Risk ranking of macrolide antibiotics - Release levels, resistance formation potential and ecological risk.

Antibiotic resistance (AR) development in natural water bodies is a significant source of concern. Macrolide antibiotics in particular have been identified as pollutants of concern for AR development throughout the literature, as well as by state and international authorities. This study utilises a probabilistic model to examine the risk of AR development arising from human-use macrolide residues, utilising administration rates from Ireland as a case study. Stages modelled included level of administration, excretion, degradation in wastewater, removal in wastewater treatment, assuming conventional activated sludge (CAS) treatment, and dilution. Release estimates per day, as well as risk quotient values for antibiotic resistance development and ecological impact, are generated for erythromycin, clarithromycin, and azithromycin. In the modelled scenario in which conventional activated sludge treatment is utilised in wastewater treatment, this model ranks risk of resistance development for each antibiotic in the order clarithromycin > azithromycin > erythromycin, with mean risk quotient values of 0.50, 0.34 and 0.12, respectively. A membrane bioreactor scenario was also modelled, which reduced risk quotient values for all three macrolides by at least 50 %. Risk of ecological impact for each antibiotic was also examined, by comparing environmental concentrations predicted to safety limits based on toxicity data for cyanobacteria and other organisms from the literature, with azithromycin being identified as the macrolide of highest risk. This study compares and quantifies the risk of resistance development and ecological impact for a high-risk antibiotic group in the Irish context, and demonstrates the potential for risk reduction achieved by adoption of alternative (e.g. membrane bioreactor) technology.

A comparative risk ranking of antibiotic pollution from human and veterinary antibiotic usage - An Irish case study.

Antibiotic use in the healthcare and agriculture sectors has resulted in levels being found in environmental compartments including surface waters. This can create a selective pressure toward antibiotic resistance development, representing a potential risk to human health. Examining the Irish scenario, this screening paper develops a novel risk ranking model to comparatively assess, on a national scale, the predicted amount of antibiotics entering water bodies as a result of their use in healthcare and agricultural sectors, and the subsequent risk of antibiotic resistance development. Probabilistic modelling approaches, based on data sourced from published literature on antibiotics, are used to account for inherent uncertainty and variability in the input factors; usage, metabolism, degradation and wastewater removal rates, estimating the mass of six antibiotic classes released daily from both sectors. These mass estimates are used to generate predicted concentrations and risk quotient values for each drug class, utilising estimated minimum inhibitory concentration values sourced from the literature. Modelled results predict higher risk quotient (RQ) values in the healthcare compared to agriculture sector, with macrolides and penicillins ranking highest in terms of RQ value. A lower RQ is also predicted from human-use tetracyclines, trimethoprim, and quinolones. Avenues for runoff reduction for each antibiotic class, in particular the higher-risk classes, in both usage sectors are discussed. For validation, predicted levels are compared to observed levels of antibiotic residues in Ireland. Key knowledge gaps to assist prediction and modelling of antibiotic pollution in future studies are also discussed. This research paper establishes a protocol and model structure, applicable to other regions, to compare the contributions of healthcare and agriculture to antibiotic pollution, and identifies highest-ranked antibiotic classes in terms of potential resistance development for prioritisation in the Irish situation.

Risk assessment of Escherichia coli in bioaerosols generated following land application of farmyard slurry.

Transfer of Escherichia coli in bioaerosols to humans during and shortly after the land application of farmyard slurry may pose human health hazards, but it has not been extensively explored to date. The present study developed a quantitative risk assessment model for E. coli through the air exposure route. The probabilistic model assessed the predicted number of microorganisms in the air (PNair) to which humans may be exposed. A Gaussian air dispersion model was used to calculate the concentration of E. coli transmitted through aerosols. Human exposure (HE) to E. coli was estimated using a Monte Carlo simulation approach. This research predicted the mean HE as 26 CFU day-1 (95th percentile 263 CFU day-1) and suggests the importance of keeping a distance of at least 100 m for the residential population from land spreading activities. However, the simulated mean daily or annual (once a year application) risk of 2.65 × 10-7 person-1 year-1 due to land application of slurry indicates very low occupational risk for farmworkers not equipped with the personal protective equipment (PPE), who are potentially exposed to E. coli indirectly. The model found that the decay constant of E. coli in air, duration of decay, and bio-aerosolisation efficiency factor (top three) could influence HE to airborne E. coli. Furthermore, this research recommends an average time lag of at least 2.5 h following the application of farmyard slurry to the field before humans access the field again without PPE, allowing the airborne pathogen to decay, thereby ensuring occupational safety. The model suggested that the bio-aerosolisation efficiency factor (E) for other pathogens requires further investigation. The information generated from this model can help to assess likely exposure from bioaerosols triggered by land application of farmyard slurry.

Antibiotic residues in the aquatic environment - current perspective and risk considerations.

Antimicrobial resistance is a major concern for human and animal health, projected to deteriorate with time and given current trends of antimicrobial usage. Antimicrobial use, particularly in healthcare and agriculture, can result in the release of antimicrobials into surface waters, promoting the development of antibiotic resistance in the environment, and potentially leading to human health risks. This study reviews relevant literature, and investigates current European and Irish antimicrobial usage trends in humans and animals, as well as potential pathways that antibiotics can take into surface waters following use. Reported levels in the aquatic environment are summarized, with particular focus on Ireland. There are relatively few studies examining Irish water bodies or sewage effluent for antibiotic residues, however, five antibiotics, namely azithromycin, ciprofloxacin, clarithromycin, metronidazole, and trimethoprim, have been measured in Irish waters, in concentrations predicted to select for resistance. Numerous isolates of multi-drug resistant bacteria have also been found in water bodies throughout Ireland and Europe. The value of risk assessment methodologies in understanding risks posed by antibiotic residues is reviewed including the advantages and disadvantages of specific approaches. Hazard quotient and bespoke Monte Carlo approaches are predominant risk assessment tools used to examine antimicrobial release and their complex pathways. This study highlights the need for monitoring of antimicrobial releases and the potential for resistance development, persistence and transmission while highlighting the role of risk assessment methodologies in assessing potential human and environmental health impacts.

Coastal iodine emissions. 1. Release of I2 by Laminaria digitata in chamber experiments.

Tidally exposed macroalgae emit large amounts of I(2) and iodocarbons that produce hotspots of iodine chemistry and intense particle nucleation events in the coastal marine boundary layer. Current emission rates are poorly characterized, however, with reported emission rates varying by 3 orders of magnitude. In this study, I(2) emissions from 25 Laminaria digitata samples were investigated in a simulation chamber using incoherent broadband cavity-enhanced absorption spectroscopy (IBBCEAS). The chamber design allowed gradual extraction of seawater to simulate tidal emersion of algae. Samples were exposed to air with or without O(3) and to varying irradiances. Emission of I(2) occurred in four distinct stages: (1) moderate emissions from partially submerged samples; (2) a strong release by fully emerged samples; (3) slowing or stopping of I(2) release; and (4) later pulses of I(2) evident in some samples. Emission rates were highly variable and ranged from 7 to 616 pmol min(-1) gFW(-1) in ozone-free air, with a median value of 55 pmol min(-1) gFW(-1) for 20 samples.

Coastal iodine emissions: part 2. Chamber experiments of particle formation from Laminaria digitata-derived and laboratory-generated I2.

Laboratory studies into particle formation from Laminaria digitata macroalgae were undertaken to elucidate aerosol formation for a range of I(2) (0.3-76 ppb(v)) and O(3) (<3-96 ppb(v)) mixing ratios and light levels (E(PAR) = 15, 100, and 235 µmol photons m(-2) s(-1)). No clear pattern was observed for I(2) or aerosol parameters as a function of light levels. Aerosol mass fluxes and particle number concentrations, were, however, correlated with I(2) mixing ratios for low O(3) mixing ratios of <3 ppb(v) (R(2) = 0.7 and 0.83, respectively for low light levels, and R(2) = 0.95 and 0.98, respectively for medium light levels). Additional experiments into particle production as a function of laboratory-generated I(2), over a mixing ratio range of 1-8 ppb(v), were conducted under moderate O(3) mixing ratios (∼24 ppb(v)) where a clear, 100-fold or greater, increase in the aerosol number concentrations and mass fluxes was observed compared to the low O(3) experiments. A linear relationship between particle concentration and I(2) was found, in reasonable agreement with previous studies. Scaling the laboratory relationship to aerosol concentrations typical of the coastal boundary layer suggests a I(2) mixing ratio range of 6-93 ppt(v) can account for the observed particle production events. Aerosol number concentration produced from I(2) is more than a factor of 10 higher than that produced from CH(2)I(2) for the same mixing ratios.