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While there have been research projects and national initiatives into AMR and the environment, there is as yet nothing available at European level to assess the risks presented. The meeting agreed on several points regarding needs around monitoring and options for reducing the risks of transmission from discharges from urban waste water treatment plants and identified a number of gaps in knowledge which should be addressed (Tables 1-4).

In summary, there is a need to establish the role that UWWT has in limiting environmental and human health risks, focusing on antibiotics, antibiotic resistant genes and co-contaminants such as metals (co-selective agents). Risk-based targets are needed, which recognise resistance poses a human health risk as well as providing an ecosystem service. Surveillance data are needed to support management options. Methods of assessing relative risk presented by UWWT in terms of selection for resistance, transmission and exposure are required.