Study warns of link between air pollution, antibiotic-resistant pathogens

Introduction

Worsening air pollution and increased resistance to antibiotics are two of the world’s most urgent public health concerns, contributing to millions of premature deaths per year — and a new study suggests they might be related.

Study Findings

Researchers from Zhejiang University and the University of Cambridge have found “significant correlations” worldwide between air pollutants known as PM 2.5 — tiny particles of solids or liquids in the air such as dust, dirt, and soot — and antibiotic resistance, according to a paper published this month in the Lancet Planetary Health journal.

Implications

The link shown in data from 116 countries over 18 years is “increasing at an accelerating rate,” the researchers said, “which could hasten the beginning of a so-called post-antibiotic era” in which superbugs, or drug-resistant diseases such as methicillin-resistant Staphylococcus aureus (MRSA), could become prevalent.

Sustainable Development Goals (SDGs)

1. Affordable and Clean Energy
2. Good Health and Well-being
3. Sustainable Cities and Communities
4. Climate Action

Impact of Air Pollution and Antibiotic Resistance

For years, scientists have been sounding the alarm about the deadly consequences of antibiotic resistance, which is sometimes called the “silent pandemic” and has long been attributed to the overuse and misuse of antibiotics. But the new peer-reviewed study’s findings suggest pollution could also be an important contributing factor. The authors estimate that antibiotic resistance derived from air pollution caused some 480,000 premature deaths in 2018, and if nothing is done to remedy the situation in the future, that death toll could rise by 56.4 percent by 2050.

Intersection of Worrying Trends

The findings point to an intersection of two worrying trends. From 2016 to 2019, deaths caused by antibiotic resistance increased more than 80 percent, researchers write in the paper. Meanwhile, air pollution is likely to worsen worldwide as a result of climate change. A study published in March found that nearly every person on the planet is exposed to levels of air pollution that the World Health Organization considers unhealthy.

Health Consequences of Air Pollution

This summer, bad air quality from wildfires left portions of the United States and Canada in an ominous haze, sparking renewed concern about the health consequences of pollution, which has already been linked to cancer, respiratory illnesses, cardiovascular disease, dementia, and depression, among other conditions. And in many parts of the world, air that burns your throat and stings your eyes is a regular struggle.

Call to Action

“Pollution has a massive effect on human health even without considering antibiotic resistance,” Mark A. Holmes, a professor of microbial genomics and veterinary science at Cambridge University who worked on the paper, wrote in an email. “This correlation between antibiotic resistance and this type of pollution provides another incentive to tackle pollution,” he said.

Additional Research Needed

The study was observational, so the authors emphasize that additional research would be needed to determine any sort of causal relationship between air pollution and resistance to antibiotics. Still, the work is significant in that it is the “first report on the relationship between PM2.5 and clinical antibiotic resistance worldwide,” the authors write.

Global Impact of Antibiotic Resistance

Antibiotic resistance was responsible for at least 1.27 million deaths globally in 2019, according to the Centers for Disease Control and Prevention, and in December the World Health Organization warned about high levels of resistance in bacteria causing life-threatening bloodstream infections in hospitals and making it harder to treat common infections.

Conclusion

While more research is needed to determine the underlying mechanism behind air pollution’s apparent link to antibiotic resistance, Hong Chen, a professor of environmental engineering at Zhejiang University who worked on the study, wrote in an email that air has been recognized as a “key vector for disseminating antibiotic resistance.” PM 2.5 has been shown to carry a variety of antibiotic-resistant bacteria and antibiotic-resistant genes, “which are transferred between environments and directly inhaled by humans,” she said.