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Quantitative Microbial Risk Assessment and Opportunist Waterborne Infections–Are There Too Many Gaps to Fill?

Author

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  • Richard Bentham

    (College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide 5001, Australia)

  • Harriet Whiley

    (College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide 5001, Australia)

Abstract

Quantitative microbial risk assessment (QMRA) is a relatively new approach in identifying health risks associated with the ubiquitous presence of pathogens and opportunists in the human environment. The methodology builds on experimental and meta-analytical data to identify measurable factors that contribute to, and can quantify, the likely extent of disease given a particular exposure. Early modelling was particularly focused on food-borne disease, and subsequently water-borne disease, with the emphasis focused on ingestion and its role in enteric disease. More recently, there has been a focus on translating these principles to opportunist waterborne infections (OWI) with primary focus on Legionella spp. Whereas dose and susceptibility are well documented via the ingestion route of exposure there is considerably less certainty regarding both factors when understanding Legionella spp. and other OWI. Many OWI can arise through numerous routes of transmission with greatly differing disease presentations. Routes of Legionella spp. infection do not include ingestion, but rather aspiration and inhalation of contaminated water are the routes of exposure. The susceptible population for OWI is a vulnerable sub-set of the population unlike those associated with enteric disease pathogens. These variabilities in dose, exposure and susceptibility call in to question whether QMRA can be a useful tool in managing risks associated with OWI. Consideration of Legionella spp. as a well-documented subject of research calls into question whether QMRA of OWI is likely to be a useful tool in developing risk management strategies.

Suggested Citation

  • Richard Bentham & Harriet Whiley, 2018. "Quantitative Microbial Risk Assessment and Opportunist Waterborne Infections–Are There Too Many Gaps to Fill?," IJERPH, MDPI, vol. 15(6), pages 1-11, June.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:6:p:1150-:d:150179
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    References listed on IDEAS

    as
    1. Harriet Whiley, 2016. "Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing," IJERPH, MDPI, vol. 14(1), pages 1-8, December.
    2. Martijn Bouwknegt & Jack F. Schijven & Johanna A.C. Schalk & Ana Maria de Roda Husman, 2013. "Quantitative Risk Estimation for a Legionella pneumophila Infection Due to Whirlpool Use," Risk Analysis, John Wiley & Sons, vol. 33(7), pages 1228-1236, July.
    3. T. W. Armstrong & C. N. Haas, 2007. "A Quantitative Microbial Risk Assessment Model for Legionnaires' Disease: Animal Model Selection and Dose‐Response Modeling," Risk Analysis, John Wiley & Sons, vol. 27(6), pages 1581-1596, December.
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    Cited by:

    1. Harriet Whiley & Jason Hinds & James Xi & Richard Bentham, 2019. "Real-Time Continuous Surveillance of Temperature and Flow Events Presents a Novel Monitoring Approach for Hospital and Healthcare Water Distribution Systems," IJERPH, MDPI, vol. 16(8), pages 1-8, April.
    2. Paul J Molino & Richard Bentham & Michael J Higgins & Jason Hinds & Harriet Whiley, 2019. "Public Health Risks Associated with Heavy Metal and Microbial Contamination of Drinking Water in Australia," IJERPH, MDPI, vol. 16(20), pages 1-12, October.
    3. Helena Modrá & Vít Ulmann & Jan Caha & Dana Hübelová & Ondřej Konečný & Jana Svobodová & Ross Tim Weston & Ivo Pavlík, 2019. "Socio-Economic and Environmental Factors Related to Spatial Differences in Human Non-Tuberculous Mycobacterial Diseases in the Czech Republic," IJERPH, MDPI, vol. 16(20), pages 1-19, October.

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