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Assessment of relative potential for Legionella species or surrogates inhalation exposure from common water uses.
[legionellosis]
The
Legionella
species
have
been
identified
as
important
waterborne
pathogens
in
terms
of
disease
morbidity
and
mortality
.
Microbial
exposure
assessment
is
a
tool
that
can
be
utilized
to
assess
the
potential
of
Legionella
species
inhalation
exposure
from
common
water
uses
.
The
screening-level
exposure
assessment
presented
in
this
paper
developed
emission
factors
to
model
aerosolization
,
quantitatively
assessed
inhalation
exposures
of
aerosolized
Legionella
species
or
Legionella
species
surrogates
while
evaluating
two
generalized
levels
of
assumed
water
concentrations
,
and
developed
a
relative
ranking
of
six
common
in
-home
uses
of
water
for
potential
Legionella
species
inhalation
exposure
.
Considerable
variability
in
the
calculated
exposure
dose
was
identified
between
the
six
identified
exposure
pathways
,
with
the
doses
differing
by
over
five
orders
of
magnitude
in
each
of
the
evaluated
exposure
scenarios
.
The
assessment
of
exposure
pathways
that
have
been
epidemiologically
associated
with
legionellosis
transmission
(
ultrasonic
and
cool
mist
humidifiers
)
produced
higher
estimated
inhalation
exposure
doses
than
pathways
where
epidemiological
evidence
of
transmission
has
been
less
strong
(
faucet
and
shower
)
or
absent
(
toilets
and
therapy
pool
)
.
With
consideration
of
the
large
uncertainties
inherent
in
the
exposure
assessment
process
used
,
a
relative
ranking
of
exposure
pathways
from
highest
to
lowest
exposure
doses
was
produced
using
culture-based
measurement
data
and
the
assumption
of
constant
water
concentration
across
exposure
pathways
.
In
this
ranking
,
the
ultrasonic
and
cool
mist
humidifier
exposure
pathways
were
estimated
to
produce
the
highest
exposure
doses
,
followed
by
the
shower
and
faucet
exposure
pathways
,
and
then
the
toilet
and
therapy
pool
exposure
pathways
.
Diseases
Validation
Diseases presenting
"legionella species surrogates while evaluating two generalized levels of assumed water concentrations"
symptom
legionellosis
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