Pharmaceuticals, toxicity and antimicrobial resistance. Advancing human health and environmental risk assessment

Abstract

Pharmaceuticals are an indispensable tool against disease and morbidity in humans and animals. However, their use also poses some challenges and can lead to undesirable consequences, some of the most concerning of which are increased environmental pollution and antimicrobial resistance. The assessment of the environmental and human health risks posed by pharmaceuticals is a critical exercise to help make the best use of available knowledge to identify data gaps and prioritize strategies holding most promise. The goal of this dissertation was to assess the risks posed by pharmaceutical pollution to the aquatic system and humans via environmental exposure. The pharmaceutical concentrations and human activities in the transboundary European Vecht River were used to demonstrate this idea. In addition, the selective pressure potential of antibiotics over antibiotic-resistance genes was investigated in artificial and natural environments. Taken together, in this dissertation we demonstrate how risk assessment remains a resourceful tool to support targeted emission and exposure reduction strategies by (local) responsible authorities. Using, statistical and mathematical modelling, we contributed to the advancement of tailored human and environmental risk assessment of pharmaceuticals and antimicrobial resistance in the environment.