레지오넬라균 출현위해도에 대한 현행 온천수 수질기준의 적합성 분석
Validation of Korean Water Quality Standards to Hot Springs for Agreement with Legionella-Incidence Risk
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초록
온난화, 고령화, 세계화로 인하여 변화하는 국내 보건환경에 현행 수질기준이 적합할 지 평가가 필요하다. 본 연구는 총대장균군 만으로 규정된 현행 온천수 수질기준의 타당성을 환경유래 내열성세균인 레지오넬라균 오염도를 검출로 평가하였다. 온천수에서 레지오넬라균을 검출한 7개의 논문에 보고된 미생물 자료에 대한 메타분석을 실시하였다. 레지오넬라균의 검출 유무의 오즈비는 총대장균군과 유의한 상관도를 보였다[odds ratio (OR), 3.1 (1.5−6.4, 95% CI), p = 0.002]. 그러나, 레지오넬라균 오염을 분변성 중온균인 총대장균군 지표가 감지할 수 있다는 점은 단순히 설명되지 않기에, 그 기작을 검토하였다. 레지오넬라균의 검출 유무는 일반세균수와 더 높은 오즈비를 보였고[4.0(2.2−7.2), p < 0.001], 40°C 미만의 수온범위에서 수온과 강한 상관도[OR, 4.3(1.4− 13.6), p = 0.011], 50°C 이상에서는 수온과 음의 상관도를 보였다[OR, 0.2 (0.1−0.4), p < 0.001]. 따라서, 수온에 의하여 세균의 현존량이 결정되는 현상 때문에 총대장균군수와 레지오넬라균 유무가 연관성을 가진 것으로 판단된다. 이에 따르면, 총대장균군보다 일반세균수가 더 직접적으로 비분변성 병원체의 증감을 반응할 것으로 생각되므로, 일반세균수를 단일 수질관리 기준으로 사용하거나, 현행 기준에 일반세균수를 추가하는 것이 타당한 것으로 판단된다.
Abstract
Observed trends in climate change, globalization and an aging population have an effect on public health conditions in Korea, prompting a reevaluation of current environmental regulations. In this study, we evaluated the performance of the total coliform (TC) standard, which is the only microbiological standard in the current regulation regime for hot spring water, by estimating correlation with the presence/absence of Legionella, a non-fecal opportunistic pathogen with heat-tolerance. Microbiological data in 7 studies that surveyed Legionella in hot spring waters were subjected to meta-analyses with the odds ratio (OR) as the effect size. The presence/absence of Legionella was significantly correlated to TC levels [OR = 3.1(1.5−6.4, 95% CI), p = 0.002]. Due to there being no direct explanation as to the reason for the occurrence of TC, mesophilic fecal bacteria, being coupled with Legionella presence, the mechanism of the correlation between the two kinds of bacteria was further investigated. Legionella presence was more prevalent with a high heterotrophic plate count [HPC; 4.0(2.2−7.2); p < 0.001] and water temperature [4.3(1.4−13.6), p = 0.011] when the temperature range was <40℃. However, it was reverse-correlated with water temperature when the temperature was >50℃ [0.2(0.1−0.4), p < 0.001]. Therefore, bacterial standing crops in hot spring waters appear to be determined by water temperature in general, and this forces TC and Legionella levels be correlated. In accordance with this relationship, HPC rather than TC reflect the levels of non-fecal contamination better. Therefore, employing HPC as the sole microbiological standard, or adding HPC into the current standard of hot spring water assessment, is suggested as a proactive measure to prevent health issues arising from contamination.
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