{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:19:41Z","timestamp":1783703981440,"version":"3.55.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100021078","name":"Norwegian Institute of Public Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100021078","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Infection by <jats:italic>Legionella<\/jats:italic> bacteria is a risk to elderly individuals in health care facilities and should be managed by preventing bacterial proliferation in internal water systems. Norwegian legislation calls for a mandatory <jats:italic>Legionella<\/jats:italic>-specific risk assessment with the subsequent introduction of an adapted water management programme. The present study investigates adherence to legislation and guidelines on <jats:italic>Legionella<\/jats:italic> control and prevention in Norwegian nursing homes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cross-sectional survey was distributed to Norwegian municipalities to investigate the status of <jats:italic>Legionella<\/jats:italic> specific risk assessments of internal water distribution systems and the introduction of water management programmes in nursing homes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 55.1% (<jats:italic>n<\/jats:italic>\u2009=\u2009228) of the participating nursing homes had performed <jats:italic>Legionella<\/jats:italic>-specific risk assessments, of which 55.3% (<jats:italic>n<\/jats:italic>\u2009=\u2009126) stated that they had updated the risk assessment within the last year. 96.5% introduced a water management programme following a risk assessment, whereas 59.6% of the ones without a risk assessment did the same. Nursing homes with risk assessments were more likely to monitor <jats:italic>Legionella<\/jats:italic> levels than those without (61.2% vs 38.8%), to remove dead legs (44.7% vs 16.5%), and to select biocidal preventive treatment over hot water flushing (35.5% vs 4.6%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study presents novel insight into <jats:italic>Legionella<\/jats:italic> control in Norway, suggesting that adherence to mandatory risk assessment in nursing homes is moderate-low. Once performed, the risk assessment seems to be advantageous as an introduction to future <jats:italic>Legionella<\/jats:italic> prevention in terms of the scope and contents of the water management programme.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-024-18993-x","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T11:45:34Z","timestamp":1717501534000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Adherence to Legionella control regulations and guidelines in Norwegian nursing homes: a cross-sectional survey"],"prefix":"10.1186","volume":"24","author":[{"given":"Anders","family":"Bekkelund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Line \u00d8deg\u00e5rd","family":"Angeloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ettore","family":"Amato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Hyllestad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"18993_CR1","unstructured":"World Health Organization. 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