One-time screening to define the problem: Legionella exposure in an electric power company

An electric utility screened 1,455 production employees for job exposure to Legionella pneumophila sources, illness history, and antibodies to L pneumophila serotypes I-IV. L pneumophila-associated illness outbreaks had occurred in a neighboring electric utility district; bacteria serocompatible with L pneumophila had been detected in all four plants participating in an environmental survey, and the company was concerned about the implications of these findings for their employees and the public living near power plants with large cooling towers. The survey revealed a prevalence of antibodies in employees consistent with general population surveys. Within the employee group, antibody titer was not associated with either reports of recent illness or work exposure to potential L pneumophila sources. Inability to detect a relationship between exposure to potential L pneumophila sources and specific antibody results was used to define L pneumophila as a historic nonproblem for this company and to rationally advise against the need for an ongoing screening program.