Epidemiology of<i>Legionella</i>and Climatic Variables in Seoul, Korea

Park, Sanghun; Jin, Young‐Hee; Ahn, Mi-Jin; Han, Seunghoon; Kim, Hee-Soon; Kim, Jinseok; Park, Joo-Hyun; Hong, Chae Kyu; Park, So-Yun; Oh, Ah-Ryung; Lee, Jib-Ho; Kim, Il‐Young; Shin, Yong-Seoung

doi:10.4167/jbv.2019.49.2.59

Cited by 5 publications

(3 citation statements)

References 41 publications

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“…Halitosis was measured for 2 hours after breakfast in the research participants using BB Checker (mBA-21, Plustech, Korea) [17,18].…”

Section: Methodsmentioning

confidence: 99%

Intra-Oral Factors Influencing Halitosis in Young Women

Shon¹,

Kim²,

Jung³

et al. 2018

Osong Public Health Res Perspect

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ObjectivesThe aim of this research was to determine intra-oral factors that affect halitosis in young women.MethodsThis study was performed between March 2014 to May 2014, and included 35 women in their 20s with good oral health. Correlation and logistic regression analyses were performed to investigate the change in halitosis immediately, and 1 hour after scaling.ResultsIn both oral gas (OG) and extraoral gas (EG) groups, halitosis was reduced after scaling compared to before scaling. The logistic regression analysis of oral state factors in OG showed that as oral fluid [odds ratio (OR) = 0.792, p = 0.045] and dental plaque (OR = 0.940, p = 0.016) decreased by 1 unit, the OR in the OG group decreased (> 50). In addition, as glucose levels in the oral cavity (OR = 1.245, p = 0.075) and tongue coating index (OR = 2.912, p = 0.064) increased by 1 unit, the OR in the OG group increased (> 50). Furthermore, in the EG group, as oral fluid (OR = 0.66, p = 0.01) and dental plaque (OR = 0.95, p = 0.04) decreased, the OR in the EG group decreased (> 50) significantly.ConclusionTo control halitosis, it is necessary to increase oral fluid and decrease the amount of tongue plaque. Furthermore, maintaining a healthy oral environment, aided by regular scaling and removal of dental plaque, may significantly control halitosis.

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“…Halitosis was measured for 2 hours after breakfast in the research participants using BB Checker (mBA-21, Plustech, Korea) [17,18].…”

Section: Methodsmentioning

confidence: 99%

Intra-Oral Factors Influencing Halitosis in Young Women

Shon¹,

Kim²,

Jung³

et al. 2018

Osong Public Health Res Perspect

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“…Warming is expected to enhance survival and propagation of OPs in the natural and built environment (Blanc et al, 2021;Walker, 2018). Seasonal increases in legionellosis observed in the late summer to early autumn in the northern hemisphere may start earlier and last longer due to climate change (Alarcon Falconi et al, 2018;Fischer et al, 2022;Fukushima et al, 2021;Park et al, 2019). The association between warmer weather and incidence of legionellosis is well documented, and increased legionellosis cases may lag a period of elevated temperatures by several weeks (Beauté et al, 2016;Brandsema et al, 2014;Fisman et al, 2005;Han, 2019;Passer et al, 2020;Simmering et al, 2017).…”

Section: Increasing Ambient Temperaturementioning

confidence: 99%

Climate change and opportunistic pathogens (OPs) in the built environment

O’Keeffe¹

2022

Environ. Health Rev.

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Table 1: Characteristics of selected opportunistic pathogens (OPs) of concern in Canada.Legionella spp. Description: Gram-negative bacteria, found in natural water systems and soils, have been detected in most large building water systems and some 10%-30% of home water systems in the United States. Legionella bacteria can be present in water storage containers, pipes, or outlets. Optimal growing conditions: Preference for warm water (e.g., 25-45 °C), high water age, low disinfectant residual, and often associated with biofilms or free-living amoeba (FLA). Routes of transmission: Inhalation or accidental aspiration of aerosolized contaminated water droplets into the lungs from faucets, showerhead, water misters, decorative fountains, hot tubs, cooling towers, etc. Outcome of infection: Legionellosis, includes Legionnaires' disease (LD), a severe pneumonia with a fatality rate of about 10%, and Pontiac fever, a milder flu-like illness. L. pneumophila is the cause of most cases of LD. Groups most at risk: Smokers, over-50s, men, immune-compromised persons, and those with conditions like chronic obstructive pulmonary disease, coronary artery disease, dementia, diabetes, kidney disease, and neurological diseases. Pseudomonas spp. Description: Gram-negative bacteria that can form or join biofilms and colonize plumbing. Found in building water system at point of use areas (e.g., faucets, drains, and showerheads) more often than distribution systems, and can colonize humidifiers, respiratory equipment, swimming pools, hot tubs, and water baths. Optimal growing conditions: Tolerate a range of temperatures (4-42 °C), with an optimum around 37 °C, and reduced virulence below 30 °C; optimal pH around 7.2 and tolerate low dissolved oxygen, low nutrient, and stagnant waters. Grow well in poorly disinfected systems, but also resist disinfectants and can survive in FLA. Routes of transmission: Direct ear and skin contact in swimming pools, hot tubs, and whirlpools; inhalation of aerosols dispersed from faucets, showerhead, etc.; indirect transfer from contaminated devices or fomites. More commonly found in plumbing fixtures than in distribution systems. Outcome of infection: Most infections (80%) associated with P. aeruginosa and P. maltophila range from minor eye, skin, and ear conditions (e.g., swimmer's ear), to bacteremia in immune-compromised individuals or other susceptible patients. A major cause of healthcare-acquired pneumonia, wound infections, and urinary tract infections, and a cause of morbidity and mortality for cystic fibrosis patients. Groups most at risk: Children with cystic fibrosis, hospitalized patients at risk of hospital-acquired pneumonia, newborns, burn patients, patients with invasive devices, and those with underlying pulmonary disease. Nontuberculous mycobacterium (NTM) Description: NTM are a group of more than 190 known species of OP found in natural waters and soil, and building water systems. Includes Mycobacterium avium complex, a group of related bacteria that includes both M. avium and M. intrac...

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“…Weather has been strongly linked to the incidence of LD 8,9 . Precipitation, high relative humidity [10][11][12][13][14][15][16] and warm temperatures 12,14,[16][17][18][19][20] before the disease onset were often reported as important risk factors. Other relevant risk factors that were less often identified included atmospheric pressure 13,19 , low wind speed 10,13 , high dew point and low daily visibility 13 .…”

Section: Introductionmentioning

confidence: 99%

Impacts of weather and air pollution on Legionnaires’ disease in Switzerland: a national case-crossover study

Fischer

Saucy

Vienneau

et al. 2022

Preprint

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BackgroundThe number of cases of Legionnaires’ disease (LD) has risen markedly in Switzerland (6.5/100,000 inhabitants in 2021) and abroad over the last decade.Legionella, the causative agent of LD, are ubiquitous in the environment. Therefore, environmental changes can affect the incidence of LD, for example by increasing bacterial concentrations in the environment or facilitating transmission.ObjectivesThe aim of this study is to understand the environmental determinants, in particular weather conditions, for the regional and seasonal distribution of LD in Switzerland.MethodsWe conducted a series of analyses based on the Swiss LD notification data from 2017 to 2021. First, we used a descriptive and hotspot analysis to map LD cases and identify regional clusters. Second, we applied an ecological model to identify environmental determinants on case frequency at the district level. Third, we applied a case-crossover design using distributed lag non-linear models to identify short-term associations between seven weather variables and LD occurrence. Lastly, we performed a sensitivity analysis for the case-crossover design including NO2levels available for the year 2019.ResultsCanton Ticino in southern Switzerland was identified as a hotspot in the cluster analysis, with a standardised notification rate of 14.3 cases/100,000 inhabitants (CI: 12.6, 16.0). The strongest association with LD frequency in the ecological model was found for large-scale factors such as weather and air pollution. The case-crossover study confirmed the strong association of elevated daily mean temperature (OR 2.83; CI: 1.70, 4.70) and mean daily vapour pressure (OR: 1.52, CI: 1.15, 2.01) 6-14 days before LD occurrence.DiscussionOur analyses showed an influence of weather with a specific temporal pattern before the onset of LD, which may provide insights into the effect mechanism. The relationship between air pollution and LD and the interplay with weather should be further investigated.

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Epidemiology ofLegionellaand Climatic Variables in Seoul, Korea

Cited by 5 publications

References 41 publications

Intra-Oral Factors Influencing Halitosis in Young Women

Intra-Oral Factors Influencing Halitosis in Young Women

Climate change and opportunistic pathogens (OPs) in the built environment

Impacts of weather and air pollution on Legionnaires’ disease in Switzerland: a national case-crossover study

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