Quantitative Microbial Risk Assessment

Provides the latest QMRA methodologies to determine infection risk
cause by either accidental microbial infections or deliberate
infections caused by terrorism

• Reviews the latest methodologies to quantify at every
  step of the microbial exposure pathways, from the first release of
  a pathogen to the actual human infection

• Provides techniques on how to gather
  information, on how each microorganism moves through the
  environment, how to determine their survival rates on various
  media, and how people are exposed to the microorganism

• Explains how QMRA can be used as a tool to measure the
  impact of interventions and identify the best policies and
  practices to protect public health and safety

• Includes new information on genetic methods

• Techniques use to develop risk models for drinking
  water, groundwater, recreational water, food and pathogens in the
  indoor environment

Auteur

Charles N. Haas is the head of the department of Civil,
Architectural and Environmental Engineering at Drexel University
and the Betz Chair Professor of Environmental Engineering. He
has served on numerous advisory committees of the US EPA and the
National Research Council

Joan Rose serves as the Homer Nowlin Chair in Water
Research at Michigan State University, the Co-Director of the
Center for Advancing Microbial Risk Assessment (CAMRA) and the
Director of the Center for Water Sciences (CWS). She is a
member of the National Academy of Engineering.

Charles P. Gerba is a Professor in the department of
Soil, Water and Environmental Science at the University of Arizona.
He is the author of 11 books and over 400 journal papers. Dr. Gerba
is a member of the U.S. Environmental Protection Agency's Science
Advisory Board Committees on Drinking Water and Research
Strategies.

Résumé
Provides the latest QMRA methodologies to determine infection risk cause by either accidental microbial infections or deliberate infections caused by terrorism
• Reviews the latest methodologies to quantify at every step of the microbial exposure pathways, from the first release of a pathogen to the actual human infection
• Provides techniques on how to gather information, on how each microorganism moves through the environment, how to determine their survival rates on various media, and how people are exposed to the microorganism
• Explains how QMRA can be used as a tool to measure the impact of interventions and identify the best policies and practices to protect public health and safety
• Includes new information on genetic methods
• Techniques use to develop risk models for drinking water, groundwater, recreational water, food and pathogens in the indoor environment

Contenu

Preface xi

Chapter 1 Motivation 1

Prevalence of Infectious Disease 1

Prior Approaches 4

Scope of Coverage 4

Potential Objectives of a QMRA 5

Site-Specific Assessment 5

Ensemble of Sites 6

Secondary Transmission 7

Outbreaks versus Endemic Cases 7

References 10

Chapter 2 Microbial Agents and Transmission 15

Microbial Taxonomy 15

Eukaryotes 15

Prokaryotes 18

Viruses 20

Prions 22

Clinical Characterization 24

Microorganisms of Interest 27

Viruses 27

Bacteria 37

Protozoa 42

Transmission Routes 45

Inhalation 48

Dermal Exposure 50

Oral Ingestion 50

References 55

Chapter 3 Risk Assessment Paradigms 63

Chemical Risk Assessment: National Academy of Sciences Paradigm 63

Ecological Risk Assessment 67

Approaches for Assessing Microbial Risks 71

Background 71

The QMRA Framework 74

Hazard Identification 74

DoseResponse Assessment 74

Exposure Assessment 76

Risk Characterization 77

Risk Management 79

Development of the QMRA Framework and Processes 79

QMRA and the Safety of Water 82

QMRA, Food Safety, and the HACCP System 84

References 86

Chapter 4 Conducting The Hazard Identification (HAZ ID) 91

Identifying and Diagnosing Infectious Disease 92

Health Outcomes Associated with Microbial Infections 95

Sensitive Populations 100

Women during Pregnancy, Neonates, and Young Babies 101

Diabetes 102

The Elderly 102

The Immunocompromised 104

Databases for Statistical Assessment of Disease 106

ICD Codes 107

Waterborne and Foodborne Outbreaks 111

Epidemiological Methods for Undertaking HAZ ID 117

Controlled Epidemiological Investigations 118

HAZ ID Data Used in the Risk Assessment Process 119

Recommendations for Updating Quantitative Data for HAZ ID Information 121

References 122

Chapter 5 Analytical Methods and The QMRA Framework: Developing Occurrence and Exposure Databases 129

Introduction 129

Approaches for Developing Occurrence and Exposure Databases 132

Overview of Methodological Issues 134

Sampling Water 136

Sampling Surfaces and Food 138

Sampling Aerosols 138

Specific Techniques for Bacteria, Protozoa, and Viruses 140

Bacteria 140

Protozoa 142

Viruses 143

Molecular Techniques 145

Probes (FISH) 146

Typing 146

Metagenomics 147

PCR and Quantitative PCR 147

References 151

Chapter 6 Exposure Assessment 159

Conducting the Exposure Assessment 159

Characterizing Concentration/Duration Distributions 160

Random (Poisson) Distributions of Organisms 160

Estimation of Poisson Mean in Count Assay (Constant and Variable Volumes) 162

Count Assay with Upper Limits 163

Estimation with Quantal Assay 164

Goodness of Fit to Poisson: Plate Assay 168

Goodness of Fit: MPN 178

Confidence Limits: Likelihood 182

Implications for Risk Assessment 187

Consumption Distributions 214

Systematic Subpopulation Differences 221

Afterword 223

Appendix 224

Microsoft Excel 224

MATLAB 225

R 227

References 230

Chapter 7 Predictive Microbiology 235

Objective 235

Basic First-Order Processes and Deviations 236

Biological and Physical Bases for Deviations 236

Physical Removal 238 Types ...