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Screening-level microbial risk assessment of urban water locations: a tool for prioritization.
[legionellosis]
People
in
urban
areas
are
exposed
to
microbial
hazards
in
urban
waters
.
In
this
study
,
various
hazards
,
diseases
,
and
water
systems
,
where
different
recreation
activities
take
place
,
are
compared
in
an
integrated
quantitative
microbial
risk
assessment
(
QMRA
)
.
The
event
and
annual
probability
of
gastrointestinal
illness
(
GI
)
and
Legionnaires
'
disease
(
LD
)
were
analyzed
in
QMRA
models
using
selected
literature
data
.
Highest
mean
event
probabilities
of
GI
were
found
for
playing
in
pluvial
flood
from
a
combined
sewer
overflow
(
34
%
)
,
swimming
(
18
%
)
,
and
rowing
(
13
%
)
in
the
river
,
swimming
(
8
.
7
%
)
and
rowing
(
4
.
5
%
)
in
the
lake
,
and
playing
in
a
water
playground
(
3
.
7
%
)
and
in
the
pluvial
flood
from
stormwater
sewers
(
4
.
7
%
)
.
At
these
locations
,
the
GI
probability
was
above
the
EU
Bathing
Water
Directive
threshold
for
excellent
water
quality
(
3
%
)
.
All
the
annual
risk
medians
were
below
the
national
incidence
of
legionellosis
of
0
.
002
%
.
The
illness
probability
was
most
sensitive
to
the
pathogens
concentration
(
particularly
Campylobacter
,
Norovirus
,
and
Legionella
)
and
exposure
frequency
.
Therefore
,
site-
specific
pathogen
data
collection
is
the
best
next
step
to
strengthen
the
certainty
of
the
risk
estimates
.
This
study
created
an
evidence-base
that
was
used
by
water
authorities
to
understand
the
health
risks
and
set
priorities
for
risk
management
.
Diseases
Validation
Diseases presenting
"combined sewer overflow (34%"
symptom
legionellosis
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