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Sporadic cases of community acquired legionnaires’ disease: an ecological study to identify new sources of contamination
  1. D Che,
  2. B Decludt,
  3. C Campese,
  4. J C Desenclos
  1. Institut de Veille Sanitaire, Saint Maurice, France
  1. Correspondence to: 
 Dr B Decludt, Institut de Veille Sanitaire, Département des Maladies Infectieuses, 12 rue du Val d’Osne, 94415 Saint Maurice cédex, France; 


Study objective: To explore the relation between incidence of sporadic and community acquired legionnaires’ disease and exposure to potentially contaminated industrial aerosols.

Design: Geographical ecological approach using the postcode as the statistical unit. A multivariate Poisson regression model was used to model the relation between exposure to industrial aerosols and legionnaires’ disease.

Setting: Metropolitan France.

Main results: More than 1000 sources of industrial exposure (aerosol and plume of smoke) were identified in 42 French departments. After adjusting for confounding factors, there was a statistically increased incidence of legionnaires’ disease in postcodes with plume of smoke in comparison with postcodes without (RR=1.45, 95% CI=1.12 to 1.87), and in postcodes with more than one aerosol in comparison with postcodes without (RR=1.37, 95% CI=1.04 to 1.79).

Conclusion: These findings highlight that any industrial systems generating water aerosols should be regarded as potential sources of contamination for legionnaires’ disease.

  • legionnaires’ disease
  • industrial exposure
  • Poisson modelling
  • ecological study

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  • Funding: this work was supported by the Fondation pour la Recherche Médicale, France.

  • Conflicts of interest: none.

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