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Nontuberculous mycobacterial aerosols in pools and spas.

Authors
Glazer-CS; Martyny-JW; Martinez-KF; Newman-LS; Murphy-J; Lee-B; Sanchez-TL; Sells-TM; Heifets-L; Rose-CS
Source
Am J Respir Crit Care Med 2003 Apr; 167(7):A610
NIOSHTIC No.
20023075
Abstract
Hot tub exposure has been causally associated with a prednisone responsive granulomatous lung disease featuring nontuberculous mycobacterial (NTM) growth in both clinical and environmental samples. Little is known about prevalence and risk factors for NTM contamination and associated illness in these settings. We analyzed the frequency of NTM growth and aerosolization in hot tubs and warm water therapy pools and the factors associated with NTM growth. We randomly selected 18 warm water therapy pools and publicly owned hot tubs in a major U.S. metropolitan area. We characterized each site by water chemistry parameters (pH, disinfectanct level); maintenance, disinfection, and water quality characteristics; and air and water sampling for quantitative culture (NTM and total bacteria). We detected NTM in air or water from 13/18 (72%) sites and found a strong correlation between the maximum air and water concentrations (rho 0.49, P = 0.04). Use of halogen (chlorine or bromine) disinfection was associated with significantly lower air and water NTM concentrations compared to UV light and hydrogen peroxide (p = 0.01-0.04). Higher water turnover rates were also associated with lower NTM concentrations (p = 0.02-0.03). Our findings suggest that NTM are frequently detectable in air and water of indoor spas and therapy pools and that particular maintenance and disinfection approaches affect mycobacterial bioaerosol concentrations in these settings.
Keywords
Bacteria; Aerosol-particles; Aerosols; Lung-disease; Environmental-factors; Risk-factors; Sampling; Halogens; Water-sampling; Air-sampling; Pulmonary-system-disorders; Biohazards; Microorganisms
CODEN
AJCMED
Publication Date
20030401
Document Type
Abstract; Conference/Symposia Proceedings
Email Address
craig.glazer@utsouthwestern.edu
Fiscal Year
2003
NTIS Accession No.
NTIS Price
Issue of Publication
7
ISSN
1073-449X
NIOSH Division
DSHEFS
Source Name
American Journal of Respiratory and Critical Care Medicine, 2003 International Conference, The American Thoracic Society, Seattle, WA, May 16-21, 2003
State
OH; TX; CO
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