Flushing of stagnant premise water systems after the COVID-19 shutdown can reduce infection risk by Legionella and Mycobacterium spp.

Raymond M. Hozalski, Timothy M. LaPara, Xiaotian Zhao, Taegyu Kim, Michael B. Waak, Tucker Burch, Michael McCarty

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37 Scopus citations


There is concern about potential exposure to opportunistic pathogens when reopening buildings closed due to the COVID-19 pandemic. In this study, water samples were collected before, during, and after flushing showers in five unoccupied (i.e., for ∼2 months) university buildings with quantification of opportunists via a cultivation-based assay (Legionella pneumophila only) and quantitative PCR. L. pneumophila were not detected by either method; Legionella spp., nontuberculous mycobacteria (NTM), and Mycobacterium avium complex (MAC), however, were widespread. Using quantitative microbial risk assessment (QMRA), the estimated risks of illness from exposure to L. pneumophila and MAC via showering were generally low (i.e., less than a 10−7 daily risk threshold), with the exception of systemic infection risk from MAC exposure in some buildings. Flushing rapidly restored the total chlorine (as chloramine) residual and decreased bacterial gene targets to building inlet concentrations within 30 min. During the postflush stagnation period, the residual chlorine dissipated within a few days and bacteria rebounded, approaching preflush concentrations after 6−7 days. These results suggest that flushing can quickly improve water quality in unoccupied buildings, but the improvement may only last a few days.

Original languageEnglish (US)
Pages (from-to)15914-15924
Number of pages11
JournalEnvironmental Science and Technology
Issue number24
StatePublished - 2020

Bibliographical note

Funding Information:
The authors thank Scott Bernardson, Kirk Hall, and Tony Gutterman from UMN Facilities Management for their assistance with building access and sampling. The authors also thank personnel at the Minnesota Department of Health (MDH), especially Anita Anderson, Kim Larsen, and Alex Bartley, for guidance in the development of a sampling and flushing plan. Finally, the authors thank MDH for financial support of this research.

Publisher Copyright:
© 2020 American Chemical Society. All rights reserved.

Copyright 2020 Elsevier B.V., All rights reserved.

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  • Journal Article


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