Legionnaires' disease is a type of pneumonia caused by
freshwater bacteria of the genus Legionella. Previous
studies have shown that monochloramine disinfection of
municipal water supplies is associated with decreased risk
of Legionnaires' disease transmitted in healthcare settings.
The authors performed a two-year, prospective environmental
study to determine whether converting from
chlorine to monochloramine for water disinfection
would decrease Legionella colonization of hot water
systems. Results of the study showed a significant reduction.
Legionella colonized 60% of the hot water systems
before monochloramine conversion versus 4% after
conversion. These findings suggest that monochloramine
in drinking water provides better control of Legionella
growth in building plumbing systems than does chlorine.
Although control of Legionnaires' disease is unlikely to
be a major factor in a water utility's decision to convert
to monochloramine for residual disinfection, if water
suppliers convert to monochloramine to reduce concentrations
of disinfection byproducts, control of the
growth of Legionella in potable water systems may be an
additional health benefit. Includes 37 references, tables, figure.