Mounting evidence shows the devastating side effects of air pollution on human health. A new study links exposure to fine particulate matter and increased antibiotic resistance.
In 2019, about 1.27 million premature deaths were caused by antibiotic resistance, which may occur naturally, but misuse of antibiotics in humans and animals is accelerating the process. Antibiotic resistance is rising in all parts of the world and is one of the greatest threats to global health and food security, according to the World Health Organization (WHO).
The new study published in The Lancet Planetary Health suggests that exposure to fine particulate matter (PM2.5) produced by fossil fuel combustion is a major contributor to antibiotic resistance.
Researchers from the United Kingdom and China looked at data from 116 countries spanning nearly two decades. The database included nine pathogens, such as Acinetobacter baumannii and Streptococcus pneumoniae, and 43 types of antibiotic agents.
The study found that the association between PM2.5 and antibiotic resistance was consistent globally in most antibiotic-resistant bacteria, and the link between them strengthened over time.
PM2.5 was found to be a larger driver of antibiotic resistance than expenditure on health, drinking water services, and antibiotic use. The researchers estimated that antibiotic resistance as a side effect of air pollution caused 480,000 premature deaths worldwide in 2018.
Reaching the WHO-set air quality target of 5 µg/m3 for annual average PM2.5 concentrations in 2050 would reduce antibiotic resistance by 16.8% and prevent 23.4% of premature deaths attributable to it, according to the study. That would be equivalent to saving $640 billion.
If no policies are applied by 2050, antibiotic resistance could increase by 17%, whereas premature deaths caused by it would grow by 56.4%, primarily in sub-Saharan Africa, according to a model designed in the study.
The authors explain that antibiotic-resistance elements carried by air pollutants could be directly exposed to humans. That poses a substantial risk because the daily intake of antibiotic-resistance genes through inhalation exceeds the intake of antibiotic-resistance genes through drinking water.
K. pneumoniae, P. aeruginosa, and E. coli are the dominant pathogens in the air and are likely to cause infections.
Although the study shows that antibiotic resistance is one of the side effects of air pollution, the mechanisms of how PM2.5 affects antimicrobial resistance are not understood, and more medical evidence is needed. The authors don’t rule out that other factors could be almost as important as PM2.5 in contributing to antibiotic resistance.
- The Lancet Planetary Health. Association between particulate matter (PM)2·5 air pollution and clinical antibiotic resistance: a global analysis.
- World Health Organization. Antibiotic resistance.