1) Executive summary

Antimicrobial resistance is a worldwide, increasing threat to human health. International cooperation to tackle it started with the transatlantic taskforce on AMR in 2009[1], growing to a UN High Level Meeting on AMR in 2016[2] and G20 Berlin Declaration in 2017[3]. Its threat level is now considered to be on a par with climate change[4].

Health and food sectors are heavily involved in action to mitigate the risk but there has been limited action in the third part of the potential exposure/transmission pathway, environment.

  • Andrea Roskosch (invited by Caroline Whalley) 01 Mar 2019 11:09:48

    The second way pollutants from waste water reaching the environment is sewage sludge remaining form waste water treatment if it is utilized for fertilizing purposes.

  • Thomas Berendonk (invited by Caroline Whalley) 05 Apr 2019 11:17:19

    In Germany and I think in Europe (would have to check) sewage sludge of WWTP cannot be used anymore for fertilization (I think by 2027), except for smaller WWTP - below 50000 citizens

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Urban waste water treatment (UWWT) is key to protecting environment and human health. The investment in UWWT is substantial, with a planned lifetime of many decades. Urban waste water treatment plants (UWWTPs) receive waste waters from many upstream sources but act as a point source, from where pollutants can enter rivers, lakes and coastal waters. Treatment taking place at UWWTPs represents the last chance to prevent pollutant releases into sewers reaching the environment.


  • Bertrand Vallet (invited by Caroline Whalley) 22 Mar 2019 12:51:30

    "from where pollutants [that have not been removed by the treatment already in place] can enter rivers, lakes and coastal waters." 

  • Thomas Berendonk (invited by Caroline Whalley) 05 Apr 2019 11:22:53

    I am not sure if here is the right place - but we should not forget to consider stormwater overflows or comined sewer overflows - they can contribute almost half of the wastewater received by the respective rivers ... but one has to say literature on this is still scarce ...

    best

    Thomas

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Key findings were summarised for the topics of monitoring, the release of treated urban waste water and transmission of AMR, and options for reducing the potential of transmission. Knowledge levels varied – from those where general agreement could be reached, to unclear and unknown situations. Priority knowledge gaps were identified as being:

  • Impact of urban waste water treatment on AMR;
  • Monitoring for information on spatial and temporal trends in the environment;
  • AMR exposure from the environment to humans;
  • Quantification of risk, or contribution to acute cases of AMR, from urban waste water treatment discharges;
  • Understanding evolution and selection in collection and sewerage systems, urban waste water treatment plants and hospitals.
  • CĂ©lia Manaia (invited by Caroline Whalley) 22 Mar 2019 00:14:46

    Quantification of risk, or contribution to cases of AMR due to direct or indirect exposure to urban waste water treatment discharges, eg. through leisure activities in rivers or lakes, or irrigation of crops with surface water with WWTPs discharges;

  • Bertrand Vallet (invited by Caroline Whalley) 22 Mar 2019 12:53:56

    Quantification of benefits from potential measures vs cost of implementation or cost of non-action.

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