Nontuberculous mycobacteria in aerosol droplets and bulk water samples from therapy pools and hot tubs

Craig S. Glazer, John W. Martyny, Ben Lee, Tracy L. Sanchez, Tricia M. Sells, Lee S. Newman, James Murphy, Leonid Heifets, Cecile S. Rose

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Hot tub exposure has been causally associated with a steroid-responsive, granulomatous lung disease featuring nontuberculous mycobacterial (NTM) growth in both clinical and environmental samples. Little is known regarding prevalence of and risk factors for NTM-contamination and associated illness in these settings. In this study, the frequency of NTM growth and aerosolization in 18 public hot tubs and warm water therapy pools and the factors associated with mycobacterial growth were analyzed. Each site was characterized by water chemistry analysis; a questionnaire on maintenance, disinfection, and water quality; and air and water sampling for quantitative NTM culture. NTM were detected in air or water from 13/18 (72%) sites; a strong correlation was found between the maximum air and water NTM concentrations (rho 0.49, p = 0.04). Use of halogen (chlorine or bromine) disinfection was associated with significantly lower air and water concentrations of NTM compared with disinfection using ultraviolet light and hydrogen peroxide (p = 0.01-0.04). Higher water turnover rates were also associated with lower air and water NTM concentrations (p = 0.02-0.03). These findings suggest that NTM are frequently detectable in the air and water of spas and therapy pools and that particular maintenance and disinfection approaches affect NTM bioaerosol concentrations in these settings.

Original languageEnglish (US)
Pages (from-to)831-840
Number of pages10
JournalJournal of Occupational and Environmental Hygiene
Volume4
Issue number11
DOIs
StatePublished - Nov 2007

Fingerprint

Nontuberculous Mycobacteria
Aerosols
Water
Disinfection
Air
Therapeutics
Growth
Maintenance
Bromine
Halogens
Water Quality
Chlorine
Ultraviolet Rays
Hydrogen Peroxide
Lung Diseases
Steroids

Keywords

  • Bioaerosols
  • Granulomas
  • Hot tubs
  • Hypersensitivity pneumonitis
  • Nontuberculous mycobacteria

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Nontuberculous mycobacteria in aerosol droplets and bulk water samples from therapy pools and hot tubs. / Glazer, Craig S.; Martyny, John W.; Lee, Ben; Sanchez, Tracy L.; Sells, Tricia M.; Newman, Lee S.; Murphy, James; Heifets, Leonid; Rose, Cecile S.

In: Journal of Occupational and Environmental Hygiene, Vol. 4, No. 11, 11.2007, p. 831-840.

Research output: Contribution to journalArticle

Glazer, Craig S. ; Martyny, John W. ; Lee, Ben ; Sanchez, Tracy L. ; Sells, Tricia M. ; Newman, Lee S. ; Murphy, James ; Heifets, Leonid ; Rose, Cecile S. / Nontuberculous mycobacteria in aerosol droplets and bulk water samples from therapy pools and hot tubs. In: Journal of Occupational and Environmental Hygiene. 2007 ; Vol. 4, No. 11. pp. 831-840.
@article{916379996e4c40578ff6f3419cfa22ca,
title = "Nontuberculous mycobacteria in aerosol droplets and bulk water samples from therapy pools and hot tubs",
abstract = "Hot tub exposure has been causally associated with a steroid-responsive, granulomatous lung disease featuring nontuberculous mycobacterial (NTM) growth in both clinical and environmental samples. Little is known regarding prevalence of and risk factors for NTM-contamination and associated illness in these settings. In this study, the frequency of NTM growth and aerosolization in 18 public hot tubs and warm water therapy pools and the factors associated with mycobacterial growth were analyzed. Each site was characterized by water chemistry analysis; a questionnaire on maintenance, disinfection, and water quality; and air and water sampling for quantitative NTM culture. NTM were detected in air or water from 13/18 (72{\%}) sites; a strong correlation was found between the maximum air and water NTM concentrations (rho 0.49, p = 0.04). Use of halogen (chlorine or bromine) disinfection was associated with significantly lower air and water concentrations of NTM compared with disinfection using ultraviolet light and hydrogen peroxide (p = 0.01-0.04). Higher water turnover rates were also associated with lower air and water NTM concentrations (p = 0.02-0.03). These findings suggest that NTM are frequently detectable in the air and water of spas and therapy pools and that particular maintenance and disinfection approaches affect NTM bioaerosol concentrations in these settings.",
keywords = "Bioaerosols, Granulomas, Hot tubs, Hypersensitivity pneumonitis, Nontuberculous mycobacteria",
author = "Glazer, {Craig S.} and Martyny, {John W.} and Ben Lee and Sanchez, {Tracy L.} and Sells, {Tricia M.} and Newman, {Lee S.} and James Murphy and Leonid Heifets and Rose, {Cecile S.}",
year = "2007",
month = "11",
doi = "10.1080/15459620701634403",
language = "English (US)",
volume = "4",
pages = "831--840",
journal = "Journal of Occupational and Environmental Hygiene",
issn = "1545-9624",
publisher = "Taylor and Francis Ltd.",
number = "11",

}

TY - JOUR

T1 - Nontuberculous mycobacteria in aerosol droplets and bulk water samples from therapy pools and hot tubs

AU - Glazer, Craig S.

AU - Martyny, John W.

AU - Lee, Ben

AU - Sanchez, Tracy L.

AU - Sells, Tricia M.

AU - Newman, Lee S.

AU - Murphy, James

AU - Heifets, Leonid

AU - Rose, Cecile S.

PY - 2007/11

Y1 - 2007/11

N2 - Hot tub exposure has been causally associated with a steroid-responsive, granulomatous lung disease featuring nontuberculous mycobacterial (NTM) growth in both clinical and environmental samples. Little is known regarding prevalence of and risk factors for NTM-contamination and associated illness in these settings. In this study, the frequency of NTM growth and aerosolization in 18 public hot tubs and warm water therapy pools and the factors associated with mycobacterial growth were analyzed. Each site was characterized by water chemistry analysis; a questionnaire on maintenance, disinfection, and water quality; and air and water sampling for quantitative NTM culture. NTM were detected in air or water from 13/18 (72%) sites; a strong correlation was found between the maximum air and water NTM concentrations (rho 0.49, p = 0.04). Use of halogen (chlorine or bromine) disinfection was associated with significantly lower air and water concentrations of NTM compared with disinfection using ultraviolet light and hydrogen peroxide (p = 0.01-0.04). Higher water turnover rates were also associated with lower air and water NTM concentrations (p = 0.02-0.03). These findings suggest that NTM are frequently detectable in the air and water of spas and therapy pools and that particular maintenance and disinfection approaches affect NTM bioaerosol concentrations in these settings.

AB - Hot tub exposure has been causally associated with a steroid-responsive, granulomatous lung disease featuring nontuberculous mycobacterial (NTM) growth in both clinical and environmental samples. Little is known regarding prevalence of and risk factors for NTM-contamination and associated illness in these settings. In this study, the frequency of NTM growth and aerosolization in 18 public hot tubs and warm water therapy pools and the factors associated with mycobacterial growth were analyzed. Each site was characterized by water chemistry analysis; a questionnaire on maintenance, disinfection, and water quality; and air and water sampling for quantitative NTM culture. NTM were detected in air or water from 13/18 (72%) sites; a strong correlation was found between the maximum air and water NTM concentrations (rho 0.49, p = 0.04). Use of halogen (chlorine or bromine) disinfection was associated with significantly lower air and water concentrations of NTM compared with disinfection using ultraviolet light and hydrogen peroxide (p = 0.01-0.04). Higher water turnover rates were also associated with lower air and water NTM concentrations (p = 0.02-0.03). These findings suggest that NTM are frequently detectable in the air and water of spas and therapy pools and that particular maintenance and disinfection approaches affect NTM bioaerosol concentrations in these settings.

KW - Bioaerosols

KW - Granulomas

KW - Hot tubs

KW - Hypersensitivity pneumonitis

KW - Nontuberculous mycobacteria

UR - http://www.scopus.com/inward/record.url?scp=39749189484&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39749189484&partnerID=8YFLogxK

U2 - 10.1080/15459620701634403

DO - 10.1080/15459620701634403

M3 - Article

C2 - 17846927

AN - SCOPUS:39749189484

VL - 4

SP - 831

EP - 840

JO - Journal of Occupational and Environmental Hygiene

JF - Journal of Occupational and Environmental Hygiene

SN - 1545-9624

IS - 11

ER -