Assessing the Ecotoxicologic Hazards of a Pandemic Influenza Medical Response
Identifieur interne : 000A23 ( Pmc/Curation ); précédent : 000A22; suivant : 000A24Assessing the Ecotoxicologic Hazards of a Pandemic Influenza Medical Response
Auteurs : Andrew C. Singer [Royaume-Uni] ; Vittoria Colizza [France, Italie] ; Heike Schmitt [Pays-Bas] ; Johanna Andrews [Royaume-Uni] ; Duygu Balcan [États-Unis] ; Wei E. Huang [Royaume-Uni] ; Virginie D. J. Keller [Royaume-Uni] ; Alessandro Vespignani [États-Unis, Italie] ; Richard J. Williams [Royaume-Uni]Source :
- Environmental Health Perspectives [ 0091-6765 ] ; 2011.
Abstract
Background: The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers.
Objectives: We assessed the ecotoxicologic risks of a pandemic influenza medical response.
Methods: To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers.
Results: Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0–14% and 5–32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0–14% and 0–30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range).
Conclusions: The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity.
Url:
DOI: 10.1289/ehp.1002757
PubMed: 21367688
PubMed Central: 3237342
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Duygu Balcan<affiliation><nlm:aff id="aff7"><addr-line>Center for Complex Networks and Systems Research, School of Informatics and Computing, and</addr-line>
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<affiliation wicri:level="1"><nlm:aff id="aff8"><addr-line>Pervasive Technology Institute, Indiana University, Bloomington, Indiana, USA</addr-line>
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<affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Institute for Scientific Interchange, Turin, Italy</addr-line>
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<front><div type="abstract" xml:lang="en"><p>Background: The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers.</p>
<p>Objectives: We assessed the ecotoxicologic risks of a pandemic influenza medical response.</p>
<p>Methods: To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers.</p>
<p>Results: Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0–14% and 5–32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0–14% and 0–30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range).</p>
<p>Conclusions: The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity.</p>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Environ Health Perspect</journal-id>
<journal-id journal-id-type="iso-abbrev">Environ. Health Perspect</journal-id>
<journal-id journal-id-type="publisher-id">EHP</journal-id>
<journal-title-group><journal-title>Environmental Health Perspectives</journal-title>
</journal-title-group>
<issn pub-type="ppub">0091-6765</issn>
<issn pub-type="epub">1552-9924</issn>
<publisher><publisher-name>National Institute of Environmental Health Sciences</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21367688</article-id>
<article-id pub-id-type="pmc">3237342</article-id>
<article-id pub-id-type="publisher-id">ehp.1002757</article-id>
<article-id pub-id-type="doi">10.1289/ehp.1002757</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Assessing the Ecotoxicologic Hazards of a Pandemic Influenza Medical Response</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Singer</surname>
<given-names>Andrew C.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Colizza</surname>
<given-names>Vittoria</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schmitt</surname>
<given-names>Heike</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Andrews</surname>
<given-names>Johanna</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Balcan</surname>
<given-names>Duygu</given-names>
</name>
<xref ref-type="aff" rid="aff7"><sup>7</sup>
</xref>
<xref ref-type="aff" rid="aff8"><sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Huang</surname>
<given-names>Wei E.</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Keller</surname>
<given-names>Virginie D.J.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vespignani</surname>
<given-names>Alessandro</given-names>
</name>
<xref ref-type="aff" rid="aff7"><sup>7</sup>
</xref>
<xref ref-type="aff" rid="aff8"><sup>8</sup>
</xref>
<xref ref-type="aff" rid="aff9"><sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Williams</surname>
<given-names>Richard J.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<aff id="aff1"><label>1</label>
<addr-line>Centre for Ecology and Hydrology, Wallingford, Oxfordshire, United Kingdom</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>INSERM, U707, Paris, France</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>UPMC Université Paris 06, Faculté de Médecine Pierre et Marie Curie, UMR S 707, Paris, France</addr-line>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Computational Epidemiology Laboratory, Institute for Scientific Interchange, Turin, Italy</addr-line>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands</addr-line>
</aff>
<aff id="aff6"><label>6</label>
<addr-line>Department of Civil and Structural Engineering, University of Sheffield, Sheffield, United Kingdom</addr-line>
</aff>
<aff id="aff7"><label>7</label>
<addr-line>Center for Complex Networks and Systems Research, School of Informatics and Computing, and</addr-line>
</aff>
<aff id="aff8"><label>8</label>
<addr-line>Pervasive Technology Institute, Indiana University, Bloomington, Indiana, USA</addr-line>
</aff>
<aff id="aff9"><label>9</label>
<addr-line>Institute for Scientific Interchange, Turin, Italy</addr-line>
</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address correspondence to A.C. Singer, Centre for Ecology and Hydrology, Maclean Building, Benson Ln., Wallingford OX10 8BB UK. Telephone: 44-1491-692434. Fax: 44-1491-692424. E-mail: <email>acsi@ceh.ac.uk</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>02</day>
<month>3</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub"><month>8</month>
<year>2011</year>
</pub-date>
<volume>119</volume>
<issue>8</issue>
<fpage>1084</fpage>
<lpage>1090</lpage>
<history><date date-type="received"><day>21</day>
<month>7</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>28</day>
<month>2</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-year>2011</copyright-year>
<license xlink:href="http://creativecommons.org/publicdomain/mark/1.0/" license-type="public-domain"><license-p>Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, ?Reproduced with permission from Environmental Health Perspectives?); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright. </license-p>
</license>
</permissions>
<abstract><p>Background: The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers.</p>
<p>Objectives: We assessed the ecotoxicologic risks of a pandemic influenza medical response.</p>
<p>Methods: To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers.</p>
<p>Results: Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0–14% and 5–32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0–14% and 0–30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range).</p>
<p>Conclusions: The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity.</p>
</abstract>
<kwd-group kwd-group-type="author"><kwd>antibiotics</kwd>
<kwd>antiviral</kwd>
<kwd>bacterial pneumonia</kwd>
<kwd>ecotoxicity</kwd>
<kwd>epidemiologic modeling</kwd>
<kwd>influenza</kwd>
<kwd>pandemic</kwd>
<kwd>Tamiflu</kwd>
<kwd>wastewater treatment plant</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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