This paper synthesizes available information on five Category A pathogens (Bacillus anthracis, Yersinia pestis, Francisella tularensis, Variola major and Lassa) to develop quantitative guidelines for how environmental pathogen concentrations may be related to human health risk in an indoor environment. An integrated model of environmental transport and human health exposure to biological pathogens is constructed which 1) includes the effects of environmental attenuation, 2) considers fomite contact exposure as well as inhalational exposure, and 3) includes an uncertainty analysis to identify key input uncertainties, which may inform future research directions. The findings provide a framework for developing the many different environmental standards that are needed for making risk-informed response decisions, such as when prophylactic antibiotics should be distributed, and whether or not a contaminated area should be cleaned up. The approach is based on the assumption of uniform mixing in environmental compartments and is thus applicable to areas sufficiently removed in time and space from the initial release that mixing has produced relatively uniform concentrations. Results indicate that when pathogens are released into the air, risk from inhalation is the main component of the overall risk, while risk from ingestion (dermal contact for B. anthracis) is the main component of the overall risk when pathogens are present on surfaces. Concentrations sampled from untracked floor, walls and the filter of heating ventilation and air conditioning (HVAC) system are proposed as indicators of previous exposure risk, while samples taken from touched surfaces are proposed as indicators of future risk if the building is reoccupied. A Monte Carlo uncertainty analysis is conducted and input-output correlations used to identify important parameter uncertainties. An approach is proposed for integrating these quantitative assessments of parameter uncertainty with broader, qualitative considerations to identify future research priorities.

10.1371/journal.pone.0032732

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Benefits of using a disinfectant residual

American Water Works Association (1999)

Charles N. Haas

Given the age and vulnerability of some US water distribution systems, use of a disinfectant residual as an added safeguard makes sense. Water distribution systems in the United States routinely carry chlorine residuals < 0.05 mg/L and invariably carry residuals > 0.1 mg/L. This article outlines some of the benefits of using chlorine as a disinfectant residual and considers system characteristics (e.g., system age and vulnerability) that support this application. Benefits accruing to maintenance of a chlorine residual include protecting against modest degrees of intrusion of contaminants, serving as a sentinel for the presence of such contamination, and reducing the potential for growth of heterotrophic organisms.

Disinfectant

10.1002/j.1551-8833.1999.tb08569.x

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Citations (45)