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. 2018 Mar 26;15(4):598.
doi: 10.3390/ijerph15040598.

Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels

Antonios Papadakis  1   2 , Dimosthenis Chochlakis  3   4 , Vassilios Sandalakis  5 , Maria Keramarou  6 , Yannis Tselentis  7 , Anna Psaroulaki  8   9
Affiliations

Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels

Antonios Papadakis et al. Int J Environ Res Public Health. .

Abstract

Several Travel-associated Legionnaires' disease (TALD) cases occur annually in Europe. Except from the most obvious sites (cooling towers and hot water systems), infections can also be associated with recreational, water feature, and garden areas of hotels. This argument is of great interest to better comprehend the colonization and to calculate the risk to human health of these sites. From July 2000-November 2017, the public health authorities of the Island of Crete (Greece) inspected 119 hotels associated with TALD, as reported through the European Legionnaires' Disease Surveillance Network. Five hundred and eighteen samples were collected from decorative fountain ponds, showers near pools and spas, swimming pools, spa pools, garden sprinklers, drip irrigation systems (reclaimed water) and soil. Of those, 67 (12.93%), originating from 43 (35.83%) hotels, tested positive for Legionella (Legionella pneumophila serogroups 1, 2, 3, 6, 7, 8, 13, 14, 15 and non-pneumophila species (L. anisa, L. erythra, L. taurinensis, L. birminghamensis, L. rubrilucens). A Relative Risk (R.R.) > 1 (p < 0.0001) was calculated for chlorine concentrations of less than 0.2 mg/L (R.R.: 54.78), star classification (<4) (R.R.: 4.75) and absence of Water Safety Plan implementation (R.R.: 3.96). High risk (≥10⁴ CFU/L) was estimated for pool showers (16.42%), garden sprinklers (7.46%) and pool water (5.97%).

Keywords: Legionella; hotel; recreational water systems; risk; water safety plan.

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Conflict of interest statement

The authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Risk assessment for Legionella contamination based on the CFU/L detected in each site tested.
See this image and copyright information in PMC

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