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REVIEW article

Front. Public Health
Sec. Environmental health and Exposome
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1415157

A Review of Legionella Transmission Risk in Built Environments: Sources, Regulations, Sampling, and Detection

Provisionally accepted
Xiaohui Yao Xiaohui Yao 1Fan Shen Fan Shen 1*Jing Hao Jing Hao 2Lu Huang Lu Huang 3Bin Keng Bin Keng 4
  • 1 Beijing Center for Disease Prevention and Control (Beijing CDC), Beijing, China
  • 2 Beijing Fengtai Disease Prevention and Control Center, Beijing, Beijing Municipality, China
  • 3 Beijing Dongcheng district Center for Disease Prevention and control, Beijing, China
  • 4 Beijing Huairou District Center for Disease Prevention and Control, Beijing, China

The final, formatted version of the article will be published soon.

    The risk of Legionella transmission in built environments remains a significant concern. Legionella can spread within buildings through aerosol transmission, prompting the exploration of airborne transmission pathways and proposing corresponding prevention and control measures based on building characteristics. To this end, a comprehensive literature review on the transmission risk of Legionella in built environments was performed. Four electronic databases (PubMed, Web of Science, Google Scholar, and CNKI) were searched from inception to March 2024 for publications reporting the risk of Legionella transmission in built environments. Relevant articles and gray literature reports were hand-searched, and 108 studies were finally included. Legionella pollution comes from various sources, mainly originates in a variety of built environments in which human beings remain for extended periods. The sources, outbreaks, national standards, regulations, and monitoring techniques for Legionella in buildings are reviewed, in addition to increases in Legionella transmission risk due to poor maintenance of water systems and long-distance transmission events caused by aerosol characteristics. Air and water sampling using various analytical methods helps identify Legionella in the environment, recognize sources in the built environments, and control outbreaks. By comparing the standard regulations of national organizations globally, the authors further highlight gaps and deficiencies in Legionella surveillance in China. Such advancements offer essential insights and references for understanding and addressing Legionella transmission risk in the built environment, with the potential to contribute to safeguarding public health and building environment safety.

    Keywords: Legionella, built environment, aerosol, transmission risk, Monitoring

    Received: 10 Apr 2024; Accepted: 08 Jul 2024.

    Copyright: © 2024 Yao, Shen, Hao, Huang and Keng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fan Shen, Beijing Center for Disease Prevention and Control (Beijing CDC), Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.