ASTM D5952-96e1
(Guide)Standard Guide for Inspecting Water Systems for Legionellae and Investigating Possible Outbreaks of Legionellosis (Legionnaires' Disease or Pontiac Fever)
Standard Guide for Inspecting Water Systems for Legionellae and Investigating Possible Outbreaks of Legionellosis (Legionnaires' Disease or Pontiac Fever)
SCOPE
1.1 This guide covers appropriate responses for employers, building owners and operators, facility managers, health and safety professionals, public health authorities, and others: (1) to a concern that a manmade water system may be contaminated with the bacteria known as legionellae (see 6.1); and (2) to the identification of one or more cases of Legionnaires' disease or Pontiac fever due to inhalation of airborne legionellae (see 6.3-6.5). Comprehensive and explicit recommendations to limit legionella multiplication in water systems and to disinfect potential sources of human exposure to legionellae are beyond this guide's scope.
1.2 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use. See 7.3 and 8.5 for specific hazard statements.
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e1
Designation: D 5952 – 96
Standard Guide for
Inspecting Water Systems for Legionellae and Investigating
Possible Outbreaks of Legionellosis (Legionnaires’ Disease
or Pontiac Fever)
This standard is issued under the fixed designation D 5952; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (e) indicates an editorial change since the last revision or reapproval.
e NOTE—Paragraphs 1.1, 2.1, and 6.2 were editorially corrected in January 2001.
1. Scope D 3370 Practices for Sampling Water from Closed Con-
duits
1.1 This guide covers appropriate responses for employers,
D 3856 Guide for Good Laboratory Practices in Laborato-
building owners and operators, facility managers, health and
ries Engaged in Sampling and Analysis of Water
safety professionals, public health authorities, and others: (1)to
D 4840 Guide for Sample Chain-of-Custody Procedures
a concern that a manmade water system may be contaminated
E 645 Test Method for Efficacy of Microbicides Used in
with the bacteria known as legionellae (see 6.1); and (2)tothe
Cooling Systems
identification of one or more cases of Legionnaires’ disease or
E 1427 Guide for Selecting Test Methods to Determine the
Pontiac fever due to inhalation of airborne legionellae (see
Effectiveness of Antimicrobial Agents and Other Chemi-
6.3-6.5). Comprehensive and explicit recommendations to
cals for the Prevention, Inactivation, and Removal of
limit legionella multiplication in water systems and to disinfect
Biofilm
potential sources of human exposure to legionellae are beyond
2.2 APHA Documents:
this guide’s scope.
The Public Health Law Manual, Second Edition
1.2 This standard does not purport to address all of the
Standard Methods for the Examination of Water and Waste-
safety concerns, if any, associated with its use. It is the
water, Seventeenth Edition
responsibility of the user of this standard to establish appro-
2.3 ASHRAE Documents:
priate safety and health practices and determine the applica-
Cooling Towers. Handbook—Heating, Ventilating, and Air-
bility of regulatory limitations prior to use. See 7.3 and 8.5 for
Conditioning Systems and Equipment
specific hazard statements.
Codes and Standards. Handbook—Heating, Ventilating, and
2. Referenced Documents
Air-Conditioning Systems and Equipment
Water Treatment. Handbook—Heating, Ventilating, and Air-
2.1 ASTM Standards:
Conditioning Systems and Equipment
D 512 Test Methods for Chloride Ion in Water
2.4 ASM Documents:
D 596 Practice for Reporting Results of Analysis of Water
Manual of Clinical Microbiology, Fifth Edition
D 887 Practices for Sampling Water-Formed Deposits
2.5 CDC Documents:
D 1067 Test Methods for Acidity or Alkalinity of Water
Guideline for Prevention of Nosocomial Pneumonia
D 1129 Terminology Relating to Water
Hospital-Laboratory Diagnosis of Legionella Infections
D 1192 Specification for Equipment for Sampling Water
Procedures for the Recovery of Legionella from the Envi-
and Steam in Closed Conduits
ronment
D 1293 Test Methods for pH of Water
D 1356 Terminology Relating to Sampling and Analysis of
Atmospheres
D 2331 Practices for Preparation and Preliminary Testing of
Annual Book of ASTM Standards, Vol 11.05.
Water-Formed Deposits 6
Available from the American Public Health Association, 1015 18th St. N.W.,
Washington, DC 20036, USA, 1990, 1989.
Available from the American Society of Heating, Refrigerating and Air-
This guide is under the jurisdiction of ASTM Committee D-22 on Sampling and Conditioning Engineers, Inc., 1791 Tullie Circle, NE, Atlanta, GA 30329, USA.
Analysis of Atmospheres and is the direct responsibility of Subcommittee D22.05 Rodgers, F. G., and Pasculle, W., “Legionella,” in Manual of Clinical
on Indoor Air. Microbiology, Balows, A., Ed., American Society for Microbiology, Washington,
Current edition approved May 10, 1996. Published September 1996. DC 20005, USA, 1991, pp. 442–453.
2 9
Annual Book of ASTM Standards, Vol 11.01. Available from the U.S. Department of Health and Human Services, Public
Annual Book of ASTM Standards, Vol 11.02. Health Service, Centers for Disease Control and Prevention, Atlanta, GA 30333,
Annual Book of ASTM Standards, Vol 11.03. USA, 1987, 1992, 1994.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
D 5952
3. Terminology laboratory test as caused by or associated with legionella
infection.
3.1 Definitions from Compilation of ASTM Standard Defi-
3.2.17 contamination, n— with legionellae, the presence of
nitions.
legionellae on or in inanimate articles or substances.
3.1.1 air conditioning, n—the simultaneous control of all,
3.2.18 convalescent phase, n— of legionellosis, the recov-
or at least the first three, of those factors affecting both the
ery phase of infection, typically four to eight weeks following
physical and chemical conditions of the atmosphere within any
symptom onset.
structure. These factors include temperature, humidity, motion,
3.2.19 cooling tower, n—a structure for lowering water
distribution, dust, bacteria, odor, and toxic gases.
temperature evaporatively by contact with atmospheric air.
3.1.2 monitoring, n—the continual sampling, measuring,
3.2.20 DFA, adj—direct fluorescent-antibody.
recording, or signaling, or both, of the characteristics of water
3.2.21 dead leg, n—a length of pipe closed at one end or
or waterborne material.
ending at a fitting through which water flows only when the
3.1.3 pH, n—the negative logarithm of hydrogen-ion activ-
fitting is open.
ity in aqueous solution or the logarithm of the reciprocal of the
3.2.22 direct fluorescent-antibody test, n—for legionellae,a
hydrogen-ion activity.
staining procedure that detects legionella surface antigens
3.1.4 sampling, n—obtaining a representative portion of the
through the use of specific antibodies labelled with fluorescent
material concerned.
compounds; bacteria to which antibody has attached fluoresce
3.1.5 scale, n—a deposit formed from solution directly
when viewed under appropriate irradiation.
upon a surface.
3.2.23 disinfect, v—to eliminate virtually all pathogenic
3.1.6 sludge, n—a water-formed sedimentary deposit.
microorganisms, but not necessarily all microbiological forms,
3.2 Definitions of Terms Specific to This Standard:
outside the body by direct exposure to chemical or physical
3.2.1 acute phase, n— of legionellosis, the initial phase of
agents.
infection; the first weeks following symptom onset.
3.2.24 drift, n—from water-cooled heat-transfer equipment,
3.2.2 aerosol, n—solid or liquid particles suspended in air.
water droplets carried from a cooling tower or other water-
3.2.3 antibody, n—to legionellae, a substance in blood
cooled heat-transfer system by air movement through the unit;
synthesized in response to legionella antigen that enters the
drift can be confused with condensed water vapor appearing as
body.
steam leaving a unit.
3.2.4 antibody rise, n— in legionella antibody, an increase
3.2.25 drift eliminator, n—a plastic, metal, or wood baffle
in the highest serum dilution at which legionella antibody is
designed to entrain water droplets and to reduce aerosol
detected in a blood sample collected weeks or months after
escape.
legionellosis onset as compared with the highest dilution for a
3.2.26 evaporative condenser, n—a heat exchanger in
sample collected before or shortly after illness onset.
which refrigerant is cooled by a combination of air movement
3.2.5 antigen, n—to legionellae, a legionella molecule that
and water spraying.
stimulates an antibody response by a host immune system.
3.2.26.1 Discussion—Evaporative air coolers (swamp cool-
3.2.6 aseptically, adv—using precautions to prevent con-
ers), which do not produce large numbers of water droplets,
tamination of samples by microorganisms.
have not been associated with legionella transmission to date.
3.2.7 back-flow preventer, n—a control valve to prevent
3.2.27 exhaust outlet, n— in a ventilation system, an outlet
reverse flow of water.
from which an air-handling system discharges air outdoors.
3.2.8 bacterium, n—pl. -ria, typically small unicellular
3.2.28 false-negative, adj—incorrectly indicating the ab-
microorganism.
sence of a finding, condition, or disease.
3.2.9 biocide, n—for legionellae, a chemical used to kill
3.2.29 false-positive, adj—incorrectly indicating the pres-
legionellae and other microorganisms.
ence of a finding, condition, or disease.
3.2.10 biofilm, n—a layer of microorganisms contained in a
3.2.30 free residual chlorine, n—the total concentration of
matrix that may form a slime on surfaces in contact with water.
hypochlorous acid and hypochlorites available to act as disin-
3.2.11 CDC, n—Centers for Disease Control and Preven-
fectant.
tion, U.S. Public Health Service, Atlanta, Georgia.
3.2.31 genus, n—a taxonomic classification of organisms;
3.2.12 clean, adj—visibly free of sludge, sediment, scale,
the division between the family or tribe and the species; a
biofilm, algae, fungi, rust, corrosion, and extraneous matter.
group of species alike in broad organizational features but
3.2.13 clean, v—to remove sludge, sediment, scale, biofilm,
different in detail.
algae, fungi, rust, corrosion, and extraneous matter by physical
3.2.32 gram-negative, adj—losing the primary violet or
or chemical means.
blue stain during decolorization in Gram’s staining method.
3.2.14 colony, n—of legionellae, a macroscopic group of
3.2.33 HVAC, adj—heating, ventilating, and air-
legionella cells arising from bacterial multiplication on the
conditioning.
surface of semisolid culture medium.
3.2.15 colony-forming unit, n— of legionellae, a colony 3.2.34 humidifier, n—a device for adding moisture to air by
boiling, spraying, or atomizing water.
arising from the multiplication of one or a cluster of viable
legionellae. 3.2.35 IFA, adj—indirect fluorescent-antibody.
3.2.16 confirmed case, n— of Legionnaires’ disease, a case 3.2.36 immunocompromised, adj—a person’s state when the
of physician-diagnosed pneumonia verified by at least one body’s natural defenses to infection are below normal.
D 5952
3.2.37 in vitro, adj—(Latin: in glass), refers to laboratory occurrence exceeding the number expected in a given time
tests performed in a test tube or other container as opposed to period and locale.
a living system; the opposite of in vivo. 3.2.56 outdoor air intake, n— for ventilation systems,an
3.2.38 in vivo, adj—(Latin: in living), refers to laboratory opening through which outdoor air is introduced into a
building’s air-handling system.
tests performed in living organisms; the opposite of in vitro.
3.2.57 PCR, adj—polymerase chain reaction.
3.2.39 incubation period, n— of legionellosis, the time
3.2.58 polymerase chain reaction test, n— a technique for
interval between initial contact with legionellae and appear-
selecting and amplifying specific genetic sequences.
ance of the first legionellosis sign or symptom.
3.2.59 Pontiac fever, n—a self-limited, short-duration, non-
3.2.40 indirect fluorescent-antibody test, n—for legionella
fatal fever caused by or associated with legionellae.
antibodies, a staining procedure that detects serum antibodies
3.2.60 probable case, n— of legionellosis, the occurrence of
to legionellae through the use of bacteria fixed on a glass slide;
an illness clinically compatible with legionellosis in a person
secondary test antibodies labelled with fluorescent compounds
with a legionella antibody titer of 256 or higher when only a
attach to fixed legionellae/serum antibody complexes and
single blood sample is available.
fluoresce when viewed under appropriate irradiation.
3.2.61 protozoan, n—pl. -a, single-celled microorganism
3.2.41 infection, n—with legionellae, the entry and devel-
representing the lowest form of animal life.
opment, or multiplication, of legionellae in humans.
3.2.62 RIA, adj—radioimmunoassay.
3.2.42 inspector, n—a person examining an environment
3.2.63 radioimmunoassay test, n—an immunological proce-
for possible contamination with legionellae.
dure in which a radioisotope-labelled compound is reacted with
3.2.43 investigator, n—a person conducting an epidemio-
a test material and the attached radioisotope is detected by
logical investigation of a potential legionellosis outbreak.
various means.
3.2.44 isolate, n—a microorganism grown from a clinical or
3.2.64 sensitivity, n— of a test for legionellosis or legionel-
environmental sample.
lae, a method’s ability to detect the presence of the disease
3.2.45 isolate, v—in vitro growth of microorganisms on
(that is, legionellosis) or the causative agent (that is, legionella)
culture medium.
being tested.
3.2.46 Legionella, n—a bacterial genus containing at least
3.2.65 serogroup, n—of legionella, a subgroup within a
30 species and at least 50 serogroups; abbreviated to the first
legionella species.
initial when used repeatedly with species names, for example,
3.2.66 serology, n—the study of blood serum for evidence
L. pneumophila.
of infection, performed by evaluating antigen-antibody reac-
3.2.47 legionella, n—pl. -ae, a bacterium in the genus
tions in vitro.
Legionella.
3.2.67 serum, n—pl. -a, the clear, thin, sticky fluid portion
3.2.48 legionellosis, n—an illness caused by or associated
of blood remaining after coagulation.
with legionella infection; two forms of legionellosis due to
3.2.68 source, n—of legionellae, the water system, supply,
inhalation of airborne legionellae are recognized, that is,
or equipment from which legionellae pass to a host.
Legionnaires’ disease and Pontiac fever.
3.2.69 species, n—a taxonomic classification of organisms;
3.2.49 Legionnaires’ disease, n—an illness characterized by
the division between genus and variety or individual; a group
pneumonia and caused by or associated with legionella infec-
of organisms bearing a close resemblance in essential organi-
tion, most often L. pneumophila.
zational features.
3.2.50 maintain, v—to perform regular and routine activi-
3.2.70 specificity, n— of a test for legionellosis or legionel-
ties aimed at preserving equipment, operational standards and
lae, a method’s ability to identify accurately an illness as
cleanliness; includes inspection, repair, preventive servicing,
legionellosis or a bacterium as a legionella; a method’s ability
and cleaning.
to select and distinguish legionella from all other bacteria in the
3.2.51 maintenance program, n—the assembly of relevant
same environment.
data and the setting out of a formal strategy and recording
3.2.71 sporadic case, n— o
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