20.500.12556/RUL-190918 Trend naraščanja legioneloz: analiza sodobnih dejavnikov tveganja magistrsko delo The rising trend of legionellosis: analysis of contemporary risk factors master thesis Uvod: Legioneloze predstavljajo vse pomembnejši javnozdravstveni izziv, njihovo naraščanje pa je povezano s prepletanjem okoljskih, tehnoloških in sistemskih dejavnikov. Poleg značilnosti in upravljanja vodovodnih sistemov postajajo vse pomembnejši sodobni dejavniki tveganja, povezani s podnebnimi spremembami, energetskim prehodom ter spremembami temperaturnih razmer v vodovodnih sistemih. Teoretično izhodišče: Višje zunanje temperature lahko prispevajo k segrevanju hladne vode v internih vodovodnih napeljavah, medtem ko lahko ukrepi za zmanjševanje porabe energije in vode spreminjajo temperaturne in hidravlične razmere v sistemih. Poseben izziv predstavljajo hladnovodni sistemi in že vzpostavljena kolonizacija, saj lahko bakterije rodu Legionella ob ugodnih pogojih vztrajajo v biofilmu in se razmnožujejo tudi v hladni vodi. Namen: Namen magistrskega dela je bil preučiti sodobne dejavnike tveganja za naraščanje legioneloz ter v empiričnem delu preveriti prisotnost in koncentracijo bakterij Legionella spp. v hladni vodi interne vodovodne napeljave v povezavi z vremenskimi in temperaturnimi razmerami, zlasti med vročinskimi valovi in ob intenzivnih padavinah. Metode dela: V sedmih objektih je bilo v različnih vremenskih in temperaturnih razmerah odvzetih skupno 72 vzorcev hladne pitne vode. Spremljali smo vremenske pogoje, temperaturo hladne vode ob odvzemu vzorca in po dveh minutah točenja, izbrane fizikalno-kemijske parametre ter prisotnost in koncentracijo bakterij Legionella spp. Rezultate smo analizirali glede na temperaturo hladne vode in vremenske razmere ter jih povezali z izbranimi značilnostmi objektov in internih vodovodnih napeljav. Rezultati: Med vročinskima valovoma je temperatura hladne vode na posameznih odvzemnih mestih dosegla oziroma presegla 25 °C tako ob odvzemu vzorca kot po dveh minutah točenja. Prisotnost bakterij Legionella spp. je bila statistično značilno pogostejša pri temperaturah hladne vode ≥ 20 °C, tako ob odvzemu vzorca (79,2 % proti 27,1 %; p < 0,001) kot po dveh minutah točenja (76,9 % proti 37,3 %; p = 0,013). Rezultati so pokazali tudi pogosto ponavljanje pozitivnih rezultatov na istih odvzemnih mestih, kar poudarja pomen predhodnega stanja internega vodovodnega sistema in morebitne že vzpostavljene kolonizacije. Vpliv vročinskih valov na koncentracijo bakterij Legionella spp. ter vpliv intenzivnih padavin na njihovo prisotnost z rezultati ni bilo mogoče statistično potrditi. Zaključek: Rezultati kažejo, da je segrevanje hladne vode pomemben dejavnik, povezan s prisotnostjo bakterij Legionella spp., pri čemer je pomembno tudi predhodno stanje vodovodnega sistema. Introduction: Legionellosis represents an increasingly important public health challenge, and its rising incidence is associated with an interplay of environmental, technological, and system-related factors. In addition to the characteristics and management of water systems, contempo-rary risk factors associated with climate change, the energy transition, and changing tempera-ture conditions within water systems are becoming increasingly important. Theoretical background: Higher outdoor temperatures can contribute to the warming of cold water in pre-mise plumbing systems, while measures aimed at reducing energy and water consumption may alter temperature and hydraulic conditions within these systems. Cold-water systems and established colonisation pose a particular challenge, as bacteria of the genus Legionella can persist in biofilms under favourable conditions and proliferate even in cold water. Aim: The aim of this master’s thesis was to examine contemporary risk factors associated with the rising incidence of legionellosis and, in the empirical part, to assess the presence and concentration of Legionella spp. in cold water within premise plumbing systems in relation to weather and tem-perature conditions, particularly during heatwaves and periods of intense rainfall. Methods: A total of 72 cold drinking water samples were collected from seven buildings under different weather and temperature conditions. Weather conditions, cold-water temperature at the time of sampling and after two minutes of flushing, selected physicochemical parameters, and the pre-sence and concentration of Legionella spp. were monitored. The results were analysed in rela-tion to cold-water temperature, weather conditions, and selected characteristics of the buildings and premise plumbing systems. Results: During the two heatwaves, cold-water temperatures at individual sampling points reached or exceeded 25 °C both at the time of sampling and after two minutes of flushing. The presence of Legionella spp. was significantly more frequent at cold-water temperatures ≥ 20 °C, both at the time of sampling (79.2 % vs. 27.1 %; p < 0.001) and after two minutes of flushing (76.9 % vs. 37.3 %; p = 0.013). The results also showed frequent recurrence of positive findings at the same sampling points, highlighting the impor-tance of the prior condition of the premise plumbing system and potential established colonisa-tion. The effects of heatwaves on Legionella spp. concentrations and of intense rainfall on their presence could not be statistically confirmed. Conclusion: The results indicate that cold-water warming is an important factor associated with the presence of Legionella spp., while the prior condition of the water system also plays an important role. magistrska dela sanitarno inženirstvo Legionella legioneloza hladna pitna voda interne vodovodne napeljave vročinski valovi padavine master's theses sanitary engineering Legionella legionellosis cold drinking water premise plumbing systems he-atwaves rainfall true false false [A. Sovinc] Slovenski jezik Angleški jezik Magistrsko delo/naloga 2026-11-07 07:46:00 2026-11-07 07:46:14 2026-11-09 08:48:30 0000-00-00 00:00:00 2026 0 Ljubljana 0 Ljubljana IX, 48 str., [11] str. pril. 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 614 171227 304369155 66302.pdf 66302.pdf 1 78EB68F4E00230B8ED8AA6EA83AC9E6B c7d221f67b31af5c813a4e469ccc8dbb915e6342da66259799f5874c62e05a06 d6ee2de7-da76-11f1-aea2-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=252720 Zdravstvena fakulteta 0 0 0