Laying the groundwork for a Legionella pneumophila risk management program for public drinking water systems.

Legionella pneumophila is different from traditional drinking water contaminants because it presents a latent public health risk for public and private drinking water systems and for the building water systems they supply. This paper reviews information on the likelihood of occurrence of L. pneumophila in public water systems to lay a foundation for public water systems, as a stakeholder in public health risk management, to better manage L. pneumophila. Important to this approach is a literature review to identify conditions that could potentially promote L. pneumophila being present in drinking water systems at either an elevated abundance or at an increased frequency of occurrence, and/or water quality and supply conditions that would contribute to its amplification. The literature review allows the development of an inventory of hazardous conditions that a public water system could experience and, therefore, can be used by water systems to develop control and monitoring strategies. However, effective L. pneumophila risk management programs are hampered by significant data and knowledge gaps. Priority research to advance public water system's risk assessments and management of L. pneumophila is proposed.