INvestigating Home water and Aerosols' Links to opportunistic pathogen Exposure (INHALE): do consumer decisions impact pathogen exposure and virulence?

当人们洗澡时，通过与水接触和吸入产生的气溶胶，他们暴露在数十亿个细菌细胞中。虽然这些生物体中的许多是无害的，但一些与饮用水有关的病原体（DWPIs）是严重健康风险的主要原因，特别是对免疫系统较弱的个体而言。如今，美国淋浴喷头市场的特点是有多种选择，消费者可以选择他们想要在淋浴系统中使用的喷雾模式、材料、流速和添加剂（例如杀菌化学品）。然而，我们对消费者选择淋浴喷头如何直接影响淋浴水中和淋浴水中产生的气溶胶中dwpi的存在和数量的基本了解有限。这个项目的首要目标是解决这个知识鸿沟。为了实现这一目标，首席研究员（pi）将在实验淋浴实验室中测试不同喷雾模式、水流速率和添加剂的淋浴喷头，目的是测量和比较淋浴水中和淋浴水中产生的气溶胶中dwpi的浓度。该项目的成功完成将通过生成新的数据和基础知识使消费者能够选择优先考虑其健康的淋浴喷头，同时增强对淋浴系统和建筑环境中dwpi雾化的基本了解，从而造福社会。通过学生教育和培训，包括在匹兹堡大学指导一名研究生和一名本科生，将为社会带来额外的好处。饮用水相关病原体引起的肺部感染主要引起免疫功能低下个体（DWPI）的感染，是美国发病率和死亡率的主要原因。虽然有许多dwpi，但据估计，嗜肺军团菌、非结核分枝杆菌（NTM）和铜绿假单胞菌每年给美国经济造成23.9亿美元的损失。虽然DWPI暴露可通过多种途径发生，但吸入与水有关的气溶胶与感染最相关。雾化作用是dwpi传播途径中的一个关键步骤，但人们对其了解甚少。具体来说，我们对消费者的喷头选择（喷雾模式、流速和材料添加剂）如何影响DWPI的毒性和从水到气溶胶相的分配知之甚少。本研究的长期目标是定量评估不同淋浴喷头设置产生的气溶胶所造成的DWPI暴露风险，并确定不同设置是否会选择更大的DWPI暴露和更致命的DWPI。这一目标将通过两个研究目标来实现。目标1将在实验淋浴实验室中测试一系列不同的淋浴喷头设置，并使用ddPCR量化淋浴水中及其相关气溶胶中嗜肺乳杆菌、铜绿假单胞菌和NTM的丰度，并为每个DWPI和淋浴喷头建立淋浴水到气溶胶的分配模型。目的2将使用基因组、动力学、生物膜聚集和巨噬细胞感染试验的组合来研究淋浴喷头设置对生物体适应性和毒力的作用。这项研究的成功完成有可能产生变革性影响，因为它产生了新的数据和基本知识，包括与淋浴水中和淋浴水中产生的气溶胶中存在的多水污染物质有关的人体健康暴露和风险的机制模型。为了实现项目的教育和培训目标，项目负责人建议利用匹兹堡大学（U Pitt） Swanson工程学院现有的项目，如EXCEL项目，从代表性不足的群体中招募和指导本科生参与项目。此外，pi计划将项目研究成果整合到皮特大学的相关本科和研究生课程中。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

As people take showers, they are exposed to billions of bacterial cells through contact with the water and inhalation of produced aerosols. While many of these organisms are harmless, some drinking water-associated pathogens (DWPIs) are a leading cause of serious health risks, especially for individuals with weakened immune systems. Today, the showerhead market in the United States features a wide range of options which leave consumers to select the type of spray pattern, material, flow rate, and additives (e.g., bacterial killing chemicals) that they want to have in their shower systems. However, we have a limited fundamental understanding of how consumer choices of showerheads directly influence the presence and amounts of DWPIs in shower water and shower water produced aerosols. The overarching goal of this project is to address this knowledge gap. To advance this goal, the Principal Investigators (PIs) will test showerheads with different spray patterns, water flow rates, and additives in an experimental shower lab with the goal of measuring and comparing the concentrations of DWPIs present in shower water and shower water produced aerosols. The successful completion of this project will benefit society through the generation of new data and fundamental knowledge that could enable consumers to select showerheads that prioritize their health while enhancing the fundamental understanding of the aerosolization of DWPIs in shower systems and the built environment. Additional benefits to society will be achieved through student education and training including the mentoring of one graduate student and one undergraduate student at the University of Pittsburgh. Pulmonary infections from drinking water-associated pathogens predominantly causing infections in immunocompromised individuals (DWPI) are a leading cause of morbidity and mortality in the United States. Although there are many DWPIs, Legionella pneumophila, nontuberculous mycobacteria (NTM) and Pseudomonas aeruginosa are estimated to cost the United States economy $2.39 billion annually. Although DWPI exposure can occur through a variety of pathways, inhalation of water associated aerosols are most associated with infection. Aerosolization, a critical step in the transmission pathway of DWPIs, remains poorly understood. Specifically, little is known about how consumer showerhead choices (spray pattern, flow rate, and material additives) influence DWPI virulence and partitioning from the water to aerosol phase. The long-term goals of this study are to quantitively assess the DWPI exposure risk posed by aerosols produced by different showerhead setups and ascertain if different setups select for greater DWPI exposure and more virulent DWPIs. This goal will be achieved through two research objectives. Objective 1 will test a range of different showerhead setups in an experimental shower lab and quantify the abundance of live L. pneumophila, P. aeruginosa, and NTM in shower water and its associated aerosols using ddPCR and develop shower water to aerosol partitioning models for each DWPI and showerhead. Objective 2 will use a combination of genomic, kinetic, biofilm aggregation, and macrophage infectivity assays to investigate the role that showerhead setup has on organism fitness and virulence. The successful completion of this research has the potential for transformative impact through the generation of new data and fundamental knowledge including mechanistic models of exposure and risk to human health related to the presence of DWPIs in shower water and shower water produced aerosols. To implement the education and training goals of the project, the PIs propose to leverage existing programs at the University of Pittsburgh (U Pitt) Swanson School of Engineering such as the EXCEL program to recruit and mentor undergraduate students from underrepresented groups to work on the project. In addition, the PIs plan to integrate the project research findings into relevant undergraduate and graduate courses at U Pitt.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.