Korean Journal of Microbiology (미생물학회지)

The Microbiological Society of Korea (한국미생물학회)
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Quantitative Microbial Risk Assessment on Legionella Infection in Children Playing in Interactive Fountains

바닥분수에서 물놀이를 하는 아동들의 Legionella균 감염 위해도 분석

  • Received : 2013.12.03
  • Accepted : 2013.12.21
  • Published : 2013.12.31
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Abstract

Recently interactive water fountains are gaining popularity in making public facilities in South Korea. The total number of interactive fountains is rapidly growing at the rate of >50% annually. In this study, we performed quantitative microbial risk assessment to estimate infection risks in children by Legionella spp. while playing in interactive fountains. The exposure dose for a given concentration of Legionella in water was calculated using water-aerosol partition rate of Legionella, exposure duration, inhalation rate, and deposit rate of aerosols in the lungs following inhalation. The dose was converted to infection risk by using the dose-response function developed for L. pneumophila. High weight and/or old children, i.e., 12-year children, running around in fountains were the highest risk group by showing >0.05 infection probability for fountain waters containing ${\geq}10^4$ CFU/L Legionella. The result supported the current guideline by Korea Centers for Disease Control and Prevention, which permits use of water with < $10^3$ CFU/L Legionella cells for all purposes. However, the results still warrant further evaluation of the guideline to accommodate risks for children because the dose-response relationship in the model was developed for healthy adults. Further risk assessment studies need to be conducted by employing dose-response model for children who generally carries weaker immune system than adults.

최근 국내의 각종 시설들에서 경관과 여름철 물놀이를 위한 바닥분수 설치가 선호되어, 그 수가 연간 50% 이상 급증하고 있다. 본 연구는, 정량적 미생물학적 위해성 평가 방법으로, 아동이 바닥분수에서 물놀이를 하는 동안 Legionella spp.에 의한 감염 위해도가 어느 정도인지 정량 하였다. 용수 중 Legionella균의 농도를 $10^{-1}-10^6$ CFU/L로 상정하고, 공기 중으로 에어로졸과 함께 비산하게 되는 Legionella균의 농도와 노출시간, 호흡률의 분포, 폐까지 도달하는 에어로졸의 비율을 곱하여 아동들의 노출량을 산정하고, Legionella pneumophila의 위해도를 도출하는 것으로 알려진 지수함수 모델에 따라, 감염 위해도로 변환하였다. 최고 위험군은 뛰어다니면서 물놀이를 하는 신체가 큰, 혹은 연령이 높은 아동이었으며, 이들이 $10^4$ CFU/L 이상의 Legionella균이 존재하는 분수 용수를 1회 이상 이용 시 0.05 이상의 위해도가 발생하였다. 이 결과에 따르면, $10^3$ CFU/L 미만의 Legionella균 농도를 공중이용시설의 모든 배관용수에 대하여 허용하는 현행 질병관리본부의 레지오넬라증 관리지침은 타당한 것으로 판정된다. 그러나, 이 기준은 건강한 성인 대상으로는 적합하나 아동의 면역력이 낮은 점을 감안하지 않았으므로, 아동에게 적합한 감염위해도 모델을 연구하여, 보다 철저한 관리 기준을 적용할 필요성이 있다.

Keywords

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