An evaluation of public health issues associated with, or arising from, drainage-based infection spread

Some microorganisms can grow in water while others merely survive. The use of the water may result in the creation of aerosols which can disseminate the products of microbial growth or the microorganisms themselves. In the home, toilets, sinks and showers can provide a reservoir for microorganisms to survive and grow. Intermittent use of disinfectants alone may not be adequate to control these microorganisms unless regular cleaning and brushing is practiced. Similar problems occur in hospitals, offices and public buildings. Here control is much more important. In these environments infections can potentially spread readily to large numbers of people from the creation of aerosols both in sanitary equipment and the sewerage system associated with it. Control is helped by regular cleaning but much more attention needs to be placed on proper construction, servicing and maintenance of the infrastructure. This article reviews the types of microorganisms associated with growth in water and with faecal material and how these organisms are spread. The nature and impact of the spread is illustrated with a number of published examples.