Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance
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Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance. / Ashbolt, Nicholas J.; Amézquita, Alejandro; Backhaus, Thomas; Borriello, Peter; Brandt, Kristian Koefoed; Collignon, Peter; Coors, Anja; Finley, Rita; Gaze, William H.; Heberer, Thomas; Lawrence, John R.; Larsson, D.G. Joakim; McEwen, Scott A.; Ryan, James J.; Schönfeld, Jens; Silley, Peter; Snape, Jason R.; Van den Eede, Christel; Topp, Edward.
In: Environmental Health Perspectives, Vol. 121, No. 9, 2013, p. 993-1001.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance
AU - Ashbolt, Nicholas J.
AU - Amézquita, Alejandro
AU - Backhaus, Thomas
AU - Borriello, Peter
AU - Brandt, Kristian Koefoed
AU - Collignon, Peter
AU - Coors, Anja
AU - Finley, Rita
AU - Gaze, William H.
AU - Heberer, Thomas
AU - Lawrence, John R.
AU - Larsson, D.G. Joakim
AU - McEwen, Scott A.
AU - Ryan, James J.
AU - Schönfeld, Jens
AU - Silley, Peter
AU - Snape, Jason R.
AU - Van den Eede, Christel
AU - Topp, Edward
PY - 2013
Y1 - 2013
N2 - Background: Only recently has the environment been clearly implicated in the risk of antibiotic resistance to clinical outcome, but to date there have been few documented approaches to formally assess these risks. Objective: We examined possible approaches and sought to identify research needs to enable human health risk assessments (HHRA) that focus on the role of the environment in the failure of antibiotic treatment caused by antibiotic-resistant pathogens. Methods: The authors participated in a workshop held 4-8 March 2012 in Québec, Canada, to define the scope and objectives of an environmental assessment of antibiotic-resistance risks to human health. We focused on key elements of environmental-resistance-development "hot spots," exposure assessment (unrelated to food), and dose response to characterize risks that may improve antibiotic-resistance management options. Discussion: Various novel aspects to traditional risk assessments were identified to enable an assessment of environmental antibiotic resistance. These include a) accounting for an added selective pressure on the environmental resistome that, over time, allows for development of antibiotic-resistant bacteria (ARB); b) identifying and describing rates of horizontal gene transfer (HGT) in the relevant environmental "hot spot" compartments; and c) modifying traditional dose-response approaches to address doses of ARB for various health outcomes and pathways. Conclusions: We propose that environmental aspects of antibiotic-resistance development be included in the processes of any HHRA addressing ARB. Because of limited available data, a multi-criteria decision analysis approach would be a useful way to undertake an HHRA of environmental antibiotic resistance that informs risk managers.
AB - Background: Only recently has the environment been clearly implicated in the risk of antibiotic resistance to clinical outcome, but to date there have been few documented approaches to formally assess these risks. Objective: We examined possible approaches and sought to identify research needs to enable human health risk assessments (HHRA) that focus on the role of the environment in the failure of antibiotic treatment caused by antibiotic-resistant pathogens. Methods: The authors participated in a workshop held 4-8 March 2012 in Québec, Canada, to define the scope and objectives of an environmental assessment of antibiotic-resistance risks to human health. We focused on key elements of environmental-resistance-development "hot spots," exposure assessment (unrelated to food), and dose response to characterize risks that may improve antibiotic-resistance management options. Discussion: Various novel aspects to traditional risk assessments were identified to enable an assessment of environmental antibiotic resistance. These include a) accounting for an added selective pressure on the environmental resistome that, over time, allows for development of antibiotic-resistant bacteria (ARB); b) identifying and describing rates of horizontal gene transfer (HGT) in the relevant environmental "hot spot" compartments; and c) modifying traditional dose-response approaches to address doses of ARB for various health outcomes and pathways. Conclusions: We propose that environmental aspects of antibiotic-resistance development be included in the processes of any HHRA addressing ARB. Because of limited available data, a multi-criteria decision analysis approach would be a useful way to undertake an HHRA of environmental antibiotic resistance that informs risk managers.
UR - http://www.scopus.com/inward/record.url?scp=84881016062&partnerID=8YFLogxK
U2 - 10.1289/ehp.1206316
DO - 10.1289/ehp.1206316
M3 - Journal article
C2 - 23838256
AN - SCOPUS:84881016062
VL - 121
SP - 993
EP - 1001
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
SN - 0091-6765
IS - 9
ER -
ID: 102623158