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Text
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URL Address
<a href="http://doi.org/10.1001/archinte.156.15.1685" target="_blank" rel="noreferrer noopener">http://doi.org/10.1001/archinte.156.15.1685</a>
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Pages
1685-1692
Issue
15
Volume
156
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Title
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Risk factors for domestic acquisition of Legionnaires disease
Publisher
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Archives of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1996
1996-08
Subject
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community-acquired pneumonia; cooling-tower; evaporative condenser; General & Internal Medicine; hot; legionella-pneumophila serogroup-1; monoclonal-antibody; outbreak; potable water; tap water; united-states; water-systems
Creator
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Straus W L; Plouffe J F; File T M; Lipman H B; Hackman B H; Salstrom S J; Benson R F; Breiman R F; Baird I; Emerick J; Gianakopoulos G; Herbert M; Parsons J; Anderson C J; Bollin G E; Farkas S A; Francis S J; Gardner W G; Myers J P; Signs D J; Tan J S; Thomson R B; Barbaree J; Fields B; Morrill W; Moyenuddin M; Pruckler J; StJohn A
Description
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Background: Legionnaires disease is a common cause of adult pneumonia. Outbreaks of legionnaires disease have been well described, but little is known about sporadically occurring legionnaires disease, which accounts for most infections. Exposure to contaminated residential water sources is 1 plausible means of disease acquisition. Methods: Employing a matched case-control study design in 15 hospitals in 2 Ohio counties, we prospectively enrolled 146 adults diagnosed as having nonepidemic, community-acquired legionnaires disease and compared each with 2 hospital-based control patients, matched for age, sex, and underlying illness category. An interview regarding potential exposures was followed by a home survey that included sampling residential sources for Legionella. Interview and home survey data were analyzed to estimate the risk of acquiring legionnaires disease associated with various exposures. Results: Multivariate analysis showed that a nonmunicipal water supply (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.17-4.37), recent residential plumbing repair (OR, 2.39; 95% CI, 1.10-5.18), and smoking (OR, 3.48; 95% CI, 2.09-5.79) were independent risk factors for legionnaires disease. Univariate analysis suggested that electric (vs gas) water heaters (OR, 1.97; 95% CI, 1.10-3.52), working more than 40 hours weekly (OR, 2.13; 95% CI, 1.12-4.07), and spending nights away from home before illness (OR, 1.68; 95% CI, 1.03-2.74) were additional possible risk factors. Lower chlorine concentrations in potable water and lower water heater temperatures were associated with residential Legionella colonization. Conclusions: A proportion of sporadic cases of legionnaires disease may be residentially acquired and are associated with domestic potable water and disruptions in residential plumbing systems. Potential strategies to reduce legionnaires disease risk include consistent chlorination of potable water, increasing water heater temperatures, and limiting exposure to aerosols after domestic plumbing repairs.
Identifier
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<a href="http://doi.org/10.1001/archinte.156.15.1685" target="_blank" rel="noreferrer noopener">10.1001/archinte.156.15.1685</a>
Format
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Journal Article
1996
Anderson C J
Archives of internal medicine
Baird I
Barbaree J
Benson R F
Bollin G E
Breiman R F
Community-acquired pneumonia
cooling-tower
Emerick J
evaporative condenser
Farkas S A
Fields B
File T M
Francis S J
Gardner W G
General & Internal Medicine
Gianakopoulos G
Hackman B H
Herbert M
hot
Journal Article
legionella-pneumophila serogroup-1
Lipman H B
monoclonal-antibody
Morrill W
Moyenuddin M
Myers J P
outbreak
Parsons J
Plouffe J F
potable water
Pruckler J
Salstrom S J
Signs D J
StJohn A
Straus W L
Tan J S
tap water
Thomson R B
united-states
water-systems