Antibiotic residues in water pose a threat to human health

According to a comprehensive analysis published in The Lancet Planetary Health by the Karolinska Institute, antibiotic residues in wastewater and sewage treatment plants in surrounding areas of China and India may contribute to antibiotic resistance, and drinking water may pose a threat
to human health.
The researchers also identified the relative contributions of various sources of antibiotic contamination in waterways, such as hospitals, municipalities, livestock, and pharmaceuticals
.

Nada Hanna, lead author of the study and a researcher in the Department of Global Public Health at Karolinska Institutet in Sweden, said: "Our results can help policymakers take risk-reduction measures against environmental residues and high-risk sites of priority antibiotics to protect human health and the environment
.
" "The effective allocation of these resources is particularly important
for resource-poor countries that produce large quantities of antibiotics.
"

Antibiotic-resistant bacteria are a global threat that can lead to incurable bacterial infections
in animals and humans.

Antibiotics can enter the environment
during production, consumption and disposal.
Antibiotic residues in the environment, such as those in wastewater and drinking water, can lead to the emergence and spread
of resistance.

From literature published between 2006 and 2019

The researchers examined levels of antibiotic residues in different aquatic sources in the Western Pacific Region (WPR) and South-East Asia Region (SEAR), as defined by the World Health Organization
.
These include China and India, the world's largest producers and consumers of antibiotics
.

This is through a systematic review of literature published between 2006 and 2019, including 218 WPR-related reports and 22 SEAR-related reports
.
The researchers also used a method called probabilistic environmental hazard assessment to identify places
where antibiotic concentrations are high enough to lead to antibiotic resistance.

WPR detected 92 antibiotics and SEAR 45
.
Antibiotic concentrations above safe levels considered to be resistant (expected no-impact concentrations, PNECs)
were observed in wastewater, effluent and effluent from wastewater treatment plants, and in the received aquatic environment.
The highest risk is observed in the influent water of wastewater and sewage treatment plants
.
The relative impact of
various contributors such as hospitals, municipalities, livestock and pharmaceuticals was also identified.

There is a potential threat to human health

In the receiving water environment, the level of resistance to the antibiotic ciprofloxacin in drinking water and WPR in China is most
likely to exceed the threshold considered safe.

"Antibiotic residues in wastewater and wastewater treatment plants can become hotspots for the development of antibiotic resistance in these areas and pose a potential threat
to human health through exposure to different water sources, including drinking water," said Nada Hanna.

A limitation to consider when interpreting the results is the lack of data on the occurrence of antibiotics in the environment in many countries in the region, and the inclusion of only studies
written in English.

The study was funded
by the Swedish Research Council.
The researchers claim that there is no conflict of
interest.