Airborne infections and modern building technology

Abstract

Over the last 30 yr an increased appreciation of the importance of airborne infection has evolved. The concept of droplet nuclein, infectious particles from 0.5 to 3 μ which stay suspended in air for long periods of time, has been accepted as an important determinant of infectivity. Important airborne pathogens in modern buildings include Legionella pneumophila, Aspergillus sp., thermophilic actinomycetes, Mycobacterium tuberculosis, measles, varicella and rubella. Perhaps, the most important microbiologic threat to most buildings is L. pneumophila. This organism can multiply in water cooling systems and contaminate effluent air which can be drawn into a building and efficiently circulated throughout by existing ventilation systems. Hospitals are a special problem because of the concentration of immunosuppressed patients who are uniquely susceptible to airborne diseases such as aspergillosis, and the likelihood that patients ill from diseases than can be spread via the airborne route will be concentrated. Humidifiers are yet another problem and have been shown to be important in several outbreaks of allergic alveolitis and legionellosis. Control of airborne infections is largely an effort at identifying and controlling reservoirs of infection. This includes regular biocide treatment of cooling towers and evaporative condensers and identification and isolation of patients with diseases that may be spread via the airborne route.