Legionella
Continued from previous page
Healthy Indoors 45
Conclusions
Legionnaires' Disease is a preventable building
related illness that infects thousands of Ameri-
cans every year, resulting in many unnecessary
deaths. The system established by the nation's
public health agencies is far from adequate,
misses most cases, investigates only a small
percentage of them, and by its own metrics is
failing. With as estimated 250% rise in inci-
dence rates since 2000 and no signs of abating,
a different approach must be considered.
Numerous factors are believed to increase the
risk of Legionnaires' Disease. Combined with
the rising number of susceptible people in our
communities we should anticipate a surge in
outbreaks and sporadic cases acquired in both
healthcare facilities and the community at large.
The collision of contributing environmental
factors with increasing risks of Legionnaires'
disease should spur efforts to shift from surveil-
lance and reactionary responses to lethal out-
breaks to proactive preventive programs run by
competent professionals.
Dr. David Krause, the national practice leader for
building health sciences at Geosyntec Consultants,
holds a Doctorate in Environmental and Occu-
pational Health and Masters of Science in Public
Health from the University of South Florida. He has
20 years of experience in environmental science
and public health, focusing in the areas of toxicol-
ogy, occupational health, industrial hygiene, indoor
air quality, and chemical emission testing. Prior to
joining Geosyntec, Dr. Krause served as the State
Toxicologist for the Florida Department of Health
and led efforts to investigate potential public health
risks associated with corrosive Chinese drywall and
the Deepwater Horizon Oil Spill. He coauthored
the 2009 Florida DOH Guidelines for the Surveil-
lance, Investigation, and Control of Legionnaires'
Disease in Florida. David is a Certified Industrial
Hygienist with expertise in combustion products,
flame retardants, irritant chemical exposures, indoor
air quality, Legionnaires disease, and mold.
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Despite challenges of doing this with the sam-
pling and measurement methods currently
available we should not simply abandon efforts
to prevent illness and disease associated with
Legionella. By moving away from the existing
CDC reactionary approach and implementing a
proactive approach based upon core principles
of Industrial Hygiene we can begin lowering the
number of people who contract Legionnaires'
disease and are made ill or die every year.
