Assessing the Ecotoxicologic Hazards of a Pandemic Influenza Medical Response

作者:Singer Andrew C*; Colizza Vittoria; Schmitt Heike; Andrews Johanna; Balcan Duygu; Huang Wei E; Keller Virginie D J; Vespignani Alessandro; Williams Richard J
来源:Environmental Health Perspectives, 2011, 119(8): 1084-1090.
DOI:10.1289/ehp.1002757

摘要

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 waste water in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to micro organisms responsible for waste water nutrient removal in waste water 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 micro organisms 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 waste water 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 anti viral medications on WWTPs and freshwater ecotoxicity.

  • 出版日期2011-8

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