Premise Plumbing Systems Research Articles

Development of a machine learning model to support low cost real-time Legionella monitoring in premise plumbing systems

Legionella pneumophila (L. pneumophila) is a pathogenic bacterium primarily known for causing Legionnaires’ Disease which is known for high mortality rates, particularly in the elderly. With caseloads continuing to increase, further research is needed to improve our understanding of optimized sampling schema and safe limits of L. pneumophila, in part to target improved treatment options and realistic population-level risk modeling. Particularly in healthcare and other high-risk locations these become crucial and time sensitive needs. Therefore, we conceptualized this research as a means of incorporating easily measured physiochemical water quality parameters and generalization of the unique ecology of building water systems to build a computational model that can allow for more rapid and accurate decision making. This research uses the specific machine learning (ML) method called statistical learning theory to incorporate concentration of host cells, such as native amoeba, and physiochemical water quality parameters to estimate the probability of observing ranges of Legionella gene copy concentrations. Using data from previously published research on Legionella prevalence in a large building, our ML method trains the model on the relative impacts of physiochemical parameters on likely amoeba host cell occurrences. The model is expanded to estimate host cell concentrations using correlations and regressions operated through LASSO algorithms. After categorization variables from these results are then used to inform a logistic regression to provide an estimate of the probability of Legionella gene copy concentration ranges. In summary, conventional results generated by logistic regression and multiple linear regression quantified the associations among ecological conditions in the water and ability to predict a likely range of Legionella concentration in a management focused way. Further, two ML methods, PCA and LASSO, demonstrated feasibility in accurate real-time monitoring of Legionella through physiochemical indicators as evidenced with good accuracy of predictions based for validation results. Furthermore results demonstrate the vital need to account for the impact of water quality on building on host cells, and via their quantified water microbial ecology, not just Legionella concentrations.

Statistical analysis of parameters affecting Legionella and total cell growth in premise plumbing systems within buildings: A field study based on an empirical data set

During the storage and distribution of water in buildings, the excessive growth of pathogens can deteriorate the quality of drinking water. This study aims to investigate the factors influencing this growth and propose technical measures for prevention. The analysis is based on an empirical data set comprising 1361 samples from 204 domestic premise plumbing systems. In 14 systems, ultrafiltration plants were installed as microbiological barriers. Legionella cultivation and flow cytometry were used to determine microbiological properties. The study identified elevated total cell counts in tapping valves and pipe end lines in numerous premise plumbing systems, indicating prolonged water stagnation prior to sampling, which facilitates microbiological growth. Higher contamination rates were observed in these systems, with peripheral taps often being contaminated in lieu of the entire system. These systems were classified as microbiologically unstable due to the relevantly higher total cell numbers at hot water taps compared to the hot water tank (>25%). Furthermore, these systems exhibited a Legionella contamination rate that was 22.3% higher than in microbiologically stable systems. In some cases, peripheral contaminations may not accurately represent the entire premise plumbing system. Increasing the discard volume during sampling from 1 L to 3–5 L could provide more precise results during standard testing. Legionella species were primarily detected in the first 1 L of water after tap activation. Additionally, statistically significant relationships were observed between direct temperature and total cell number, as well as between the presence of ultrafiltration and total cell numbers at cold water taps.

Effects of Copper on Legionella pneumophila Revealed via Viability Assays and Proteomics.

Cu is an antimicrobial that is commonly applied to premise (i.e., building) plumbing systems for Legionella control, but the precise mechanisms of inactivation are not well defined. Here, we applied a suite of viability assays and mass spectrometry-based proteomics to assess the mechanistic effects of Cu on L. pneumophila. Although a five- to six-log reduction in culturability was observed with 5 mg/L Cu2+ exposure, cell membrane integrity only indicated a <50% reduction. Whole-cell proteomic analysis revealed that AhpD, a protein related to oxidative stress, was elevated in Cu-exposed Legionella relative to culturable cells. Other proteins related to cell membrane synthesis and motility were also higher for the Cu-exposed cells relative to controls without Cu. While the proteins related to primary metabolism decreased for the Cu-exposed cells, no significant differences in the abundance of proteins related to virulence or infectivity were found, which was consistent with the ability of VBNC cells to cause infections. Whereas the cell-membrane integrity assay provided an upper-bound measurement of viability, an amoebae co-culture assay provided a lower-bound limit. The findings have important implications for assessing Legionella risk following its exposure to copper in engineered water systems.

Point-of-use filtration units as drinking water distribution system sentinels

Municipal drinking water distribution systems (DWDSs) and associated premise plumbing (PP) systems are vulnerable to proliferation of opportunistic pathogens, even when chemical disinfection residuals are present, thus presenting a public health risk. Monitoring the structure of microbial communities of drinking water is challenging because of limited continuous access to faucets, pipes, and storage tanks. We propose a scalable household sampling method, which uses spent activated carbon and reverse osmosis (RO) membrane point-of-use (POU) filters to evaluate mid- to long-term occurrence of microorganisms in PP systems that are relevant to consumer exposure. As a proof of concept, POU filter microbiomes were collected from four different locations and analyzed with 16S rRNA gene amplicon sequencing. The analyses revealed distinct microbial communities, with occasional detection of potential pathogens. The findings highlight the importance of local, and if possible, continuous monitoring within and across distribution systems. The continuous operation of POU filters offers an advantage in capturing species that may be missed by instantaneous sampling methods. We suggest that water utilities, public institutions, and regulatory agencies take advantage of end-of-life POU filters for microbial monitoring. This approach can be easily implemented to ensure drinking water safety, especially from microbes of emerging concerns; e.g., pathogenic Legionella and Mycobacterium species.

Risks of stannous chloride without filtration for hexavalent chromium treatment

AbstractWith increasing interest in using stannous chloride without filtration to achieve hexavalent chromium maximum contaminant level compliance in California, there is new urgency to quantify its effects on water quality and risks to public health manifested in distribution and premise plumbing systems. Accordingly, a 12‐week groundwater pilot study was completed using ubiquitous premise plumbing materials under flowing (to waste) and stagnating conditions of hexavalent chromium‐containing groundwater following stannous chloride addition without filtration. Results quantified the accumulation and release of chromium and tin, with total chromium concentrations exceeding regulatory or acceptable levels under stagnating conditions. Sediment with elevated chromium, tin, arsenic, and manganese concentrations was also observed. Given these observations would likely occur and worsen over time in distribution systems that cumulatively serve large populations, the use of stannous chloride without filtration represents an unacceptable risk to public health compared to other, more well‐established, best available technologies.

Efficacy of chlorine-based disinfectants to control Legionella within premise plumbing systems

Legionella is an opportunistic waterborne pathogen that causes Legionnaires’ disease. It poses a significant public health risk, especially to vulnerable populations in health care facilities. It is ubiquitous in manufactured water systems and is transmitted via inhalation or aspiration of aerosols/water droplets generated from water fixtures (e.g., showers and hand basins). As such, the effective management of premise plumbing systems (building water systems) in health care facilities is essential for reducing the risk of Legionnaires’ disease. Chemical disinfection is a commonly used control method and chlorine-based disinfectants, including chlorine, chloramine, and chlorine dioxide, have been used for over a century. However, the effectiveness of these disinfectants in premise plumbing systems is affected by various interconnected factors that can make it challenging to maintain effective disinfection. This systematic literature review identifies all studies that have examined the factors impacting the efficacy and decay of chlorine-based disinfectant within premise plumbing systems. A total of 117 field and laboratory-based studies were identified and included in this review. A total of 20 studies directly compared the effectiveness of the different chlorine-based disinfectants. The findings from these studies ranked the typical effectiveness as follows: chloramine > chlorine dioxide > chlorine. A total of 26 factors were identified across 117 studies as influencing the efficacy and decay of disinfectants in premise plumbing systems. These factors were sorted into categories of operational factors that are changed by the operation of water devices and fixtures (such as stagnation, temperature, water velocity), evolving factors which are changed in-directly (such as disinfectant concentration, Legionella disinfectant resistance, Legionella growth, season, biofilm and microbe, protozoa, nitrification, total organic carbon(TOC), pH, dissolved oxygen(DO), hardness, ammonia, and sediment and pipe deposit) and stable factors that are not often changed(such as disinfectant type, pipe material, pipe size, pipe age, water recirculating, softener, corrosion inhibitor, automatic sensor tap, building floor, and construction activity). A factor-effect map of each of these factors and whether they have a positive or negative association with disinfection efficacy against Legionella in premise plumbing systems is presented. It was also found that evaluating the effectiveness of chlorine disinfection as a water risk management strategy is further complicated by varying disinfection resistance of Legionella species and the form of Legionella (culturable/viable but non culturable, free living/biofilm associated, intracellular replication within amoeba hosts). Future research is needed that utilises sensors and other approaches to measure these key factors (such as pH, temperature, stagnation, water age and disinfection residual) in real time throughout premise plumbing systems. This information will support the development of improved models to predict disinfection within premise plumbing systems. The findings from this study will inform the use of chlorine-based disinfection within premise plumbing systems to reduce the risk of Legionnaires disease.

Quantitative Microbial Risk Assessment Framework Incorporating Water Ages with Legionella pneumophila Growth Rates.

Water age in drinking water systems is often used as a proxy for water quality but is rarely used as a direct input in assessing microbial risk. This study directly linked water ages in a premise plumbing system to concentrations of Legionella pneumophila via a growth model. In turn, the L. pneumophila concentrations were used for a quantitative microbial risk assessment to calculate the associated probabilities of infection (Pinf) and clinically severe illness (Pcsi) due to showering. Risk reductions achieved by purging devices, which reduce water age, were also quantified. The median annual Pinf exceeded the commonly used 1 in 10,000 (10-4) risk benchmark in all scenarios, but the median annual Pcsi was always 1-3 orders of magnitude below 10-4. The median annual Pcsi was lower in homes with two occupants (4.7 × 10-7) than with one occupant (7.5 × 10-7) due to more frequent use of water fixtures, which reduced water ages. The median annual Pcsi for homes with one occupant was reduced by 39-43% with scheduled purging 1-2 times per day. Smart purging devices, which purge only after a certain period of nonuse, maintained these lower annual Pcsi values while reducing additional water consumption by 45-62%.

Assessing the Impact of Stochastic Demands and Fixture Purging on Free Chlorine Residuals in Premise Plumbing Systems

Assessing the Impact of Stochastic Demands and Fixture Purging on Free Chlorine Residuals in Premise Plumbing Systems

Microbial and physicochemical water quality changes within distribution and premise plumbing systems during a chlorine conversion

A strategy for nitrification control within chloraminated drinking water systems (CDWSs) is to temporarily switch from chloramine secondary disinfection to free chlorine, also known as a free chlorine conversion (FCC). However, the long-term and beneficial effects of FCCs are unclear, especially regarding opportunistic pathogen occurrence. In this study, the impacts to microbial and physicochemical parameters were monitored throughout a CDWS implementing a FCC. Water samples were collected weekly for 4–6 weeks before, during, and after a FCC at eight locations: four distribution system and four residential sites. Monochloramine residual (mean±standard deviation) before and after the FCC averaged 1.8±0.9 and 1.6±1.0 parts per million (ppm) for all sites, respectively. Free chlorine levels averaged 2.3±0.9 ppm. There were no significant differences in turbidity and hardness at each location during the three time periods, but some were noted for pH, temperature, and orthophosphate levels across various sites and sampling periods. For all locations, heterotrophic plate count levels were lower during the FCC compared to the periods before and after. All samples from one residence were culture positive for P. aeruginosa which exhibited high levels before the FCC, decreasing levels during, and steadily increasing levels after. Additionally, one week prior to the FCC, sediment samples from two elevated storage tanks, ET-1 and ET-2, were analyzed with ET-1 displaying higher levels of culturable heterotrophic bacteria and molecularly detected total bacteria, Legionella spp., and nontuberculous mycobacteria (NTM), as well as presence of culturable P. aeruginosa and total coliforms compared to ET-2. Fourteen P. aeruginosa and total coliform isolates were whole genome sequenced with genetic differences observed depending on the sampling location and timepoint. Collectively, the observed differences in chemical and microbial parameters advocates for a better understanding of the effects associated with implementing FCCs to determine both their effectiveness and potential risks/rewards to water quality.

On-site filtration of large sample volumes improves the detection of opportunistic pathogens in drinking water distribution systems.

In this study, we compared conventional vacuum filtration of small volumes through disc membranes (effective sample volumes for potable water: 0.3-1.0 L) with filtration of high volumes using ultrafiltration (UF) modules (effective sample volumes for potable water: 10.6-84.5 L) for collecting bacterial biomass from raw, finished, and tap water at seven drinking water systems. Total bacteria, Legionella spp., Legionella pneumophila, Mycobacterium spp., and Mycobacterium avium complex in these samples were enumerated using both conventional quantitative PCR (qPCR) and viability qPCR (using propidium monoazide). In addition, PCR-amplified gene fragments were sequenced for microbial community analysis. The frequency of detection (FOD) of Legionella spp. in finished and tap water samples was much greater using UF modules (83% and 77%, respectively) than disc filters (24% and 33%, respectively). The FODs for Mycobacterium spp. in raw, finished, and tap water samples were also consistently greater using UF modules than disc filters. Furthermore, the number of observed operational taxonomic units and diversity index values for finished and tap water samples were often substantially greater when using UF modules as compared to disc filters. Conventional and viability qPCR yielded similar results, suggesting that membrane-compromised cells represented a minor fraction of total bacterial biomass. In conclusion, our research demonstrates that large-volume filtration using UF modules improved the detection of opportunistic pathogens at the low concentrations typically found in public drinking water systems and that the majority of bacteria in these systems appear to be viable in spite of disinfection with free chlorine and/or chloramine.IMPORTANCEOpportunistic pathogens, such as Legionella pneumophila, are a growing public health concern. In this study, we compared sample collection and enumeration methods on raw, finished, and tap water at seven water systems throughout the State of Minnesota, USA. The results showed that on-site filtration of large water volumes (i.e., 500-1,000 L) using ultrafiltration membrane modules improved the frequency of detection of relatively rare organisms, including opportunistic pathogens, compared to the common approach of filtering about 1 L using disc membranes. Furthermore, results from viability quantitative PCR (qPCR) with propidium monoazide were similar to conventional qPCR, suggesting that membrane-compromised cells represent an insignificant fraction of microorganisms. Results from these ultrafiltration membrane modules should lead to a better understanding of the microbial ecology of drinking water distribution systems and their potential to inoculate premise plumbing systems with opportunistic pathogens where conditions are more favorable for their growth.

Photodynamic Inactivation of Opportunistic Premise Plumbing Pathogens and Their Biofilms

Opportunistic premise plumbing pathogens (OPPPs) form a group of microorganisms that normally live in water supply systems and have adapted especially well to the conditions in premise plumbing systems, and as such pose a threat to human health. Since the beginning of the 21st century, this threat has been escalating, and it is becoming increasingly evident that current water disinfection methods fall short in effectively controlling these pathogens. In researching new approaches to this emergency, phototherapy looks promising, especially one that combines photosensitizers, light, and oxygen, which is known as photodynamic inactivation (PDI). This review describes the main characteristics of the recognized (Pseudomonas aeruginosa, Legionella pneumophila, and Mycobacterium avium) and most important emerging OPPPs, and it offers a brief overview of current disinfection methods and their limitations in the fight against OPPPs. The principle and outcomes of PDI with endogenous and, in particular, exogenous photosensitizers are then explained and described through representative examples of PDI on recognized and emerging OPPPs and their biofilms. Finally, the prospects and future directions of PDI research in water disinfection and control of OPPPs are discussed.

Impact of fixture purging on water age and excess water usage, considering stochastic water demands

Higher water ages are linked with water quality decline as chlorine dissipates, temperatures become more favorable for microbial growth, and metals and organic matter leach from the pipes. Water fixtures with automated purging devices can limit water age in premise plumbing systems, but also increase water use. To develop purging strategies that lower age while also minimizing water use, the stochastic nature of water demands must be considered. In this research, a hydraulic plumbing network model, with stochastic demands at fixtures, was used to compare water age and water use for five purging conditions: purging at regular intervals, “smart” purging (considering the time of last use), purging with different volumes of water, purging at different fixtures, and the purging with different levels of home occupancy. Higher purging frequency and volume resulted in lower water ages, but higher water use. Purging greatly reduced the variability in water ages, avoiding extreme ages entirely. Water age was minimized by scheduling the purging around occupancy behavior, such as before the occupants wake up or return from work. Scheduled purging used more water than smart purging. Purging after 12 h of nonuse used only 55% of the additional water required for purging every 12 h. Purging after 24 h of nonuse at the kitchen tap and shower used only 38% of the additional water required for purging every 24 h, while maintaining lower water ages and removing the variability in water ages. While larger purging volumes had a greater impact on water age, there were diminishing returns. Purging has a larger impact on low-occupancy homes because fixtures have less frequent use. Overall, this research provides a methodology to compare purging strategies that minimize both water age and water use. While the numerical results presented here are only valid for the specific layout and usage habits, they provide insights and trends applicable to other cases.

Reducing Water Age in Residential Premise Plumbing Systems

Reducing Water Age in Residential Premise Plumbing Systems

Bacterial populations in different parts of domestic drinking water systems are distinct and adapted to the given ambient temperatures

Drinking water enters buildings with a given microbiological community composition. Within premise plumbing systems, the drinking water is subject to very different conditions and temperatures. Whereas part of the water stays cold, another part is heated to provide hot water. In this study, drinking water samples were taken at different locations in four buildings that had central heating circles and that were equipped with ultrafiltration modules. The latter were intended to keep bacterial numbers low. When studying the increase in bacterial concentrations in these water samples using regrowth tests at different incubation temperatures, a temperature-dependence could be observed. Bacteria in cold water samples propagated best when incubated at 22°C, but often poorly at 36°C and not at all at 50°C. Bacteria in hot water samples showed the reverse behavior and grew best when incubated at 50°C, whereas growth at 22°C was poor or associated with a long growth lag. Water samples from distal taps in periphery locations used for retrieving both cold and hot water showed intermediate growth behaviors. Results suggest the existence of different temperature-adapted bacterial populations within domestic drinking water systems. The finding was supported by sequence data revealing distinct differences in the microbiomes between cold and hot water samples. Abundant bacterial groups in hot water included Deinococci, Kryptonia, Ignavibacteria, Nitrospiria, Gemmatimonadetes and different genera of Gammaproteobacteria. Stagnation of hot water at 50°C, 55°C, or 60°C furthermore shaped the microbiome in different ways indicating that small temperature differences can have a substantial impact on the bacterial communities.

Premise plumbing bacterial communities in four European cities and their association with Legionella

IntroductionLegionella species are Gram negative, facultative, intracellular bacteria found in natural and engineered water systems. Understanding the bacterial interactions underlying the success of Legionella in aquatic environments could be beneficial for control.Materials and methodsWe aimed to profile, by 16S rRNA gene amplicon sequencing (V3-V4), the bacterial communities in premise plumbing systems of buildings in four European cities (Copenhagen, Warsaw, Rome, Athens), and identify positive and negative associations of specific community members to culturable Legionella.ResultsThe coarse taxonomic composition was similar across the four cities, but Copenhagen and Warsaw had richer, more diverse communities than Athens and Rome, with a greater number of city-specific amplicon sequence variants (ASVs). The cities had statistically significant differences in bacterial communities at the ASV level, with relatively few shared ASVs. Out of 5,128 ASVs, 73 were classified as Legionella, and one or more of these were detected in most samples from each city (88.1% overall). Interestingly, the relative abundance of Legionella ASVs did not correlate with Legionella culture status. Overall, 44.2% of samples were Legionella culture positive: 71.4% in Warsaw, 62.2% in Athens, 22.2% in Rome, and 15.2% in Copenhagen. 54 specific ASVs and 42 genera had significant positive or negative associations with culturable Legionella. Negative associations included Staphylococcus, Pseudomonas, and Acinetobacter. Positive associations included several Nitrospira ASVs and one classified as Nitrosomodaceae oc32, ASVs in the amoeba-associated genera Craurococcus-Caldovatus and Reyranella, and the predatory genus Bdellovibrio.DiscussionSome of these associations are well supported by laboratory studies, but others are the opposite of what was expected. This highlights the difficulties in translating pure culture results to in complex real-life scenarios. However, these positive and negative associations held across the four cities, across multiple buildings and plumbing compartments. This is important because developing better control measures, including probiotic approaches, will require an understanding of ecological relationships that can be generalised across different engineered water systems.

Pressure dependent analysis in premise plumbing system modeling.

Modeling premise plumbing systems requires accurate treatment of fixture-specific pressure and flow rate relationships. Each fixture in a building may experience different flow rates based on variable service pressure, its unique pressure-flow behavior, and demands throughout the building. Unique experimentally derived pressure-flow parameters for four faucets, a shower/tub fixture, and toilet were developed. The Water Network Tool for Resilience (WNTR) was also used to explore the impact of premise plumbing systems on water distribution systems through two simple skeletonization cases. Minimum pressures for nodes in water distribution system models that represent demand aggregated premise plumbing systems will likely be non-zero and must capture additional pressure drop or elevation differences at the building scale and associated components, such as water meters or backflow preventers. Results showed that flow rates are impacted by pressure in these systems in complex ways, and usage and system characteristics must be considered to be modeled accurately.

Relative Water Age in Premise Plumbing Systems Using an Agent-Based Modeling Framework.

Tools used to predict hydraulics and water quality within premise plumbing systems have gained recent interest. An open-source Python-based tool-PPMtools-for modeling and analyzing premise plumbing systems with WNTR or EPANET is presented. A relative water age-the time water has spent in a home-study using three real-world single-family homes was used to demonstrate PPMtools. Results showed that increased use-more people or higher flow fixtures-led to a general decrease in relative water ages. However, even with more use, one user could still experience water for a drinking activity with a relative water age equal to, or longer than, the duration of the longest stagnant period (sleeping or absence from home). Simulations also showed that the general relative water ages increased if the homes were plumbed with larger diameter piping [19.1 mm (3/4 in.) versus 12.7 mm (1/2 in.)]. Hot water heaters were found to have the largest impact on relative water age. Smaller volume uses generally had more variability in relative water ages, while larger volume uses (e.g., showering) resulted in generally low relative water ages with less variability because larger uses fully replaced water in the home with water from the main. This study highlights the potential for using PPMtools to explore more complex water quality modeling within premise plumbing systems.

Reduction in water consumption in premise plumbing systems: Impacts on lead concentration under different water qualities

Water conservation measures are increasing in response to regulatory requirements addressing the need for lower environmental footprint and in response to water shortages. In households with lead service lines (LSLs), lowering consumption can adversely impact lead release as it will increase stagnation. Using a lead dissolution model and data from extensive pilot studies on excavated LSLs, the impact of adaptation to different water conservation strategies on dissolved lead contamination at the kitchen tap is assessed under three water qualities and three LSL lengths (3, 14 and 30 m) using hydraulic and water quality modelling. Consumers' behavioural variability is also assessed based on integration of EPANET and results of the stochastic water demand model SIMDEUM. Demand reduction increased the dissolved lead concentrations (Pbdiss) at the end of the LSL with mean values ranging from 28.4 to 63.3 μg/L (without corrosion control) and from 4.6 to 9.9 μg/L with corrosion control (addition of orthophosphate and pH adjustment). Adding orthophosphate (1 mg P/L) to the water reduces the mean Pbdiss values at the kitchen tap from 7.1 μg/L to 1.2 μg/L for a high water demand scenario and from 31.2 to 4.9 μg/L for a low water demand scenario. Finally, the Integrated Exposure Uptake Biokinetic (IEUBK) model is used to predict the potential blood lead levels (BLLs) for children aged 0–84 months. Results showed that the orthophosphate addition of only 1 mg P/L can significantly decrease the proportion of children with a BLL >5 μg/dL, from 82 % to 17 %, under the most extreme water conservation scenario studied, using the 90th percentile of Pbdiss concentrations during usage at kitchen tap. Wide variations of Pbdiss concentrations at the kitchen tap were calculated at times of use over a week (up to 155 μg/L in lower demand scenarios, without corrosion control) showing evident limitations of single random daytime sampling.

Flushing Temporarily Improves Microbiological Water Quality for Buildings Supplied with Chloraminated Surface Water but Has Little Effect for Groundwater Supplies.

Microbial communities in premise plumbing systems were investigated after more than 2 months of long-term stagnation, during a subsequent flushing event, and during post-flush stagnation. Water samples were collected from showers in buildings supplied with chlorinated groundwater, untreated groundwater, and chloraminated surface water. The building supplied with chlorinated groundwater generally had the lowest bacterial concentrations across all sites (ranging from below quantification limit to 5.2 log copies/L). For buildings supplied with untreated groundwater, bacterial concentrations (5.0 to 7.6 log copies/L) and microbial community diversity index (ACE) values were consistent throughout sampling. Nontuberculous mycobacteria (NTM) and Legionella pneumophila were not detected in any groundwater-supplied buildings. Total bacteria, Legionella spp., and NTM were abundant in the surface water-supplied buildings following long-term stagnation (up to 7.6, 6.2, and 7.6 log copies/L, respectively). Flushing decreased these concentrations by ∼1 to >4 log units and reduced microbial community diversity, but the communities largely recovered within a week of post-flush stagnation. The results suggest that buildings supplied with disinfected surface water are more likely than buildings supplied with treated or untreated groundwater to experience deleterious changes in microbiological water quality during stagnation and that the water quality improvements from flushing with chloraminated water, while substantial, are short-lived.

The benefits of flushing for mitigating Legionella spp. in non-chlorinated building plumbing systems

Flushing is a common corrective action recommended by Legionella management guidelines to remove stagnant water and replenish disinfectant. Due to water age and different local regulations, buildings may receive water with low or no residual disinfectant. In such situations, the evidence for flushing efficacy is often anecdotal, and the benefits are poorly quantified. Using a pilot-scale premise plumbing system, flushed shower outlets were evaluated against non-flushed outlets during simulated periods of both active and low water demand. Water and biofilm concentrations of total bacteria, Legionella spp., and Vermamoeba vermiformis were quantified using real-time quantitative PCR. Even after all outlets returned to active water demand, flushed shower outlets continued to have lower quantities of Legionella compared to non-flushed outlets for several days, but the decrease was of little practical benefit (&amp;lt;0.5 log10[copies/L]). During prolonged periods of low water demand, however, there was no apparent benefit to flushing. Total bacteria grew to stationary phase within 3 ± 1 days, while Legionella spp. took 12 ± 6 days, regardless of whether the pipes had recently been flushed or not. Flushing with hot or cold water had little to no effect on the concentrations of total bacteria and Legionella in pipe wall biofilms. Flushing with cold water (9.6 and 13.2°C) decreased total bacteria concentrations in the water by 0.96 and 1.00 log10[copies/L], respectively and by 1.27 and 1.74 log10[copies/L] with hot water (49 and 60°C, respectively) but the difference in Legionella spp. concentrations between flushing with cold (1.55 log10[copies/L] for both) and hot water (1.32 to 1.88 log10[copies/L], respectively) was negligible. This suggests that hot water flushing, even at 60°C, provides little or no added benefit for managing Legionella in non-chlorinated building plumbing systems versus cold water flushing. Finally, the immediate benefits of flushing in terms of reductions in total bacteria and Legionella in the water were comparable as well as the rates at which those populations recovered during post-flush or post-shower stagnation.