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Environmental mycobacteriosis and drinking water: what are the connections?
Citation:
HILBORN, E. D. AND A. J. GHIO. Environmental mycobacteriosis and drinking water: what are the connections? Presented at International conference of Emerging Infectious Diseases, Atlanta, GA, February 29 - March 03, 2008.
Impact/Purpose:
research results
Description:
Background: During the last 20 years, incidence rates of pulmonary environmental mycobacteriosis appear to be increasing in the US and other developed countries. Environmental mycobacteria have been detected in multiple media: soil, ground and surface waters, water aerosols and treated drinking water. The US Environmental Protection Agency regulates drinking water quality and has been directed to examine emerging contaminants for potential regulation under the Safe Drinking Water Act. The Agency has included Mycobacterium avium complex on the most recent Contaminant Candidate List of emerging drinking water contaminants. Methods: We systematically review the published peer-reviewed literature for reports of epidemiologic and/or molecular association between pulmonary environmental mycobacteriosis and drinking water among residents of developed countries. Results: We found multiple species of environmental mycobacteria implicated as the causative agent of human pulmonary disease and found in drinking water. Species associated with waterborne pulmonary mycobacteriosis vary by region and country of report but are most commonly slow-growing species such as M. avium and M. kansasii. Conclusions: There is clear evidence that drinking water is a source of pulmonary environmental mycobacteriosis; however the etiologic fraction of disease attributable to drinking water is unknown. Population-based studies including data collected at the individual level are needed to estimate the magnitude of risk associated with drinking water exposure. This is an abstract of a proposed presentation and does not necessarily reflect EPA policy.