Assessing the ecotoxicologic hazards of a pandemic influenza medical response

Singer, Andrew C. ORCID:; Colizza, Vittoria; Schmitt, Heike; Andrews, Johanna; Balcan, Duygu; Huang, Wei E.; Keller, Virginie D.J.; Vespignani, Alessandro; Williams, Richard J.. 2011 Assessing the ecotoxicologic hazards of a pandemic influenza medical response. Environmental Health Perspectives, 119 (8). 1084-1090.

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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.

Item Type: Publication - Article
Digital Object Identifier (DOI):
Programmes: CEH Topics & Objectives 2009 - 2012 > Biogeochemistry > BGC Topic 3 - Managing Threats to Environment and Health
UKCEH and CEH Sections/Science Areas: Hails
Boorman (to September 2014)
ISSN: 0091-6765
Additional Pages: Supplemental material
Additional Information. Not used in RCUK Gateway to Research.: Open Access article - please click on the Official URL link for full text
Additional Keywords: antibiotics, antiviral, bacterial pneumonia, ecotoxicity, epidemiologic modelling, influenza, pandemic, Tamiflu, wastewater treatment plant
NORA Subject Terms: Ecology and Environment
Date made live: 02 Aug 2011 09:58 +0 (UTC)

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