses result - relative more savings heat is for long interrupted distribution systems and for little the number of flat in building.

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