Water distribution systems have been demonstrated to be a major source of nosocomial legionellosis. We describe an outbreak in our institution in which a novel source of Legionella pneumophila was identified in the plumbing system.
After an outbreak of 10 cases of legionellosis in our hospital, recommended measures including superheating of the hot water to 80 degrees C, hyperchlorination to 2 ppm, and flushing resulted in no new cases in the following 5 years. Recently, despite these control measures, three new cases occurred. Surveillance cultures of shower heads and water tanks were negative; cultures of tap water samples remained positive. This prompted a search for another reservoir. Shock absorbers installed within water pipes to decrease noise were suspected.
One hundred twenty-five shock absorbers were removed and cultured. A total of 13 (10%) yielded heavy growth of L. pneumophila (serogroup 1). Since their removal, no new cases have been found and the percentage of positive results of random tap water culture has dropped from 20% to 5%.
This is the first report that identifies shock absorbers as a possible reservoir for L. pneumophila. We recommend that institutions with endemic legionellosis assess the water system for possible removal of shock absorbers.
Sociohygienic monitoring on the railway transport, which is a branch part of the state sociohygienic monitoring system, includes observation, analysis, assessment, and prediction of the health status and habitat of railway workers and population to be served, as well as the establishment of associations of the health status with environmental factors. Standard legal, scientific-and-methodological, and organizational bases have been set up for branch monitoring. The basic parameters and the procedure for interaction of branch and territorial entities have been defined.
The methods for integral assessments of human health indices were tested at different territorial units within the framework of development of sociohygienic monitoring. A microterritory as an information unit is proposed as the most adequate object of observation. The method of integral health indices is recommended for their assessment at the level of microterritories, integral entropy should be used for mapping an urban dwelling area.
The chemical environmental pollution of industrial urban areas was comprehensively assessed. There was a correlation between some diseases and chemicals; some pollutants exert unidirectional adverse effects on human health. As a way of influencing the man-made load, the authors suggest that an increasing coefficient to the allocations to the health insurance fund should be introduced for the enterprises that cause the proven hazard to human health. The addressing approach to analyzing morbidity rates increases the validity of studies establishing the relationship of environmental factors to health indices.
A cross sectional study was undertaken to assess lung health among plumbers and pipefitters. Respiratory symptoms, lung function, and radiographic changes among 99 actively employed plumbers and pipefitters with > or = 20 years of union membership were compared with 100 telephone workers.
A respiratory symptom questionnaire was administered, including smoking and occupational histories. Spirometry was conducted according to standard criteria. Posteroanterior chest radiographs were evaluated by two experienced chest physicians, with a third arbitrating disagreed films. Members of the union were categorised as pipefitters (n = 57), plumbers (n = 16), or welders (n = 26), based on longest service, and compared with the telephone workers and internally (between groups). Lung health was also compared with employment in several work sectors common to Alberta for time, and for time weighted by exposure to dust and fumes.
Compared with the telephone workers, plumbers and pipefitters had more cough and phlegm, lower forced vital capacity, and more radiographic changes (20% with any change), including circumscribed (10%) and diffuse pleural thickening (9%). None of the plumbers and pipefitters had small radiographic opacities. Among the three subgroups of workers, plumbers had the highest prevalence of radiographic changes. Both plumbers and pipefitters showed higher odds ratios for cough and phlegm than the welders. No differences between groups were found for lung function. Indicators of lung health were not related to work in any sector.
Plumbers and pipefitters had increased prevalence of symptoms suggestive of an irritant effect with no evidence of bronchial responsiveness. The chest radiographs showed evidence of asbestos exposure, especially in the plumbers, but at lower levels than previously reported. Health screening programmes for these workers should be considered, although the logistical problems associated with screening in this group would be considerable.
Cites: J Natl Cancer Inst. 1977 Oct;59(4):1147-85903993
Cites: Chest. 1997 Feb;111(2):404-109041989
Cites: J Occup Med. 1980 Mar;22(3):183-97365557
Cites: J Occup Med. 1983 Oct;25(10):749-566631560
Cites: AJR Am J Roentgenol. 1984 Jan;142(1):53-86606965
Cites: Chest. 1985 Oct;88(4):608-173899533
Cites: J Occup Med. 1985 Oct;27(10):771-53877801
Cites: Am Rev Respir Dis. 1991 May;143(5 Pt 1):1134-482024826
Cites: Occup Environ Med. 1994 Aug;51(8):553-67951781
Cites: Am J Ind Med. 1994 Dec;26(6):741-547892825
Cites: Occup Environ Med. 1995 Jan;52(1):33-427697138
Cites: Am J Ind Med. 1995 Jul;28(1):49-707573075
Cites: Int J Epidemiol. 1995 Aug;24(4):750-78550272
Cites: J Occup Environ Med. 1996 Dec;38(12):1229-388978514
In order to determine whether water or water-related surfaces are a reservoir for opportunistic filamentous fungi, water sampling in the paediatric bone marrow transplantation (BMT) unit of the National Hospital University of Oslo, Norway was performed. During a six-month period 168 water samples and 20 samples from water-related surfaces were taken. The water samples were taken from the taps and showers in the BMT unit and from the main pipe supplying the paediatric department with water. In addition, 20 water samples were taken at the intake reservoir supplying the city of Oslo with drinking water. Filamentous fungi were recovered from 94% of all the water samples taken inside the hospital with a mean colony forming unit (cfu) count of 2.7/500mL of water. Aspergillus fumigatus was recovered from 49% and 5.6% of water samples from the taps and showers, respectively (mean 1.9 and 1.0cfu/500mL). More than one third (38.8%) of water samples from the main pipe revealed A. fumigatus (mean 2.1cfu/500mL). All water samples taken at the intake reservoir were culture positive for filamentous fungi, 85% of the water samples showed A. fumigatus (mean 3.1cfu/500mL). Twenty-five percent of water-related surfaces yielded filamentous fungi, but A. fumigatus was recovered from only two samples. We showed that filamentous fungi are present in the hospital water and to a lesser extent on water-related surfaces. The recovery of filamentous fungi in water samples taken at the intake reservoir suggests that the source of contamination is located outside the hospital.