Environmental Risks Explained by an expert -showers, swimming, hiking

Posted by Sue, Volunteer Mentor @sueinmn, Oct 22 10:35am

This was posted today by a noted expert in NTM regarding risks and aerosols on another NTM & Bronchiectasis site. (ntminfo.org)
For those of you asking about enjoying the outdoors, rest assured that your risk of infection from your surroundings is low because of SPACE - in open air any germs are well-diluted by huge volumes of air.
His post:
"Yes, with the fact that MAC and NTM are everywhere, the concern is that there is no safe place.

Well, the important fact to remember is space. Showering in a bathroom exposes someone to a high density of NTM aerosolized from water to air by the showerhead. Further, staying in the misty bathroom means the exposure duration is longer.

Outside, NTM mists from waterfalls and rapids are diluted by the large volume of outside air. The same holds true for a hot tub. Outside hot tubs of spas are okay because the mist from the tub or spa is diluted by the outdoor air. An indoor spa or hot tub exposes one to an NTM mist in a closed space for a long period of time.

Swimming in lakes and streams is okay as long as you don't swallow lots of water and have gastric reflux (GERD), again as the aerosols from the water are diluted by the vast volume of air.

Outside rambles are fine, as long as one doesn't find themselves in an enclosed space, like a cave or grotto by waterfalls."
Joseph Falkinham
Professor of Microbiology
Virginia Tech

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

@jenniferhunter

I hold my breath anytime there is dust or smoke, and then put on a mask or respirator. We decided not to get a leaf blower because it will just blow everything into the air. I also have trouble in hotels because of carpet powder used in cleaning and I take a respirator with me just in case. I’ve also hauled an air filter with me into hotels and that is a lot of extra effort.

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That is why we like to travel with our camper - we are in total control of our environment!

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@sueinmn

According to Dr Falkinham, cool mist vaporizers should never be used - even with distilled water. The only same kind is a steam vaporizer. Even then, the tank should be according to manufacturer instructions at least weekly.

As for bath vs shower, there is probably less steam associated with a bath, if it is warm water and not hot water producing clouds of steam - again it is about exposure - the less steam, you are exposed to, the fewer number of organisms you will breathe in.

For myself, I prefer a quick, hot shower with the bath fan running (and in summer the window wide open) to a tepid bath.

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The cool mist vaporizers make tiny droplets and when the water evaporates, it leaves a dust which is the precipitate of minerals that were dissolved in the water. Boiling water to create steam causes a phase change to steam, and the precipitates should be left behind. Distilled water is boiled to create steam, and the steam is cooled to phase change back to liquid water.

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@sueinmn

That is why we like to travel with our camper - we are in total control of our environment!

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That makes a lot of sense.

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@jenniferhunter

@sueinmn Sue, I have a question. I was wondering how much lung infection risk would be associated with using a leaf blower or being in the area when a lawn crew is using one? I would expect this to be a potential source of spreading dust, bacteria and fungal spores that you wouldn’t want to inhale.

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Interesting that you raise that question. I believe I have had BE/MAI a good few years before I was diagnosed and am of the belief '"the straw that broke the camels back" was blowing dry leaves away from the house foundation in 2021. I didn't normally do that myself but it was Covid and my help couldn't come to to do it as he normally did for me.
Diagnosed with BE in 2022 after having lost 35 pounds and my PCP finally understood, after a year or so of saying SOMETHING IS WRONG WITH ME, yes there is something wrong with you. He ordered the CScan and then called me in to the office to explain the result and held my hand as he told me BE.
Barbara

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@pb50

I contracted this in my late 20’s after a trip to NYC for a small student conference. The water supply in our restaurant that might was stored in a rooftop tank - not uncommon in New York. We left town the next day. Long story short, about 25% us developed pneumonia - really bad pneumonia. I was told for 3 days in the ER That my fever wasn't rising to 103 at might - I must be reading the thermometer wrong. They took an x-ray and said it was normal. Bronchitis they said. I told them i was sleeping in their waiting room. And predictably by 2- 3 am i was coughing so hard i couldn't breathe and my fever was 103. They admitted me for overnight into a ward. (I was broke college student with no insurance). The next say they came running into the ward and hustled me into a private room. Turns out the overexposed x-ray was a white-out and I had ARDS. After cultures and more films i was diagnosed with macoplasmic (?) pneumonia and was a long time recovering. I am positive if i got it today i would die.

Long story to say this is a bad bad bug .

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In the mid 80's I contracted mycoplasma pneumonia and legionella pneumonia at the same time. My PCP at the time saved my life. I believe it leaves a 'scar' and eventually one does develop the BE that may not become full blown until later years. At least I believe that is what happened for me....BE delayed until late in my life....30 years after the pneumonias and having lived life with all that we are subjected to.
Barbara

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The CDC came to the small GA town where i was in school. they believed the number of us in NYC who became so acutely ill were infected by contaminated water storage on the roof of the reataurant - aka legionella. It was a very long recovery for someone in their 20’s.

What is BE?

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@pb50

The CDC came to the small GA town where i was in school. they believed the number of us in NYC who became so acutely ill were infected by contaminated water storage on the roof of the reataurant - aka legionella. It was a very long recovery for someone in their 20’s.

What is BE?

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BE is shorthand for Bronchiectasis, a lung disease characterized by "stretching out" and calcification of the bronchioles, so they are unable to function properly to remove mucus from the lung.

Like Barbara (@blm1007blm1007) it is likely my bronchiectasis developed after years of repeated bronchitis and pneumonia infections that were not well-treated as well as exposure to a number of toxic environments as a kid & young adult. All of this was probably made worse by asthma that I didn't take seriously enough, leading to long-term undertreatment.

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How dreadful! I have been prone to pneumonia since that event and have had lung cancer a couple of years ago. I wear masks a lot and get every vaccine i can sign up for - pneumonia, RSV, covid, flu - and counting. Interestingly i am not prone to bronchitis and virtually never cough.

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Here in NYC we have the street cleaning trucks that come around with their big rotating brushes which kick up an enormous dust cloud of every awful thing imaginable. I have actually run when I have seen them coming on days I don't have a mask handy.

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@sueinmn

BE is shorthand for Bronchiectasis, a lung disease characterized by "stretching out" and calcification of the bronchioles, so they are unable to function properly to remove mucus from the lung.

Like Barbara (@blm1007blm1007) it is likely my bronchiectasis developed after years of repeated bronchitis and pneumonia infections that were not well-treated as well as exposure to a number of toxic environments as a kid & young adult. All of this was probably made worse by asthma that I didn't take seriously enough, leading to long-term undertreatment.

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In 2012 I contracted Pseudomonas, I have no idea how. The Dr kept thinking I was having asthma problems. I didn't look sick for most of the time until the end. Finally after 5 Dr.s and the last being an infectious Dr he knew what it was. First question, how long have you been hoarse? I told him a year and that it felt like I was breathing through a thick web or a thick piece of cheese cloth. He knew what it was. Confirmed with sputum samples and got rid of it. By the end of the year my lungs were so damaged from the year long episode with Pseudomonas that all of the little hairy things in the lungs were either deformed and destroyed. I could no longer move mucus out of my lungs. That led to many other infections, one after another. Finally I got an airway clearance device but by that time I think I had already had so many infections and so much scarring, Bronchiectasis had arrived. If I had have found the correct Dr with the Pseudomonas sooner, I do not believe that I would have the lung issues that I have today.

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