1、Designation: D 5952 02Standard Guide forInspecting Water Systems for Legionellae and InvestigatingPossible Outbreaks of Legionellosis (Legionnaires Diseaseor Pontiac Fever)1This standard is issued under the fixed designation D 5952; the number immediately following the designation indicates the year
2、 oforiginal adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon (e) indicates an editorial change since the last revision or reapproval.1. Scope1.1 This guide covers appropriate responses for employers,b
3、uilding owners and operators, facility managers, health andsafety professionals, public health authorities, and others: (1)toa concern that a water system may be contaminated with thebacteria known as legionellae (see 6.1); and (2) to the identi-fication of one or more cases of Legionnaires disease
4、orPontiac fever (see 6.3-6.5). Comprehensive and explicit rec-ommendations to limit legionella multiplication in water sys-tems and to disinfect potential sources of human exposure tolegionellae are beyond this guides scope.1.2 This standard does not purport to address all of thesafety concerns, if
5、any, associated with its use. It is theresponsibility of the user of this standard to establish appro-priate safety and health practices and determine the applica-bility of regulatory limitations prior to use. See 7.3 and 8.5 forspecific hazard statements.2. Referenced Documents2.1 ASTM Standards:2D
6、 512 Test Methods for Chloride Ion in WaterD 596 Practice for Reporting Results of Analysis of WaterD 887 Practices for Sampling Water-Formed DepositsD 1067 Test Methods for Acidity or Alkalinity of WaterD 1129 Terminology Relating to WaterD 1192 Specification for Equipment for Sampling Waterand Ste
7、am in Closed ConduitsD 1293 Test Methods for pH of WaterD 1356 Terminology Relating to Sampling and Analysis ofAtmospheresD 2331 Practices for Preparation and Preliminary Testing ofWater-Formed DepositsD 3370 Practices for Sampling Water from Closed ConduitsD 3856 Guide for Good Laboratory Practices
8、 in Laborato-ries Engaged in Sampling and Analysis of WaterD 4840 Guide for Sample Chain-of-Custody ProceduresE 645 Test Method for Efficacy of Microbicides Used inCooling Systems2.2 APHA Documents:3The Public Health Law Manual, Second EditionStandard Methods for the Examination of Water and Waste-w
9、ater, Twentieth EditionControl of Communicable Diseases Manual, SeventeenthEdition2.3 ASHRAE Documents:4Cooling Towers. HandbookHeating, Ventilating, and Air-Conditioning Systems and EquipmentCodes and Standards. HandbookHeating, Ventilating, andAir-Conditioning Systems and EquipmentWater Treatment.
10、 HandbookHeating, Ventilating, and Air-Conditioning Systems and EquipmentMinimizing the Risk of LegionellosisAssociated with Build-ing Water Systems2.4 ASM Documents:Manual of Clinical Microbiology, Fifth Edition5Manual of Environmental Microbiology62.5 CDC Documents:7Guidelines for Prevention of No
11、socomial PneumoniaHospital-Laboratory Diagnosis of Legionella Infections1This guide is under the jurisdiction ofASTM Committee D22 on Sampling andAnalysis of Atmospheres and is the direct responsibility of Subcommittee D22.05on Indoor Air.Current edition approved November 10, 2002. Published January
12、 2003. Origi-nally approved in 1996. Last previous edition approved in 1996 as D 5952 - 96(02).2For referenced ASTM standards, visit the ASTM website, www.astm.org, orcontact ASTM Customer Service at serviceastm.org. For Annual Book of ASTMStandards volume information, refer to the standards Documen
13、t Summary page onthe ASTM website.3Available from the American Public Health Association, 1015 18th St. N.W.,Washington, DC 20036, USA, 1990, 1989.4Available from the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc., 1791 Tullie Circle, NE, Atlanta, GA 30329, USA.5Winn
14、, W.C., “Legionella,” in Manual of Clinical Microbiology, Murray, P.R.,Ed., American Society for Microbiology, Washington, DC 20005, USA, 1999, pp.572585.6Fields, B. S. Legionellae and Legionnaires disease in Manual of Environmen-tal Microbiology. Hurst, C.J., Ed.,American Society for Microbiology,
15、Washington,DC 20005, USA, 1997, pp. 666675.7Available from the U.S. Department of Health and Human Services, PublicHealth Service, Centers for Disease Control and Prevention, Atlanta, GA 30333,USA, 1987, 1994, 1996, 1997, 2000.1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West C
16、onshohocken, PA 19428-2959, United States.Procedures for the Recovery of Legionella from the Envi-ronmentFinal Recommendations to Minimize Transmission of Le-gionnaires Disease from Whirlpool Spas on CruiseShipsCase Definitions for Infectious Conditions Under PublicHealth SurveillanceGuidelines for
17、Preventing Opportunistic Infections AmongHematopoietic Stem Cell Transplant RecipientsOccupational Safety and Health Administration TechnicalManual, Section II - Chapter 7, Legionnaires Disease2.6 State of Maryland Documents:8Report of the Maryland Scientific Working Group to StudyLegionella in Wate
18、r Systems in Healthcare Institutions3. Terminology3.1 Definitions from Compilation of ASTM Standard Defi-nitions.3.1.1 air conditioning, nthe simultaneous control of all,or at least the first three, of those factors affecting both thephysical and chemical conditions of the atmosphere within anystruc
19、ture. These factors include temperature, humidity, motion,distribution, dust, bacteria, odor, and toxic gases.3.1.2 monitoring, nthe continual sampling, measuring,recording, or signaling, or both, of the characteristics of wateror waterborne material.3.1.3 pH, nthe negative logarithm of hydrogen-ion
20、 activ-ity in aqueous solution or the logarithm of the reciprocal of thehydrogen-ion activity.3.1.4 sampling, nobtaining a representative portion of thematerial concerned.3.1.5 scale, na deposit formed from solution directlyupon a surface.3.1.6 sludge, na water-formed sedimentary deposit.3.2 Definit
21、ions of Terms Specific to This Standard:3.2.1 acute phase, n of legionellosis, the initial phase ofinfection; the first weeks following symptom onset.3.2.2 aerosol, nsolid or liquid particles suspended in air.3.2.3 antibody, nto legionellae, a substance in bloodsynthesized in response to legionella
22、antigen that enters thebody.3.2.4 antibody rise, n in legionella antibody, an increasein the highest serum dilution at which legionella antibody isdetected in a blood sample collected weeks or months afterlegionellosis onset as compared with the highest dilution for asample collected before or short
23、ly after illness onset.3.2.5 antigen, nto legionellae, a legionella molecule thatstimulates an antibody response by a host immune system.3.2.6 aseptically, advusing precautions to prevent con-tamination of samples by microorganisms.3.2.7 back-flow preventer, na control valve to preventreverse flow o
24、f water.3.2.8 bacterium, npl. -ria, typically small unicellularmicroorganism.3.2.9 biocide, nfor legionellae, a chemical used to killlegionellae and other microorganisms.3.2.10 biofilm, na layer of microorganisms contained in amatrix that may form a slime on surfaces in contact with water.3.2.11 CDC
25、, nCenters for Disease Control and Preven-tion, U.S. Public Health Service, Atlanta, Georgia.3.2.12 clean, adjvisibly free of sludge, sediment, scale,biofilm, algae, fungi, rust, corrosion, and extraneous matter.3.2.13 clean, vto remove sludge, sediment, scale, biofilm,algae, fungi, rust, corrosion,
26、 and extraneous matter by physicalor chemical means.3.2.14 colony, nof legionellae, a macroscopic group oflegionella cells arising from bacterial multiplication on thesurface of semisolid culture medium.3.2.15 colony-forming unit, n of legionellae, a colonyarising from the multiplication of one or a
27、 cluster of viablelegionellae.3.2.16 confirmed case, n of Legionnaires disease, a caseof physician-diagnosed pneumonia verified by at least onecomfirmatory laboratory test as meeting the laboratory criteriajointly developed by CDC and the Council of State andTerritorial Epidemiologists (CSTE).3.2.17
28、 contamination, n with legionellae, the presence oflegionellae on or in inanimate articles or substances.3.2.18 convalescent phase, n of legionellosis, the recov-ery phase of infection, typically four to eight weeks followingsymptom onset.3.2.19 cooling tower, na structure for lowering watertemperat
29、ure evaporatively by contact with atmospheric air.3.2.20 DFA, adjdirect fluorescent-antibody.3.2.21 dead leg, na length of pipe closed at one end orending at a fitting through which water flows only when thefitting is open.3.2.22 direct fluorescent-antibody test, nfor legionellae,astaining procedure
30、 that detects legionella surface antigensthrough the use of specific antibodies labelled with fluorescentcompounds; bacteria to which antibody has attached fluorescewhen viewed under appropriate irradiation.3.2.23 disinfect, vto eliminate virtually all pathogenicmicroorganisms, but not necessarily a
31、ll microbiological forms,outside the body by direct exposure to chemical or physicalagents.3.2.24 drift, nfrom water-cooled heat-transfer equipment,water droplets carried from a cooling tower or other water-cooled heat-transfer system by air movement through the unit;drift can be confused with conde
32、nsed water vapor appearing assteam leaving a unit.3.2.25 drift eliminator, na plastic, metal, or wood baffledesigned to entrain water droplets and to reduce aerosolescape.3.2.26 enzyme immunoassay (EIA), na technique to detectvery small quantities of antigens through use of an anti-antibody attached
33、 to an enzyme that causes a color change inits substrate3.2.27 evaporative condenser, na heat exchanger inwhich refrigerant is cooled by a combination of air movementand water spraying.8Available from State of Maryland, Department of Health the division between the family or tribe and the species; a
34、group of species alike in broad organizational features butdifferent in detail.3.2.33 gram-negative, adjlosing the primary violet orblue stain during decolorization in Grams staining method.3.2.34 HVAC, adjheating, ventilating, and air-conditioning.3.2.35 humidifier, na device for adding moisture to
35、 air byboiling, spraying, or atomizing water.3.2.36 IFA, adjindirect fluorescent-antibody.3.2.37 immunocompromised, adja persons state when thebodys natural defenses to infection are below normal.3.2.38 in vitro, adj(Latin: in glass), refers to laboratorytests performed in a test tube or other conta
36、iner as opposed toa living system; the opposite of in vivo.3.2.39 in vivo, adj(Latin: in living), refers to laboratorytests performed in living organisms; the opposite of in vitro.3.2.40 incubation period, n of legionellosis, the timeinterval between initial contact with legionellae and appear-ance
37、of the first legionellosis sign or symptom.3.2.41 indirect fluorescent-antibody test, nfor legionellaantibodies, a staining procedure that detects serum antibodiesto legionellae through the use of bacteria fixed on a glass slide;secondary test antibodies labelled with fluorescent compoundsattach to
38、fixed legionellae/serum antibody complexes andfluoresce when viewed under appropriate irradiation.3.2.42 infection, nwith legionellae, the entry and devel-opment, or multiplication, of legionellae in humans.3.2.43 inspector, na person examining an environmentfor possible contamination with legionell
39、ae.3.2.44 investigator, na person conducting an epidemio-logical investigation of a potential legionellosis outbreak.3.2.45 isolate, na microorganism grown from a clinical orenvironmental sample.3.2.46 isolate, vin vitro growth of microorganisms onculture medium.3.2.47 Legionella, na bacterial genus
40、 containing over 40species and at least 50 serogroups; abbreviated to the firstinitial when used repeatedly with species names, for example,L. pneumophila.3.2.48 legionella, npl. -ae, a bacterium in the genusLegionella.3.2.49 legionellosis, nan illness caused by or associatedwith legionella infectio
41、n; two forms of legionellosis due toinhalation of airborne legionellae are recognized, that is,Legionnaires disease and Pontiac fever.3.2.50 Legionnaires disease, nan illness characterized bypneumonia and caused by or associated with legionella infec-tion, most often L. pneumophila.3.2.51 maintain,
42、vto perform regular and routine activi-ties aimed at preserving equipment, operational standards andcleanliness; includes inspection, repair, preventive servicing,and cleaning.3.2.52 maintenance program, nthe assembly of relevantdata and the setting out of a formal strategy and recordingsystem for e
43、ffective management of a series of maintenanceprocedures.3.2.53 make-up water, nfresh water added to circulatingwater systems to compensate for losses due to evaporation,purging, drift, or leakage.3.2.54 microorganism, na microscopic organism.3.2.55 opportunistic infection, nan infection caused byno
44、rmally nonpathogenic organisms in a host whose resistancehas been decreased.3.2.56 outbreak, nof legionellosis, the occurrence of twoor more confirmed legionellosis cases in a limited time period(for example, weeks to months) and geographic region (forexample, a building, limited area within a build
45、ing, or up toseveral kilometres around a potential source); the occurrence ofcases in excess of the number expected in a given time periodand locale.3.2.57 outdoor air intake, n for ventilation systems,anopening through which outdoor air is introduced into abuildings air-handling system.3.2.58 PCR,
46、adjpolymerase chain reaction.3.2.59 polymerase chain reaction test, n a technique forselecting and amplifying specific genetic sequences.3.2.60 Pontiac fever, na self-limited, short-duration, non-fatal disease characterized by fever and cough caused by orassociated with legionellae.3.2.61 protozoan,
47、 npl. -a, single-celled microorganismrepresenting the lowest form of animal life.3.2.62 sensitivity, n of a test for legionellosis or legionel-lae, a methods ability to detect the presence of the disease(that is, legionellosis) or the causative agent (that is, legionella)being tested if present.3.2.
48、63 serogroup, nof legionella, a subgroup within alegionella species.3.2.64 serology, nthe study of blood serum for evidenceof infection, performed by evaluating antigen-antibody reac-tions in vitro.3.2.65 serum, npl. -a, the clear, thin, sticky fluid portionof blood remaining after coagulation.3.2.6
49、6 source, nof legionellae, the water system, supply,or equipment from which legionellae pass to a host.3.2.67 species, na taxonomic classification of organisms;the division between genus and variety or individual; a groupof organisms bearing a close resemblance in essential organi-zational features.3.2.68 specificity, n of a test for legionellosis or legionel-lae, a methods ability to identify accurately an illness asD5952023legionellosis or a bacterium as a legionella; a methods abilityto select a
