The effect of temperature and chlorine residual on the presence of Legionella spp. in water systems of public and tourist facilities

Bešić, Adna; Obradović, Zarema; Dautbegovic, Adisa; Obradovic, Amina

doi:10.17532/jhsci.2017.413

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…The reason for the different levels in municipal water was possibly due to municipal water treatment plant disinfection practices and climatic conditions during the study period. 15 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Dialysis Water Quality at Hospitals in Baghdad, Iraq

Humudat

Al‐Naseri

2020

Journal of Health and Pollution

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Background. Dialysis water quality is one of the most important factors for ensuring the safe and effective delivery of hemodialysis. It has been known for over a decade that there might be hazardous contaminants in the water and concentrates used to prepare dialysis fluid. Rigorous international standards for the purification of dialysis fluids have been established, which were used in the present study to compare the quality of dialysis water as there is no national standard for dialysis water quality in Iraq. Objectives. There are more than 20 dialysis centers in Iraq, most of which contain similar units for the processing of dialysis water. The present study evaluated the quality of water used for dialysis in four dialysis centers located within Baghdad hospitals. Methods. Physical and chemical tests were carried out in the laboratory after sampling water from each dialysis center. Water samples were collected from three locations in each dialysis center. Hospital municipal water samples were collected from the tanks feeding dialysis units; samples of dialysis water were collected from the dialysis water treatment unit outlets; and samples of dialysis water were collected from the distribution network in dialysis rooms. Results. The results showed a fluctuation in the quality of the dialysis water (dialysis water and water from the dialysis distribution network), indicating that it is unacceptable compared to international standards. Chemical analysis showed that 75% of the dialysis water had elevated aluminum concentrations. Chemical analysis also found that dialysis water had elevated concentrations of free residual chlorine at some dialysis centers. Conclusions. All hemodialysis centers need careful monitoring and preventive maintenance to ensure good water quality. In addition, it is important to revise the design of the water treatment units according to water quality. Competing Interests. The authors declare no competing financial interests

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“…The reason for the different levels in municipal water was possibly due to municipal water treatment plant disinfection practices and climatic conditions during the study period. 15 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Dialysis Water Quality at Hospitals in Baghdad, Iraq

Humudat

Al‐Naseri

2020

Journal of Health and Pollution

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“…Studies regarding hotel colonization with Legionella were conducted in Greece from Alexiou et al in 1989, Mouchtouri et al in 2007, and finally, Fragou et al in 2012; however, none of the aforementioned studies evaluated the influence of physical and chemical characteristics of water on Legionella presence. Similarly, the majority of the published data regarding hotel colonization with Legionella focus on hot-water systems, since these temperatures favor Legionella growth [15]. A recent review that evaluated 136 Legionnaires’ disease and Pontiac fever outbreaks between 2006 and 2017 highlighted the importance of building water systems as major contributors to outbreak-related cases and deaths [16].…”

Section: Introductionmentioning

confidence: 99%

Legionella Colonization of Hotel Water Systems in Touristic Places of Greece: Association with System Characteristics and Physicochemical Parameters

Kyritsi

Mouchtouri

Katsioulis

et al. 2018

IJERPH

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This study aimed to assess the colonization of hotel water systems in central Greece and Corfu by Legionella, and to investigate the association between physicochemical parameters and Legionella colonization. Standardized hygiene inspection was conducted in 51 hotels, and 556 water samples were analyzed for Legionella spp. Free chlorine concentration, pH, hardness, conductivity, and trace metals were defined in cold water samples. The results of inspections and chemical analyses were associated with the microbiological results using univariate and logistic regression analysis. According to the score of the checklist used for the inspections, 17.6% of the hotels were classified as satisfactory, 15.7% as adequate, and 66.7% as unsatisfactory. Moreover, 74.5% of the hotels were colonized by Legionella spp. and 31.4% required remedial measures according to the European guidelines. Legionella spp. were isolated in 28% of the samples. Unsatisfactory results of inspections were associated with Legionella presence (relative risk (RR) = 7.67, p-value = 0.043). In hot-water systems, <50 °C temperatures increased the risk of Legionella colonization (RR = 5.36, p-value < 0.001). In cold-water systems, free chlorine concentration <0.375 mg/L (odds ratio (OR) = 9.76, p-value = 0.001), pH ≥ 7.45 (OR = 4.05, p-value = 0.007), and hardness ≥321 mgCaCO3/L (OR = 5.63, p-value = 0.003) increased the risk, whereas copper pipes demonstrated a protective role (OR = 0.29, p-value = 0.0024). The majority of the hotels inspected were colonized with Legionella. Supplementary monitoring of the risk factors that were identified should be considered.

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