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During the COVID-19 pandemic, the use of disinfectants, alcohol-based hand sanitizers, and antiseptic hand wash has surged. As a precaution, many authorities have also increased chlorine dosage in wastewater disinfection to achieve a free chlorine residual concentration greater than 6.5 mg/liter (1), despite evidence that a free chlorine residual of just above 0.5 mg/liter can completely inactivate human coronavirus (2). These chemicals can reach aquatic and terrestrial environments through direct discharge of wastewater into receiving waters. Disinfection protocols put in place to prevent COVID-19 should be limited to the minimum required to kill severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and weighed against their potential to increase antimicrobial resistance (AMR).
Disinfectants facilitate the bacterial acquisition of AMR, potentially the biggest global health challenge next to the COVID-19 pandemic (3). For example, antiseptic ingredients quaternary ammonium compounds (4), triclosan (5), chlorhexidine (6), and ethanol (7); chlorine-based disinfectants (8); and disinfection by-products (9) can promote the spread of AMR through mutation or horizontal gene transfer. Thus, current increases in disinfection practices may pose an environmental and public health risk by accelerating the spread of AMR.
Unlike human viruses, which cannot independently reproduce and rarely survive in the environment, bacteria can proliferate and persist, conceivably inheriting AMR over generations. The health of humans and animals is inextricably connected to the environment, potentially creating a cycle of AMR dissemination. Indeed, humans and animals can acquire AMR from the environment through food (10), water (11), and air (12).
From the One Health perspective, a robust risk assessment is necessary to evaluate the environmental and public health risks of increased disinfection and its role in mediating the spread of AMR, particularly in the long term. To reduce the release of disinfectants into the environment, policies should be enacted to reduce unnecessary fomite disinfection, reduce the chlorine load to maintain a free chlorine residual of just above 0.5 mg/liter (2), and dechlorinate treated effluent before discharge. These approaches may be critical to protecting the public from future health threats by slowing down the dissemination of AMR.
https://science.sciencemag.org/content/371/6528/474.1
http://www.awmc.uq.edu.au/science-letter-disinfection-spreads-antimicrobial-resistance
https://pubmed.ncbi.nlm.nih.gov/33510019/
Disinfectants facilitate the bacterial acquisition of AMR, potentially the biggest global health challenge next to the COVID-19 pandemic (3). For example, antiseptic ingredients quaternary ammonium compounds (4), triclosan (5), chlorhexidine (6), and ethanol (7); chlorine-based disinfectants (8); and disinfection by-products (9) can promote the spread of AMR through mutation or horizontal gene transfer. Thus, current increases in disinfection practices may pose an environmental and public health risk by accelerating the spread of AMR.
Unlike human viruses, which cannot independently reproduce and rarely survive in the environment, bacteria can proliferate and persist, conceivably inheriting AMR over generations. The health of humans and animals is inextricably connected to the environment, potentially creating a cycle of AMR dissemination. Indeed, humans and animals can acquire AMR from the environment through food (10), water (11), and air (12).
From the One Health perspective, a robust risk assessment is necessary to evaluate the environmental and public health risks of increased disinfection and its role in mediating the spread of AMR, particularly in the long term. To reduce the release of disinfectants into the environment, policies should be enacted to reduce unnecessary fomite disinfection, reduce the chlorine load to maintain a free chlorine residual of just above 0.5 mg/liter (2), and dechlorinate treated effluent before discharge. These approaches may be critical to protecting the public from future health threats by slowing down the dissemination of AMR.
https://science.sciencemag.org/content/371/6528/474.1
http://www.awmc.uq.edu.au/science-letter-disinfection-spreads-antimicrobial-resistance
https://pubmed.ncbi.nlm.nih.gov/33510019/