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Quantitative Microbial Risk Assessment Applied to Legionella Contamination on Long-Distance Public Transport

Author

Listed:
  • Ileana Federigi

    (Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy)

  • Osvalda De Giglio

    (Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy)

  • Giusy Diella

    (Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy)

  • Francesco Triggiano

    (Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy)

  • Francesca Apollonio

    (Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy)

  • Marilena D’Ambrosio

    (Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy)

  • Lorenzo Cioni

    (Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy)

  • Marco Verani

    (Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy)

  • Maria Teresa Montagna

    (Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy)

  • Annalaura Carducci

    (Laboratory of Hygiene and Environmental Virology, Department of Biology, University of Pisa, Via S. Zeno 35/39, 56127 Pisa, Italy)

Abstract

The quantitative microbial risk assessment (QMRA) framework is used for assessing health risk coming from pathogens in the environment. In this paper, we used QMRA to evaluate the infection risk of L. pneumophila attributable to sink usage in a toilet cabin on Italian long-distance public transportation (LDT). LDT has water distribution systems with risk points for Legionella proliferation, as well as premise plumbing for drinking water, but they are not considered for risk assessment. Monitoring data revealed that approximately 55% of water samples (217/398) were positive for L. pneumophila , and the most frequently isolated was L. pneumophila sg1 (64%, 139/217); therefore, such data were fitted to the best probability distribution function to be used as a stochastic variable in the QMRA model. Then, a sink-specific aerosolization ratio was applied to calculate the inhaled dose, also considering inhalation rate and exposure time, which were used as stochastic parameters based on literature data. At L. pneumophila sg1 concentration ≤100 CFU/L, health risk was approximately 1 infection per 1 million exposures, with an increase of up to 5 infections per 10,000 exposures when the concentrations were ≥10,000 CFU/L. Our QMRA results showed a low Legionella infection risk from faucets on LDT; however, it deserves consideration since LDT can be used by people highly susceptible for the development of a severe form of the disease, owing to their immunological status or other predisposing factors. Further investigations could also evaluate Legionella -laden aerosols from toilet flushing.

Suggested Citation

  • Ileana Federigi & Osvalda De Giglio & Giusy Diella & Francesco Triggiano & Francesca Apollonio & Marilena D’Ambrosio & Lorenzo Cioni & Marco Verani & Maria Teresa Montagna & Annalaura Carducci, 2022. "Quantitative Microbial Risk Assessment Applied to Legionella Contamination on Long-Distance Public Transport," IJERPH, MDPI, vol. 19(4), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:1960-:d:745892
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    References listed on IDEAS

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    1. 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.
    2. 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. Annalisa Lombardi & Tonia Borriello & Elvira De Rosa & Fabiana Di Duca & Michele Sorrentino & Ida Torre & Paolo Montuori & Ugo Trama & Francesca Pennino, 2023. "Environmental Monitoring of Legionella in Hospitals in the Campania Region: A 5-Year Study," IJERPH, MDPI, vol. 20(8), pages 1-17, April.
    2. Michele Treglia & Margherita Pallocci & Giorgio Ricciardi Tenore & Paola Castellani & Fabrizio Pizzuti & Giovanna Bianco & Pierluigi Passalacqua & Lucilla De Luca & Claudia Zanovello & Daniela Mazzuca, 2022. "Legionella and Air Transport: A Study of Environmental Contamination," IJERPH, MDPI, vol. 19(13), pages 1-10, June.

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