A Critical Review on the Factors that Influence Opportunistic Premise Plumbing Pathogens: From Building Entry to Fixtures in Residences

Abstract

Residential buildings provide unique conditions for opportunistic premise plumbing pathogen (OPPP) exposure via aerosolized water droplets produced by showerheads, faucets, and tubs. The objective of this review was to critically evaluate the existing literature that assessed the impact of potentially enhancing conditions to OPPP occurrence associated with residential plumbing and to point out knowledge gaps. Comprehensive studies on the topic were found to be lacking. Major knowledge gaps identified include the assessment of OPPP growth in the residential plumbing, from building entry to fixtures, and evaluation of the extent of the impact of typical residential plumbing design (e.g., trunk and branch and manifold), components (e.g., valves and fixtures), water heater types and temperature setting of operation, and common pipe materials (copper, PEX, and PVC/CPVC). In addition, impacts of the current plumbing code requirements on OPPP responses have not been assessed by any study and a lack of guidelines for OPPP risk management in residences was identified. Finally, the research required to expand knowledge on OPPP amplification in residences was discussed.

Drinking Water Microbiota, Entero-Mammary Pathways and Breast Cancer: Focus on Nontuberculous Mycobacteria

“…Notably, OPPPs have been identified in hospital plumbing, contributing to approximately 21% of all documented cases of hospital-acquired infections [30]. Exposure can occur via aerosolized water droplets generated by showerheads, faucets, and other endpoint devices, or through ingestion or direct contact with contaminated tap water [31].…”

Assessing the impact of anti-microbial showerheads on the prevalence and abundance of opportunistic pathogens in shower water and shower water-associated aerosols

“…Antimicrobial showerheads were expected to decrease the number of genera in both phases due to their marketed bactericidal properties, however the sequencing results illustrated that the silver-embedded and filter-based showerheads supported growth of microbial genera not recovered from the conventional ABS plastic showerhead. There is a large body of work that suggests that the type of material used in DW plumbing significantly alters the microbiome, but these studies have only been conducted on conventional piping materials (Cullom et al, 2020;Wang et al, 2014;Proctor et al, 2016;Proctor et al, 2017;Logan-Jackson et al, 2023). This trend of material influencing the microbiome is likely also occurring inside these antimicrobial showerheads and may explain the differences in community membership.…”

Assessing residential activity in a home plumbing system simulator: monitoring the occurrence and relationship of major opportunistic pathogens and phagocytic amoebas

“…The unique characteristics of premise plumbing (e.g., large surface area to volume ratio, long water age, favorable temperature, and low or no disinfectant residual) provide a favorable environment for microbial proliferation and growth within plumbing surface biofilms, including opportunistic premise plumbing pathogens (OPPPs) that cause infectious disease ( National Research Council, 2006 ). These built environments provide unique conditions for OPPPs exposure via aerosolized water droplets produced by showerheads, faucets, and tubs ( Logan-Jackson et al, 2023 ).…”