A ‘Lancet’ study has established a connection between bacterial antibiotic resistance and air pollution; inhaling PM 2.5 can lead to antibiotic resistance
There was a sense of palpable urgency to address climate change, air pollution and degradation of the environment at the recently concluded three-day G20 summit held in New Delhi. Led by India, the G20 nations agreed to urgently accelerate their actions to address environmental crises and climate change challenges with the help of a green development plan. This in a way reflects the prophetic warning to world leaders by the UN Secretary-General António Guterres at the 27th Conference of the Parties to the UN Framework Convention on Climate Change (COP27) held in 2022, that humanity is on a “highway to climate hell with a foot on the accelerator”. Because 80 per cent of the world’s greenhouse gas emissions emanate from G20 nations, the member nations needed to understand the gravity of the problem and ensure meaningful progress in this regard.
As the stakes for mankind keep rising thanks to rising pollution and climate change, keeping global average temperatures below 2 degrees centigrade alone may not be the urgent goal of the nations. Newer and more perilous problems are arising due to unabated pollution levels. A recent study published in the health journal “Lancet” has established a connection between bacterial antibiotic resistance and air pollution, particularly PM 2.5. The study suggests that PM 2.5 contains elements of antibiotic resistance, and inhaling this pollutant can lead to an increase in the spread of antibiotic resistance. The authors of the study aimed to estimate the global premature death toll caused by resistance to antibiotics due to PM 2.5 pollution.
PM 2.5 refers to particulate matter with a diameter of 2.5 micrometres or smaller. These particles, consisting of solid and liquid elements, are of varying sizes, with some, like dust and soot, visible to the naked eye and others, such as PM 2.5, only observable under electron microscopes. Inhaling these pollutants can pose serious health risks, especially to the respiratory system. The Lancet study compared and analysed the PM 2.5 levels with levels of antibiotic resistance and made a disturbing discovery that the higher the pollutant level, the greater the antibiotic resistance. PM 2.5 are smaller than human hair and contains antibiotic resistance elements.
As these pollutants travel through the ambient air, they disperse antibiotic resistance elements, which can then be inhaled by humans which in turn sets in motion the resistance. The concerning aspect is that antibiotic-resistant bacteria can withstand antibiotic treatments, rendering the drugs ineffective against them. Antibiotics are primarily used to eliminate microorganisms, especially bacteria, but resistant bacteria are impervious to their effects.
The data for this research was collated from 116 countries utilising sources like ResistanceMap, the European Center for Disease Prevention and Control Surveillance Atlas, and the PLISA Health Information Platform. Overall, nine pathogens and 43 drugs were analysed. It was observed that the surge in antibiotic resistance among bacteria is largely attributed to the indiscriminate use of antibiotics. Repeated and widespread antibiotic usage can empower bacteria to develop resistance over time, often facilitated by Antibiotic Resistance Genes (ARGs). Pathogenic bacteria, responsible for infections and diseases, can acquire antibiotic resistance through ARGs in a process known as horizontal gene transfer.
The Lancet health report concluded that the need of the hour is to address the PM2.5 levels. Without this, antibiotic resistance may increase by approximately 17%, with related deaths rising by 56% globally by 2050. Conversely, adhering to the World Health Organization's recommended PM 2.5 level of 5 µg/m³ could lead to a 17% reduction in antibiotic resistance and a 23% decrease in deaths. But this is easier said than done. Of the world’s 30 cities with the worst air pollution, 21 are in India. Capital New Delhi is the worst with PM 2.5 being nearly 10 times higher than the World Health Organisation levels.
According to the CleanAir organisation India sees 2 million early deaths and a loss of 95 billion to the economy due to PM 2.5. Given these bleak conditions, India needs to cover a lot of ground to rein in PM 2.5 levels while there is still time. The National Clean Air Program (NCAP) is a determined step in the right direction, but it needs more grit and resolve behind it if the initiative has to succeed.
Some major steps are the need of the hour for India. Firstly, immediate curbs on ammonia release in farms are essential, this must be followed by a full ban on refuse burning. Apart from this rural brick kilns must be persuaded to shift to cleaner kiln-firing technologies. Urgent efforts also need to be made to convert coal-based power plants to clean energy, as this by itself will make a huge difference. To make this a reality, India must make a push for creating the correct financial architecture through investment funds with a dedicated green focus that can play an instrumental role in catalysing the growth of green industries and simultaneously addressing the twin problems of air pollution and climate change. These funds would combine a returns-driven strategy with the sustainability imperative and accelerate investment in green industries. Measures such as these can help India fight air pollution and prevent a calamitous future where common antibiotic efficacy is not held to ransom by polluted air.
(The writer is a policy analyst; views are personal)