1、Designation: D 5952 08Standard Guide for theInspection of Water Systems for Legionella and theInvestigation of Possible Outbreaks of Legionellosis(Legionnaires Disease or Pontiac Fever)1This standard is issued under the fixed designation D 5952; the number immediately following the designation indic
2、ates the year 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 () indicates an editorial change since the last revision or reapproval.1. Scope1.1 This guide covers appropriate responses for
3、 employers,building owners and operators, facility managers, health andsafety professionals, public health authorities, and others: (1)toa concern that a water system may be contaminated with thebacterium known as legionella (see 6.1); and (2)totheidentification of one or more cases of Legionnaires
4、disease orPontiac fever (see 6.3-6.5). Comprehensive and explicit rec-ommendations to limit legionella multiplication in water sys-tems, disinfect potential sources of human exposure to le-gionella, and prevent health-care associated infections arebeyond this guides scope.1.2 This standard does not
5、purport to address all of thesafety concerns, if 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 statem
6、ents.2. Referenced Documents2.1 ASTM Standards:2C 1080 Specification for Asbestos-Cement Products OtherThan Fill For Cooling TowersD 512 Test Methods for Chloride Ion In WaterD 596 Guide for Reporting Results of Analysis of WaterD 887 Practices for Sampling Water-Formed DepositsD 1067 Test Methods f
7、or Acidity or Alkalinity of WaterD 1129 Terminology Relating to WaterD 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 Co
8、nduitsD 3856 Guide for Good Laboratory Practices in Laborato-ries Engaged in Sampling and Analysis of WaterD 4840 Guide for Sampling Chain-of-Custody ProceduresE 645 Test Method for Efficacy of Microbicides Used inCooling Water SystemsF 444 Consumer Safety Specification for Scald-PreventingDevices a
9、nd Systems in Bathing AreasF 445 Consumer Safety Specification for Thermal-Shock-Preventing Devices and Systems in Showering Areas2.2 APHA Documents:3Public Health Law Manual, Third EditionStandard Methods for the Examination of Water and Waste-water, Twenty-first EditionControl of Communicable Dise
10、ases Manual, EighteenthEdition2.3 ASHRAE Documents:4Codes and Standards. 2004 ASHRAE HandbookHeating,Ventilating, and Air-Conditioning Systems and Equip-mentCooling Towers. 2004 ASHRAE HandbookHeating, Ven-tilating, and Air-Conditioning Systems and EquipmentWater Treatment. 2004ASHRAE HandbookHeatin
11、g, Ven-tilating, and Air-Conditioning Systems and Equipment122000 Minimizing the Risk of Legionellosis Associatedwith Building Water Systems62.1-2007 ASHRAE Standard. Ventilation for AcceptableIndoor Air Quality2.4 ASM Documents:Manual of Clinical Microbiology, Ninth Edition5Manual of Environmental
12、Microbiology, Third Edition61This guide is under the jurisdiction of ASTM Committee D22 on Air Qualityand is the direct responsibility of Subcommittee D22.05 on Indoor Air.Current edition approved April 1, 2008. Published July 2008. Originallyapproved in 1996. Last previous edition approved in 2002
13、as D 5952 - 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 Document Summary page onthe ASTM website.3Available from the American Public Health Ass
14、ociation, 800 I St. N.W.,Washington, DC 20001, USA, http:/www.apha.org.4Available from the American Society of Heating, Refrigerating, and Air-Conditioning Engineers, Inc. (ASHRAE), 1791 Tullie Circle, NE, Atlanta, GA30329, USA, http:/www.ashrae.org.5Edelstein, P.H., “Legionella,” in Manual of Clini
15、cal Microbiology , Murray,P.R., Ed., American Society for Microbiology, Washington, DC 20005, USA, 2007,pp. 835849.6Fields, B.S., “Legionellae and Legionnaires disease” in Manual of Environ-mental Microbiology. Hurst, C.J., Ed., American Society for Microbiology, Wash-ington, DC 20005, USA, 2007, pp
16、. 10051015.1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.Manual of Molecular and Clinical Laboratory Immunology,Seventh Edition72.5 AWT Document:8Legionella 2003: An Update and Statement by the Associa-tion of Water Technologies (A
17、WT)2.6 CDC Documents:92000 Guidelines for Preventing Opportunistic InfectionsAmong Hematopoietic Stem Cell Transplant Recipients2003 Guidelines for Environmental Infection Control inHealth-Care Facilities2003 Guidelines for Preventing Health-Care-AssociatedPneumonia2005 Procedures for the Recovery o
18、f Legionella from theEnvironment2005 Case Definition for Legionellosis (Legionella pneumo-phila)2.7 Code of Federal Regulations:10Title 42, Volume 1, 84. Approval of Respiratory ProtectiveDevices2.8 CTI Document:11Legionellosis Guideline: Best Practices for Control of Le-gionella2.9 OSHA Document:12
19、2003 Occupational Safety and Health Administration(OSHA) Technical Manual, Section III: Chapter 7, Le-gionnaires Disease2.10 WHO Document:13Legionella and the Prevention of Legionellosis3. Terminology3.1 Definitions from Compilation of ASTM Standard Defi-nitions.3.1.1 aerosol, na dispersion of solid
20、 or liquid particles ina gaseous medium.3.1.2 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 anystructure. These factors include temperature, humidity, motion,distribution, d
21、ust, bacteria, odor, and toxic gases.3.1.3 biocide, nany chemical intended for use to killorganisms.3.1.4 biofilm, nan accumulation of cells immobilized on asubstratum and frequently embedded in an organic polymermatrix of microbial origin.3.1.5 cooling tower, na structure used to dissipate heat ino
22、pen recirculating cooling systems.3.1.6 exposure, ncontact with a chemical, biological,physical, or other agent over a specified time period.3.1.7 inspection, nthe process of measuring, examining,testing, gaging, or otherwise evaluating materials, products,services, systems, or environments.3.1.8 mo
23、nitoring, nthe continual sampling, measuring,recording, or signaling, or both, of the characteristics of wateror waterborne material.3.1.9 pH, nthe negative logarithm of hydrogen-ion activ-ity in aqueous solution or the logarithm of the reciprocal of thehydrogen-ion activity.3.1.10 sample, na portio
24、n of a population intended to berepresentative of the whole.3.1.11 sampling, na process consisting of the withdrawalor isolation of a fractional part of the whole.3.1.12 scale, na deposit formed from solution directlyupon a surface.3.1.13 sludge, na water-formed sedimentary deposit.3.1.14 testing, n
25、the determination by technical means ofproperties; performance; or elements of materials, products,services, systems, or environments which involve applicationof established scientific principles and procedures.3.2 Definitions of Terms Specific to This Standard:3.2.1 acute phase, nof legionellosis,
26、the initial phase ofinfection; the first weeks following symptom onset.3.2.2 antibody, nto legionella, a substance in blood syn-thesized in response to a legionella antigen that enters the body.3.2.3 antibody rise, nin legionella antibody, an increasein the highest serum dilution at which legionella
27、 antibody isdetected in a blood sample collected weeks or months afterlegionellosis onset as compared with the highest dilution for asample collected before or shortly after illness onset.3.2.4 antigen, nto legionella, a legionella molecule thatstimulates an antibody response by a host immune system
28、.3.2.5 aseptically, advusing precautions to prevent con-tamination of samples by microorganisms.3.2.6 back-flow preventer, na control valve to preventreverse flow of water.3.2.7 bacterium, npl. -ria, a typically small unicellularmicroorganism.3.2.8 CDC, nCenters for Disease Control and Prevention,U.
29、S. Public Health Service, Atlanta, Georgia.3.2.9 clean, adjvisibly free of sludge, sediment, scale,biofilm, algae, fungi, rust, corrosion, and extraneous matter.3.2.10 clean, vto remove sludge, sediment, scale, biofilm,algae, fungi, rust, corrosion, and extraneous matter by physicalor chemical means
30、.3.2.11 colony, nof legionella, a macroscopic group oflegionella cells arising from bacterial multiplication on thesurface of semisolid culture medium.3.2.12 colony-forming unit, nof legionella, a colony aris-ing from the multiplication of one or a cluster of viablelegionella.3.2.13 confirmed case,
31、nof Legionnaires disease, a caseof physician-diagnosed pneumonia verified by at least one7Edelstein, P.H., “Detection of Antibodies to Legionella,” in Manual ofMolecular and Clinical Laboratory Immunology. Detrick, B., Hamilton, R.G.,Folds, J.D., Eds., American Society for Microbiology, Washington,
32、DC 20005,USA, 2006, pp. 468476.8Available from the Association of Water Technologies, 15245 Shady GroveRd., Rockville, MD 20850, USA, http:/www.awt.org, 2003.9Available from the U.S. Department of Health and Human Services, PublicHealth Service, Centers for Disease Control and Prevention, 1600 Clift
33、on Rd.,Atlanta, GA 30333, USA, http:/www.cdc.gov.10Available from the U.S. Government Printing Office, 732 N. Capitol St., N.W.,Washington DC, 20401, USA, 42CFR84, 2004.11Available from the Cooling Tower Institute, P.O. Box 73383, Houston, TX,USA, http:/www.cti.org, 2006.12Available from Occupationa
34、l Safety and Health Administration (OSHA), 200Constitution Ave., NW, Washington, DC 20210, USA, http:/www.osha.gov.13Available from the World Health Organization, Geneva, Switzerland, http:/www.who.int/en/, 2007.D5952082confirmatory test as meeting the laboratory criteria jointlydeveloped by the CDC
35、 and the Council of State and TerritorialEpidemiologists.3.2.14 contamination, nwith legionella, the presence oflegionella on or in inanimate articles or substances.3.2.15 convalescent phase, nof legionellosis, the recoveryphase of infection, typically four to eight weeks followingsymptom onset.3.2.
36、16 DFA, adjdirect fluorescent-antibody.3.2.17 dead leg, na length of pipe closed at one end orending at a fitting through which water flows only when thefitting is open.3.2.18 direct fluorescent-antibody test, nfor legionella,astaining procedure that detects legionella surface antigensthrough the us
37、e of specific antibodies labeled with fluorescentcompounds; bacteria to which antibody has attached fluorescewhen viewed under appropriate irradiation.3.2.19 disinfect, vto eliminate virtually all pathogenicmicroorganisms, but not necessarily all microbiological forms,outside the body by direct expo
38、sure to chemical or physicalagents.3.2.20 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 condensed water vapor appearing assteam leaving a unit.3.2.21
39、 drift eliminator, na plastic, metal, or wood baffledesigned to entrain water droplets and to reduce aerosolescape.3.2.22 evaporative condenser, na heat exchanger inwhich refrigerant is cooled by a combination of air movementand water spraying.3.2.22.1 DiscussionEvaporative air coolers (swamp cool-e
40、rs), which do not produce large numbers of water droplets,have not been associated with legionella transmission to date.3.2.23 exhaust outlet, nin a ventilation system, an outletfrom which an air-handling system discharges air outdoors.3.2.24 false-negative, adjincorrectly indicating the ab-sence of
41、 a finding, condition, or disease.3.2.25 false-positive, adjincorrectly indicating the pres-ence of a finding, condition, or disease.3.2.26 free residual chlorine, nthe total concentration ofhypochlorous acid and hypochlorites available to act as disin-fectant.3.2.27 genus, na taxonomic classificati
42、on of organisms;the division between the family or tribe and the species; agroup of species alike in broad organizational features butdifferent in detail.3.2.28 gram-negative, adjlosing the primary violet orblue stain during decolorization in Grams staining method.3.2.29 HVAC, adjheating, ventilatin
43、g, and air-conditioning.3.2.30 humidifier, na device for adding moisture to air byboiling, spraying, or atomizing water.3.2.31 IHC, nimmunohistochemistry.3.2.32 immunocompromised, adja persons state when thebodys natural defenses to infection are below normal.3.2.33 immunohistochemistry, na staining
44、 procedure thatdetects antigens in tissue sections through the use of specificlabeled antibodies.3.2.34 in vitro, adj(Latin: in glass), refers to laboratorytests performed in a test tube or other container as opposed toa living system; the opposite of in vivo.3.2.35 in vivo, adj(Latin: in living), r
45、efers to laboratorytests performed in living organisms; the opposite of in vitro.3.2.36 incubation period, n of legionellosis, the timeinterval between initial contact with legionella and appearanceof the first legionellosis sign or symptom.3.2.37 infection, nwith legionella, the entry and develop-m
46、ent, or multiplication, of legionella in humans.3.2.38 inspector, na person examining an environmentfor possible contamination with legionella.3.2.39 investigator, na person conducting an epidemio-logical investigation of a potential legionellosis outbreak.3.2.40 isolate, na microorganism grown from
47、 a clinical orenvironmental sample.3.2.41 isolate, vin vitro growth of microorganisms onculture medium.3.2.42 Legionella, na bacterial genus containing over 50species and at least 71 serogroups; abbreviated to the firstinitial when used repeatedly with a species name, for example,L. pneumophila.3.2.
48、43 legionella, npl. -ae, a bacterium in the genusLegionella.3.2.44 legionellosis, na respiratory illness caused by orassociated with legionella; two forms of legionellosis due toinhalation of airborne legionella are recognized, that is, Le-gionnaires disease and Pontiac fever.3.2.45 Legionnaires dis
49、ease, nan illness characterized bypneumonia and caused by or associated with legionella infec-tion, most often L. pneumophila.3.2.46 maintain, vto perform regular and routine activi-ties aimed at preserving equipment, operational standards, andcleanliness; includes inspection, repair, preventive servicing,and cleaning.3.2.47 maintenance program, nthe assembly of relevantdata and the setting out of a formal strategy and recordingsystem for effective management of a series of maintenanceprocedures.3.2.
