Antimicrobial Resistance in Waterways: Drug-resistant superbugs are increasing. In the UK, researchers and campaigners are calling for a clean-up of water systems.
Growing Health Risks from Sewage Pollution
Swimming in rivers and coastal waters in the UK has become risky. Untreated sewage spills expose people to many health risks, such as acute sickness, ear infections, or tummy upsets. Another significant health hazard is antimicrobial resistance (AMR). AMR develops when pathogens mutate to resist medicines. This can lead to drug-resistant infections, sometimes called “superbugs.” AMR is linked to 1.27 million deaths each year and could cause 10 million deaths annually by 2050, according to the UN Environment Programme.
AMR: A Silent Pandemic
The World Health Organization (WHO) calls AMR a “silent pandemic.” It’s a serious global public health threat, yet it’s not often discussed by the media or policymakers. Untreated sewage can spread AMR. When sewage pollution with AMR reaches the environment, people, including swimmers, can be exposed. However, while sewage spills make headlines, AMR often gets overlooked.
Tracking AMR Sources and Solutions
Scientists are working to identify the most dangerous sources of AMR and effective solutions to reduce its spread. In the UK, evolutionary microbiologist Elitsa Penkova from the University of Exeter is coordinating the Poo-Sticks project. This project assesses the link between sewage pollution in rivers and AMR in swimmers and non-swimmers by analyzing 300 poo samples.
How Sewage Pollution Spreads AMR
Humans don’t metabolize antibiotics well, and up to 70% of these antibiotics are excreted via urine and faeces. This can get flushed into the water system. Sewage pollution includes effluent from wastewater treatment plants, combined sewer overflows, and septic tanks. Hospital wastewater and agricultural run-off are also major concerns.
Poor Water Quality in the UK
Antimicrobial residues end up in soil, river sediment, waterways, and oceans. A report from Earthwatch Europe shows that 75% of the UK’s rivers are in poor ecological health. Polluted rivers create conditions for the spread of antibiotic-resistant bacteria. Penkova’s research follows the University of Exeter’s 2018 Beach Bums study. This study found a strong link between water users and AMR.
Coastal Swimmers and AMR
Interestingly, a 2023 Irish study found that coastal swimmers were less likely than non-swimmers to carry antibiotic-resistant bacteria in their guts. This might be because swimmers swallow smaller volumes of water than surfers.
AMR Risk Beyond Swimming
Polluted rivers aren’t just a threat to swimmers and surfers. AMR can get into the bloodstream through cuts, or enter the body through the ears, eyes, or mouth. Continuous exposure increases the risk that AMR gets passed on to vulnerable individuals. AMR infections are hard to treat because antibiotics won’t work, making it a significant concern.
Limited Monitoring and Action Needed
Government authorities monitor sewage in rivers and coasts by measuring levels of E. coli and intestinal enterococci. However, this only provides a snapshot of river health. Thousands of species of antibiotic-resistant bacteria exist, making our sewage system a breeding ground for AMR.
Improving Wastewater Treatment
Wastewater treatment plants are major contributors to AMR. They remove bacteria and their resistance genes by about 100-fold, but untreated sewage is much worse. In the UK, untreated sewage often spills from combined sewer overflows or leaks from old pipes. Monitoring and legal requirements for volume meters at storm overflows could help manage this issue.
AMR in Developing Countries
In developing countries like India, the situation can be much worse. Only about 20% of sewage gets treated, leading to urban rivers full of raw sewage. Improving wastewater treatment in developing countries can help tackle the global AMR issue.
Global Monitoring and Climate Change
A global project by the University of York in 2022 found high concentrations of pharmaceuticals in rivers, driving the evolution of AMR. As the world population grows, so does the demand for sewerage infrastructure. Climate change also worsens the AMR problem. Droughts concentrate sewage in waterways, while floods increase agricultural run-off and overwhelm sewers.
Calls for a Sewage-System Clean Up in the UK
In 2023, 1,924 people reported getting ill after entering UK waters. Many of these cases were in waters classified as ‘excellent.’ Surfers Against Sewage (SAS) is pushing for an independent inquiry into sewage pollution and better water quality monitoring.
Effective Solutions and Personal Actions
Research shows wastewater treatment works are effective at removing AMR genes and organisms from effluent. Countries with advanced AMR monitoring strategies have cleaner waterways. The UK Environment Agency needs better resources to understand what’s in our rivers and coastal waters.
Conclusion
AMR is a global problem that needs urgent action. Policymakers must prioritize reducing antibiotic overuse in healthcare and farming. Individuals can help by avoiding overusing antibiotics and safely disposing of unused medicine. New antibiotics and better monitoring systems are being developed to combat AMR. By taking these steps, we can help reduce the spread of antimicrobial resistance and ensure cleaner, safer waters for everyone.
