{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:52:37Z","timestamp":1780573957599,"version":"3.54.1"},"reference-count":35,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2015,1,15]],"date-time":"2015-01-15T00:00:00Z","timestamp":1421280000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Appl Environ Microbiol"],"published-print":{"date-parts":[[2015,1,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Legionnaires' disease can result when droplets or aerosols containing legionella bacteria are inhaled and deposited in the lungs. A number of outbreaks have been associated with the use of a spa pool where aeration, a high water temperature, and a large and variable organic load make disinfectant levels difficult to maintain. Spa pool ownership is increasing, and the aim of this study, using two surrogate organisms (MS-2 coliphage and\n            <jats:named-content content-type=\"genus-species\">Pseudomonas aeruginosa<\/jats:named-content>\n            [a natural contaminant]), was to assess the potential risk to domestic users when disinfection fails. A representative \u201centry level\u201d domestic spa pool was installed in an outdoor courtyard. The manufacturer's instructions for spa pool maintenance were not followed. A cyclone sampler was used to sample the aerosols released from the spa pool with and without activation of the air injection system. Samples were taken at increasing heights and distances from the pool. An aerodynamic particle sizer was used to measure the water droplet size distribution at each sample point. When the air injection system was inactivated, neither surrogate organism was recovered from the air. On activation of the air injection system, the mean mass of droplets within the respirable range (10 cm above the water line) was 36.8 \u03bcg cm\n            <jats:sup>\u22123<\/jats:sup>\n            . This corresponded to a mean air concentration of\n            <jats:named-content content-type=\"genus-species\">P. aeruginosa<\/jats:named-content>\n            of 350 CFU m\n            <jats:sup>\u22123<\/jats:sup>\n            . From extrapolation from animal data, the estimated risk of infection from aerosols contaminated with similar concentrations of\n            <jats:named-content content-type=\"genus-species\">Legionella pneumophila<\/jats:named-content>\n            was 0.76 (males) and 0.65 (females). At 1 m above and\/or beyond the pool, the mean aerosol mass decreased to 0.04 \u03bcg cm\n            <jats:sup>\u22123<\/jats:sup>\n            and corresponded to a 100-fold reduction in mean microbial air concentration. The estimated risk of infection at this distance was negligible.\n          <\/jats:p>","DOI":"10.1128\/aem.02912-14","type":"journal-article","created":{"date-parts":[[2014,11,8]],"date-time":"2014-11-08T06:58:59Z","timestamp":1415429939000},"page":"555-561","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":11,"title":["Aerosolization of Respirable Droplets from a Domestic Spa Pool and the Use of MS-2 Coliphage and Pseudomonas aeruginosa as Markers for Legionella pneumophila"],"prefix":"10.1128","volume":"81","author":[{"given":"Ginny","family":"Moore","sequence":"first","affiliation":[{"name":"Public Health England, Porton Down, Salisbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Public Health England, Porton Down, Salisbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Public Health England, Porton Down, Salisbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy T.","family":"Walker","sequence":"additional","affiliation":[{"name":"Public Health England, Porton Down, Salisbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan M.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Public Health England, Porton Down, Salisbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/152.1.145"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.2004.02458.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/aem.43.5.1104-1110.1982"},{"key":"e_1_3_2_5_2","volume-title":"Legionnaires' disease in England and Wales, 2011, Health Protection Report","author":"Naik FC","year":"2012","unstructured":"Naik FC, Zhao H, Harrison TG, Phin N. 2012. Legionnaires' disease in England and Wales, 2011, Health Protection Report, vol 6. Health Protection Agency, London, United Kingdom."},{"key":"e_1_3_2_6_2","first-page":"1083","article-title":"Legionellosis\u2014United States, 2000\u20132009","volume":"60","author":"Hicks L","year":"2011","unstructured":"Hicks L, Garrison L, Nelson G, Hampton L. 2011. Legionellosis\u2014United States, 2000\u20132009. 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An outbreak of Legionella pneumophila suspected to be associated with spa pools on display at a retail store in New Zealand. N Z Med J 119(1243):U2253. http:\/\/www.nzma.org.nz\/journal\/119-1243\/2253.","journal-title":"N Z Med J"},{"key":"e_1_3_2_16_2","article-title":"Outbreak of legionellosis associated with a spa pool, United Kingdom","volume":"11","author":"Foster K","year":"2006","unstructured":"Foster K, Gorton R, Waller J. 2006. Outbreak of legionellosis associated with a spa pool, United Kingdom. Euro Surveill 11:pii=3053. http:\/\/www.eurosurveillance.org\/ViewArticle.aspx?ArticleId=3053.","journal-title":"Euro Surveill"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.2807\/ese.15.26.19602-en"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2807\/ese.17.37.20271-en"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0013-9351(86)80003-2"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.08.024"},{"key":"e_1_3_2_21_2","volume-title":"National Standard Method W 12","author":"Health Protection Agency","year":"2006","unstructured":"Health Protection Agency. 2006. Detection and enumeration of Legionella species by filtration and centrifugation. National Standard Method W 12. 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