The Lancet Planetary Health journal published a comprehensive study on Monday, which suggests that the rise in antibiotic resistance may be linked to an increase in air pollution. A 10% surge in PM2.5 levels in India could result in 2% more antibiotic resistant material.
The misuse and overuse of antibiotics are the main drivers of resistance, but there is evidence that PM2.5 particulate matter can harbor antibiotic-resistant bacteria and resistance genes, which can be transmitted to humans and inhaled by humans, as reported by nine authors, with eight from Zhejiang University in China and one from the department of veterinary medicine, University of Cambridge, UK.
According to the report, India and China’s high populations could be responsible for the most premature deaths caused by antibiotic resistance due to changes in PM2.5. A 10% increase in annual PM 2.5 levels in India could lead to a 2.5% surge in antibiotic resistant compounds and nearly 4% premature mortality rates.
The urgency of localized climate action in the Northeast is causing alarming air pollution.
Air pollution, they noted, could potentially reduce antibiotic resistance leading to almost 500,000 premature deaths in 2018, and reducing levels of harmful air pollution could also help prevent it.
According to the paper titled “Association between PM2.5 air pollution and clinical antibiotic resistance: A global analysis”, increased air pollution is potentially linked to higher risk of antibiotic-resistant bacteria across global region; however, it has also been shown that this relationship has strengthened in recent years, with air Pollution levels coinciding with larger increases in antibiotic resistant bacteria.
Prior to this study, there was limited knowledge on the extent to which PM2.5 air pollution, consisting of particles 30 times smaller than human hair, affects antibiotic resistance.
Industrial processes, road transport, and domestic coal and wood burning are all sources of PM2.5.
According to the authors, 7.3 billion people worldwide are directly exposed to hazardous average annual PM2.5 levels, with 80% of them living in low- and middle-income nations.
The researchers highlighted that antibiotic resistance and air pollution are two distinct threats to the health of the planet, with a clear picture between them. However, they suggested that controlling air quality could have both positive and negative impacts on overall health by curbing the spread of antibiotic-resistant bacteria.
The tendency for key pathogens to resist essential antimicrobials or antibiotics is known as antibacterial resistance, and superbugs like Carbapenem are also resistant. This class of antibiotic usually targets multidrug-resistant bacterial infections.
According to the authors, antibiotic resistance increases with PM2.5, with every 1% increase in air pollution associated with an increase of antibiotic resistant (antibiotic) resistance between 0.5% and 1.9% or more, depending on the pathogen. The association has become stronger over time, but changes in PM 2.5 levels lead to larger increases in antibiotic susceptibility in recent times.
The study’s lead author, Hong Chen, from Zhejiang University, stated that antibiotic resistance and air pollution are two distinct threats to global health, with unclear links between the latter and both.
Antibiotic resistance is most prevalent in North Africa, the Middle East, and South Asia, while it is low in Europe and North America. Due to their large populations, China and India are believed to be the countries where PM2.5 changes have the greatest impact on the premature death rate caused by antibiotic resistance.
According to the authors, PM2.5 is responsible for 11% of global variations in average resistance levels and is one of the primary drivers of antibiotic resistance. In contrast, health spending accounts for 10% of such changes, while drinking water services make up 3%. North Africa and western Asia are the most affected by PM 2.5, accounting for 19% of resistant levels.
Air pollution-induced antibiotic resistance is responsible for an estimated 480,000 premature deaths in 2018, and the study also estimates that it will result in additional economic costs of $395 billion.
If current policies on air pollution were not altered, the authors suggest that antibiotic resistance could rise by 17% globally by 2050. They predict that the annual premature death toll from antibiotics would reach approximately 840,000, with the highest increases in sub-Saharan Africa.
Nevertheless, in other situations, such as increasing health expenditures, controlling air pollution, improving drinking water quality, and decreasing antibiotic usage, antibiotic resistance may be significantly reduced.
The authors suggest that implementing a policy of limiting PM2.5 to 5 g/m3 in the atmosphere could lead to fewer premature deaths linked to antibiotic resistance, which could reduce global antibiotic resistant by 17% by 2050 and save $640 billion annually.
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The editor of Hindustan Times, Rhythma Kaul, is responsible for covering health and related issues. She holds the position of assistant editor and is affiliated with the ministry of health und welfare in India.