Strategies for safe living among lung transplant recipients: a single-center survey.
BACKGROUND
Lung transplant (LT) recipients are at high risk for infection owing to lifelong immunosuppression and direct communication of the graft with the environment. Guidelines have been established for safe-living strategies after transplantation. We conducted a survey of LT patients to determine compliance with these strategies.


METHODS
Adult LT outpatients completed a survey consisting of questions on a 5-point Likert scale with the following categories: hand washing, gardening, respiratory infections, food and water safety, animal contact, travel, and occupation.


RESULTS
A total of 194 LT recipients completed the survey (age 54.4 ± 13.3 years; time post transplant 4.76 ± 3.5 years). Regular hand washing was practiced usually or always by 87.6%. Of those who worked with soil/gardened, 70/99 (70.7%) never wore a mask and 15.7% never wore gloves. Pet ownership was common (52%), but most patients used specific precautions during handling. Over one-third of patients continued employment after transplant but, of these, 56% had modified their occupation often because of perceived infectious risks. Most patients were fully compliant with influenza vaccination (92.3%). Patients <40 years of age were less likely to wear long-sleeved clothing in mosquito season (P = 0.002), more likely to handle pet feces (P = 0.005), and less likely to wear a mask with sick contacts (P = 0.021).


CONCLUSIONS
We provide important insight into safe-living practices following lung transplantation and identify specific areas and subgroups of patients that could be targeted for enhanced education, with potential significant clinical benefit.
Transplant Infectious Diseases, University Health Network, Toronto, Ontario, Canada.
A
A
Jain
A
A
Humar
D
D
Lien
J
J
Weinkauf
D
D
Kumar
D000293:Adolescent; D000328:Adult; D000368:Aged; D060766:Drinking Water; D005260:Female; D059022:Food Safety; D051639:Gardening / Q000706:statistics & numerical data; D006084:Graft Rejection / Q000517:prevention & control*; D006235:Hand Disinfection; D015438:Health Behavior; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016040:Lung Transplantation; D008297:Male; D008397:Masks / Q000706:statistics & numerical data*; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data; D057805:Pets; D011795:Surveys and Questionnaires; D066027:Transplant Recipients; D014195:Travel / Q000706:statistics & numerical data; D055815:Young Adult
D060766:Drinking Water; D007166:Immunosuppressive Agents
exposure; immunosuppression; infection; lung transplant; safe-living practices survey