Air Pollution and Antibiotic Resistance

Air pollution can be measured in Particle Matter (or PM), which is the term for a mixture of solid particles and liquid droplets found in the air. Some of these particles are dust, dirt, soot, or smoke. But PM's can also carry potentially harmful bacteria, viruses and fungal spores over large distances.

Now, research seems to indicate that PM_2.5 (2.5 micrometers and smaller) has diverse elements of antibiotic resistance that increase its spread after inhalation[1]. Antibiotic resistance is a constantly increasing global issue, causing millions of deaths worldwide every year.

PM _2.5 carries abundant antibiotic resistance-determinant genes. These levels are higher than what is found in sediments, soil, rivers and some engineering treatment systems. Humans are potentially directly exposed to antibiotic-resistant elements while inhaling air pollutants. The daily intake of antibiotic-resistant genes through inhalation exceeds what you would through drinking water.

Analysis suggests that environmental dissemination of antibiotic resistance genes (ARG's), particularly via airborne fine particle, the PM _2.5, may be partly to blame for the highest levels of antibiotic resistance and premature death in population-dense India and China.

With every one per cent rise in PM _2.5 pollution, there is an increase in antibiotic resistance between 0.5 and 1.9 per cent, depending on the pathogen. The analysis indicates antibiotic resistance resulting from air pollution is linked to an estimated 480,000 premature deaths in 2018.

Also, the continued overuse of antibiotics in humans and animals exacerbates the emergence of antibiotic-resistant elements, which can be primarily discharged into environment via waste water, agricultural manure application, or evaporation. Often, these antibiotic-resistant elements can be transferred from environmental micro-organisms to human pathogens through drinking water, food and air inhalation. The pollution can cross regional boundaries and spread antibiotic resistance over long distances and on a large scale, which could be a crucial link between the dissemination of environmental and human antibiotic resistance.

Zhou et al: Association between particulate matter (PM)_2.5 air pollution and clinical antibiotic resistance: a global analysis in Lancet Global Health – 2023.