Tag: Centre of Expertise for Waters

New research explores antimicrobial resistance in Scotland’s waters

Research by James Hutton Institute and Heriot-Watt University scientists has carried out the first review of antimicrobial resistance (AMR) in Scotland’s waters.

Antibiotic-resistant bacteria, such as Staphylococcus aureus and Escherichia coli, are a major source of concern for public health. According to the World Health Organisation, new resistance mechanisms continue to emerge and spread globally, threatening our ability to treat common infectious diseases and endangering the achievement of the Sustainable Development Goals set by the United Nations.

Work by Hutton and Heriot-Watt researchers, funded by Scotland’s Centre of Expertise for Waters, considered the available information on antimicrobial resistance in Scotland’s waters and identified emerging monitoring approaches and potential technological solutions for detecting and tackling antimicrobial resistance.

Findings will help policymakers develop solutions for detecting, monitoring and reducing antimicrobial resistance in Scottish waters.

Dr Lisa Avery, a senior environmental microbiologist at the James Hutton Institute’s Environmental and Biochemical Sciences department and co-author of the study, said: “So far, there has not been enough monitoring of antimicrobial resistance in Scotland’s waters to know how widespread or how concentrated the levels of resistant microbes, genes and resistance-driving chemicals are.

“Globally, lots of different methods are used for detecting resistance. The most common ones are to detect antibiotic resistant bacteria by culturing (growing) them and using polymerase chain reaction (PCR) – based methods to detect specific resistance genes. Our study found no consensus on the best detection method.”

Dr Helen Bridle, Associate Professor at the Institute of Biological Chemistry, Biophysics and Bioengineering of Heriot-Watt University added: “A diversity of approaches is needed for research purposes.

“However, if we can develop some guidelines so that those researching or monitoring resistance in waters are encouraged to use at least one or two of the same approaches across all of the different studies, this would help in understanding antimicrobial resistance and how it is linked across humans, animals and the environment.”

At a recent meeting of the Scottish Parliament, Maree Todd MSP, Minister for Public Health, Women’s Health and Sport, said: “We need to recognise that antimicrobial resistance does not affect only humans.

“Bacteria with the potential to become resistant to antibiotics exist in animals and in the environment. For that reason, we require a one health approach to the threat that recognises that the health of people is closely connected to the health of animals and our shared environment.”

The researchers conclude that agreement across methodological approaches and guidance would support technology developers to develop and validate new approaches for detecting antimicrobial resistance, as most current methods are developed for the clinical, rather than environmental field.

It’s hoped that treatment technologies can remove antimicrobial resistance, but cost-benefit analyses are needed to compare different treatment and mitigation strategies.

A spokesperson from SEPA commented: “SEPA welcomes the publication of the Centre of Expertise for Waters’ (CREW) policy briefing, which provides valuable insights to better understanding the risks of AMR in Scotland’s water environment.

“There are many sectors and activities we regulate that have the potential to exacerbate the spread of AMR through the environment, and we are committed to playing our role in understanding and helping to address the issue.

“Through research and multi-agency collaboration we are working to ensure that interventions are developed and implemented in a way that recognises how the health of people is closely and inextricably linked to the health of animals and our shared environment. This includes our involvement in key groups such as the One Heath Breakthrough Partnership and the Scottish One Health National AMR Action Plan Group.”

The policy outputs, including a policy note (Antimicrobial resistance in Scotland’s waters) and policy brief (Technologies for monitoring and treatment of antimicrobial resistance in water), are both available from the CREW website [https://www.crew.ac.uk/publications]. 

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Research provides comprehensive view of pharmaceutical pollution of Scotland’s water environment

  • Study to be used to promote positive action on medicine use and disposal, to reduce pharmaceutical pollution
  • Data on 60 medicines in the water environment, known to occur through consumption and inappropriate disposal into wastewater systems, were obtained from a range of sources
  • Nine medicines were recommended for further action to reduce the potential environmental risk

A study carried out by researchers at Glasgow Caledonian University (GCU) with the James Hutton Institute and the Environmental Research Institute (University of the Highlands and Islands) has delivered the first national assessment of the emerging area of concern around pharmaceutical pollution of Scotland’s water environment, with an innovative Scottish partnership using results to promote practical actions to reduce this globally recognised public health and environmental issue.

Pharmaceuticals (medicines) enter the water environment when people taking medicines go to the toilet (between 30-100% of a dose is excreted) and when partially used or expired medicines are inappropriately flushed down the toilet instead of being returned to a pharmacy for proper disposal.

Information on 60 medicines was added to a database of over 3,000 data points representing 11 ‘types of water’ – such as water in the environment, influent wastewater and treated wastewater.

The study, commissioned by the Centre of Expertise for Waters (CREW) to support the work of the One Health Breakthrough Partnership, combined published and unpublished academic data with monitoring data from Scottish Water and SEPA.

Lead researcher Dr Karin Helwig says: “Pharmaceuticals (medicines) are designed to have an effect on humans so it’s no surprise that they affect water organisms, too, and that could disturb the balance in ecosystems.

“There is still much we don’t know about how serious these risks are, but if we value our environment it makes sense to try and reduce this kind of pollution as much as possible.

“Different organisations collect monitoring data for their own different purposes, so it was a real testament to partnership working that we were able to collate everything together and get a clearer picture of this area of emerging concern for the Scottish environment.”

The study found that nine medicines, including ibuprofen (an anti-inflammatory painkiller) and antibiotics, may pose higher risks of ecotoxicity and antimicrobial resistance (AMR), although the authors emphasise that monitoring is often carried out at higher risk locations.

Dangers to human health are extremely unlikely, but the findings do illustrate levels of pharmaceuticals in the environment.

Wastewater treatment plants were not initially designed to treat pharmaceuticals and are unable to treat some pharmaceuticals. So tackling this complex issue requires “up-stream” actions.  

The One Health Breakthrough Partnership (OHBP), which was involved in the design and oversight of this study, is a cross-sector initiative bringing together key stakeholders to develop and implement sustainable interventions in healthcare.

NHS Highland lead and OHBP co-founder, Sharon Pfleger, Consultant in Pharmaceutical Public Health, says: “It is important to try to prevent or reduce the impact of pollution by medicines as much as possible rather than trying to deal with the problem.

“That’s why the OHBP is taking an “up-stream” public health approach, ensuring that prescribers and the public understand that medicines do pollute our waters and how they can help, developing guidance for prescribers on more eco-friendly choices of medicines, promoting the use of green and blue spaces to help physical and mental health instead of using medicines and ensuring that people know how to correctly dispose of unused or unwanted medicines.”

The OHBP (Scottish Water, SEPA, NHS Highland, and the Environmental Research Institute-University of the Highlands and Islands) is committed to working with partners to develop solutions and progress the recommendations put forward in this report. Together the OHBP aims to drive research and innovation and influence policy in Scotland to achieve optimal health for people, animals, plants and the environment.

This study recommends that further environmental research be done for areas of the country where few data are available, and, similarly, for groundwater, lochs, and coastal and estuarine waters.

The study will be used by researchers, environmental regulators, the water industry, and the health service as a baseline to assess whether, and to what extent, future interventions and OHBP activities help to reduce pharmaceutical pollution.

The report and its appendices are available on CREW’s website. 

CRW2017_16_Main_ReportDownload