ASTM D5952-2008 军团菌的水系统检查和可能爆发军团病(军团病或庞蒂亚克热)调查的标准指南

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【英文标准名称】:StandardGuidefortheInspectionofWaterSystemsforLegionellaandtheInvestigationofPossibleOutbreaksofLegionellosis(Legionnaires''DiseaseorPontiacFever)
【原文标准名称】:军团菌的水系统检查和可能爆发军团病(军团病或庞蒂亚克热)调查的标准指南
【标准号】:ASTMD5952-2008
【标准状态】:现行
【国别】:美国
【发布日期】:2008
【实施或试行日期】:
【发布单位】:美国材料与试验协会(US-ASTM)
【起草单位】:D22.05
【标准类型】:(Guide)
【标准水平】:()
【中文主题词】:空调系统
【英文主题词】:air-conditioningsystems;epidemiologicalinvestigation;heating;legionella;L.pneumophila;legionellosis;legionellosissurveillance;Legionnaires'disease;microbiologicalwatermonitoring;outbreakinvestigation;
【摘要】:Watersystemsmaybeinspected(seeSection7)andtested(seeSection8)forlegionellaunderthreecircumstances(1)intheabsenceofreportedlegionellosis(see5.2);(2)whenasinglelegionellosiscasehasbeenreported(see5.3);and(3)whentwoormorelegionellosiscasesarereportedinalimitedtimeperiodandgeographicregion(see5.4).Followingarefactorsbuildingownersandoperatorsneedtounderstandwhenconsideringtestingwatersystemsforlegionellaintheabsenceofillness(see5.2)andforsinglelegionellosiscases(see5.3).ReferalsototheCDC2003GuidelinesforPreventingHealth-CareAssociatedPneumonia,andtheCDC2000GuidelinesforPreventingOpportunisticInfectionsAmongHematopoieticStemCellTransplantRecipients,andtheWHOLegionellaandthePreventionofLegionellosis.Detectionoflegionellainawatersystemisnotsufficienttoidentifythesystemasahealthhazard.However,failuretodetectlegionelladoesnotindicate,conclusively,thatthebacteriumisnotpresent(see6.2.4)orthatthewatersystemmaynotposeapotentialhealthhazard.Methodstodetectlegionellavaryinsensitivityandspecificity(see6.2),andlaboratoriesvaryintheirskillandexperienceintheisolationandidentificationoflegionella.Isolationofapparentlyidenticallegionellaefromclinicalandenvironmentalsamples(see6.2.1,6.6.2.4,andSection8)maysuggestthatawatersystemwasthesourceofthelegionellaresponsibleforapatient''sinfection(see5.3.2).However,casesofLegionnaires''diseaseduetodifferentlegionellaserogroupsorspeciesneednotnecessarilyhavedifferentsourcesofexposurebecauseasystemmaybecontaminatedbymorethanonelegionella.Timelyinspection,testing,andtreatmentofpossiblelegionellasourcesmayreducelegalliabilitiesforfacilityownersandoperators.ReferalsototheAPHAPublicHealthLawManual.EnvironmentalTestingforLegionellaintheAbsenceofIllness:Concernedemployers,buildingownersandoperators,facilitymanagers,andothersseektopreventrealandpotentialhealthhazards,ifpossible.Watersystemoperatorsmayidentifyundesirablesituationsbymonitoringroutinelyforlegionellaandmaybeabletoimplementcontrolmeasuresbeforethebacteriumreachesanamountsufficienttocausehumanillness(see6.2.4.2).TheCDC2000GuidelinesforPreventingOpportunisticInfectionsAmongHematopoieticStemCellTransplantRecipientsadvisesthatbecausetransplantrecipientsareatmuchhigherriskfordiseaseanddeathfromlegionellosiscomparedwithotherhospitalizedpersons,periodicculturingforlegionellainwatersamplesfromacenter''spotablewatersupplycouldberegardedaspartofanoverallstrategyforthepreventionofLegionnaires''diseaseintransplantcentersandotherfacilitieshousingpersonsathighriskofinfectionifexposed(see6.4.2).Thereissomeevidencethatenvironmentallegionellasurveillanceshouldbeconsideredaproactivestrategyforthepreventionofhospital-acquiredLegionnairesx2019;disease(1).However,theoptimalmethodology(thatis,frequencyornumberofsites)forenvironmentalsurveillanceculturesintransplantcentershasnotbeendetermined,andthecost-effectivenessofsuchastrategyhasnotbeenevaluatedforeithertransplantcentersorotherhealth-caresettingsnorforinstitutional,commercial,orresidentialbuildings.Someexpertsadviseagainsttestingwatersystemsforlegionellaintheabsenceofillness,particularlyinbuildingsotherthanhospitalsorhealth-carefacilities,giventhatabsoluteexclusionofthisbacteriumfromwatersystemsmaynotbenecessarytopreventlegionellosisnormayitbeachiev.......
【中国标准分类号】:C51
【国际标准分类号】:07_100_10
【页数】:17P.;A4
【正文语种】:英语