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An Exclusive Collection of Papers from Editorial Board Members of the Section "Environmental Science and Engineering"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Science and Engineering".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 30107

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School of Computing, Engineering & Physical Sciences, University of the West of Scotland, Paisley PA1 2BE, UK
Interests: environmental geochemistry and health; behavior and transport of pollutants in atmospheric, aquatic, and terrestrial environments; policy related to environmental regulation (waste and environmental management); contaminated land risk and remediation; urban management; environmental and public health
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Dear Colleagues, 

I am pleased to announce this Special Issue entitled “An Exclusive Collection of Papers from Editorial Board Members of the Section ‘Environmental Science and Engineering’”. This Special Issue will be a collection of high-quality papers from Editorial Board Members. Both original research articles and comprehensive review papers are welcome, addressing current critical issues in the field, grounded in sound science and providing authoritative commentary and novel concepts. All papers will be published with fully open access after successful peer review.

Prof. Dr. Andrew S. Hursthouse
Guest Editor

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Keywords

  • environmental pollution and remediation
  • environmental quality and treatment
  • environmental modeling and exposure or risk assessment
  • environmental engineering techniques in public health
  • environmental toxicological assessment
  • environmental systems and public health
  • environmental management and public health
  • environmental governance and public health

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Published Papers (12 papers)

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Research

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14 pages, 3902 KiB  
Article
Determination of Neonicotinoid Insecticides in Environmental Water by the Enrichment of MIL-53 Mixed Matrix Membrane Coupled with High Performance Liquid Chromatography
by Gege Wu, Jiping Ma, Chenxi Wei, Shuang Li, Jinhua Li, Xiaoyan Wang and Lingxin Chen
Int. J. Environ. Res. Public Health 2023, 20(1), 715; https://doi.org/10.3390/ijerph20010715 - 30 Dec 2022
Cited by 7 | Viewed by 1988
Abstract
Metal organic framework based mixed matrix membranes (MOF-MMMs) were synthesized and applied for dispersive membrane extraction (DME) of four neonicotinoid insecticides (nitenpyram, thiacloprid, imidacloprid, and acetamiprid) in environmental water, combined with high performance liquid chromatography (HPLC) for determination. Several experimental conditions were optimized [...] Read more.
Metal organic framework based mixed matrix membranes (MOF-MMMs) were synthesized and applied for dispersive membrane extraction (DME) of four neonicotinoid insecticides (nitenpyram, thiacloprid, imidacloprid, and acetamiprid) in environmental water, combined with high performance liquid chromatography (HPLC) for determination. Several experimental conditions were optimized in detail, involving dosage percentage of MOF, extraction time, sample pH, salinity, type and volume of eluent, and elution time. High sensitivity with limits of detection and quantification were achieved as 0.013–0.064 μg L−1 and 0.038–0.190 μg L−1, respectively, and good precision with relative standard deviations were obtained as 3.07–12.78%. The proposed method has been successfully applied to determine four neonicotinoid insecticides in tap water, surface water, and seawater, satisfactory recoveries of spiked water samples were between 72.50 and 117.98%. Additionally, the MOF-MMMs showed good reusability with the extraction efficiencies almost remaining stable after 14 cycles. The MOF-MMMs based DME followed by the HPLC method can be a promising utility for the determination of neonicotinoid insecticides in environmental water samples, with high sensitivity and convenient operation. Full article
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12 pages, 1732 KiB  
Article
Potentiometric MIP-Modified Screen-Printed Cell for Phenoxy Herbicides Detection
by Camilla Zanoni, Stefano Spina, Lisa Rita Magnaghi, Marta Guembe-Garcia, Raffaela Biesuz and Giancarla Alberti
Int. J. Environ. Res. Public Health 2022, 19(24), 16488; https://doi.org/10.3390/ijerph192416488 - 8 Dec 2022
Cited by 8 | Viewed by 1553
Abstract
In this study, a molecularly imprinted polymer (MIP)-based screen-printed cell is developed for detecting phenoxy herbicides using 2-methyl-4-chlorophenoxyacetic acid (MCPA) as the template. MCPA is a phenoxy herbicide widely used since 1945 to control broadleaf weeds via growth regulation, primarily in pasture and [...] Read more.
In this study, a molecularly imprinted polymer (MIP)-based screen-printed cell is developed for detecting phenoxy herbicides using 2-methyl-4-chlorophenoxyacetic acid (MCPA) as the template. MCPA is a phenoxy herbicide widely used since 1945 to control broadleaf weeds via growth regulation, primarily in pasture and cereal crops. The potentiometric cell consists of a silver/silver chloride pseudo-reference electrode and a graphite working electrode coated with a MIP film. The polymeric layer is thermally formed after drop-coating of a pre-polymeric mixture composed of the reagents at the following molar ratio: 1 MCPA: 15 MAA (methacrylic acid): 7 EGDMA (ethylene glycol dimethacrylate). After template removal, the recognition cavities function as the ionophore of a classical ion selective electrode (ISE) membrane. The detected ion is the deprotonated MCPA specie, negatively charged, so the measurements were performed in phosphate buffer at pH 5.5. A linear decrease of the potential with MCPA concentration, ranging from 4 × 10−8 to 1 × 10−6 mol L−1, was obtained. The detection limit and the limit of quantification were, respectively, 10 nmol L−1 and 40 nmol L−1. A Nernstian slope of about −59 mV/dec was achieved. The method has precision and LOD required for MCPA determination in contaminated environmental samples. Full article
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17 pages, 5963 KiB  
Article
Chemical and Microbial Leaching of Valuable Metals from PCBs and Tantalum Capacitors of Spent Mobile Phones
by Asma Sikander, Steven Kelly, Kerstin Kuchta, Anika Sievers, Thomas Willner and Andrew S. Hursthouse
Int. J. Environ. Res. Public Health 2022, 19(16), 10006; https://doi.org/10.3390/ijerph191610006 - 13 Aug 2022
Cited by 7 | Viewed by 2130
Abstract
We compared chemical and microbial leaching for multi-metal extraction from printed circuit boards (PCBs) and tantalum capacitor scrap. A mixed consortium of acidophiles and heterotrophic fungal strains were used in the experiments and compared to chemical leaching using specific acids (sulfuric, citric and [...] Read more.
We compared chemical and microbial leaching for multi-metal extraction from printed circuit boards (PCBs) and tantalum capacitor scrap. A mixed consortium of acidophiles and heterotrophic fungal strains were used in the experiments and compared to chemical leaching using specific acids (sulfuric, citric and oxalic acids). Under optimum conditions, 100% extraction efficiency of Cu, and nearly 85% of Zn, Fe, Al and Ni were achieved from PCB and tantalum capacitor scrap samples using sulfuric acid. The mixed consortium of acidophiles successfully mobilized, Ni and Cu (99% and 96%, respectively) while Fe, Zn, Al and Mn reached an extraction yield of 89, 77, 70 and 43%, respectively, from the PCB samples. For the tantalum capacitor samples, acidophiles mobilized 92% Cu, 88% Ni, 78% Fe, 77% Al, 70% Zn and 57% Mn. Metal mobilization from PCBs and tantalum capacitor scrap by A. niger filtrate showed efficient solubilization of Cu, Fe, Al, Mn, Ni, Pb and Zn at an efficiency of 52, 29, 75, 5, 61, 21 and 35% from PCB samples and 61, 25, 69, 23, 68, 15 and 45% from tantalum capacitor samples, respectively. Microbial leaching proved viable as a method to extract base metals but was less specific for tantalum and precious metals in electronic waste. The implications of these results for further processing of waste electronic and electrical equipment (WEEE) are considered in potential hybrid treatment strategies. Full article
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15 pages, 2569 KiB  
Article
Air Quality Assessment by the Determination of Trace Elements in Lichens (Xanthoria calcicola) in an Industrial Area (Sicily, Italy)
by Daniela Varrica, Federica Lo Medico and Maria Grazia Alaimo
Int. J. Environ. Res. Public Health 2022, 19(15), 9746; https://doi.org/10.3390/ijerph19159746 - 8 Aug 2022
Cited by 7 | Viewed by 2057
Abstract
This study provides data on variation in the content of metals and metalloids measured in the lichens (Xanthoria calcicola Oxner) collected in the Syracusan petrochemical complex (Sicily, Italy) which is considered one of the largest in Europe. Concentrations of eighteen trace elements [...] Read more.
This study provides data on variation in the content of metals and metalloids measured in the lichens (Xanthoria calcicola Oxner) collected in the Syracusan petrochemical complex (Sicily, Italy) which is considered one of the largest in Europe. Concentrations of eighteen trace elements measured in the lichens that were collected from 49 different points were analyzed using an inductively coupled plasma (ICP-MS) device. The concentrations of the typical elements of industrial emissions (As, Cr, Ni, and V) highlight the environmental criticality that exists in the study area. The interpretation of the data in terms of multi-element statistical analysis (FA) and enrichment factor (EFs) proved to be particularly useful in identifying several sources that contribute to the presence of trace elements in the atmospheric particulate between anthropogenic emissions and geogenic emissions. The results of this study reveal the versatility of the lichen species Xanthoria calcicola Oxner in the search for trace elements in highly anthropized environments, so the approach followed in this study can also be applied to other industrial contexts. Full article
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12 pages, 3310 KiB  
Article
Perfluorooctanoic Acid Affects Thyroid Follicles in Common Carp (Cyprinus carpio)
by Maurizio Manera, Giuseppe Castaldelli and Luisa Giari
Int. J. Environ. Res. Public Health 2022, 19(15), 9049; https://doi.org/10.3390/ijerph19159049 - 25 Jul 2022
Cited by 6 | Viewed by 2046
Abstract
Carp kidney is comprised of nephrons, hemopoietic tissue, and also hormonally-active thyroid follicles. Given this anatomical trait, it has been used to assess the thyroid disrupting potential of perfluorooctanoic acid (PFOA), a widespread and feared per- poly-fluoroalkyl substance and a persistent organic pollutant [...] Read more.
Carp kidney is comprised of nephrons, hemopoietic tissue, and also hormonally-active thyroid follicles. Given this anatomical trait, it has been used to assess the thyroid disrupting potential of perfluorooctanoic acid (PFOA), a widespread and feared per- poly-fluoroalkyl substance and a persistent organic pollutant capable of interfering with the endocrine system in animals and humans. The occurrence and morphology of thyroid follicles in kidneys of carp experimentally exposed to 200 ng L−1 or 2 mg L−1 waterborne PFOA for 56 days were studied. The abundance of thyroid follicles was significantly higher and vesiculation increased in exposed fish as compared to controls. The number of vesiculated follicles/total number of follicles was positively correlated with PFOA blood concentration in fish exposed to the highest dose (2 mg L−1). The structure and ultrastructure of thyroid follicles were affected by PFOA also at the lower, environmentally relevant, concentration (200 ng L−1). Increased cellular projections, enhanced colloid endocytosis, rough endoplasmic reticulum enlargement and fragmentation and cytoplasm vacuolation were the main features displayed by PFOA-exposed carp. These results show that PFOA affects the occurrence and status of follicles and suggest the utility of fish kidney as a multipurpose biomarker organ in environmental pathology research, according to the One Health approach. Full article
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23 pages, 4403 KiB  
Article
Updating Indoor Air Quality (IAQ) Assessment Screening Levels with Machine Learning Models
by Ling-Tim Wong, Kwok-Wai Mui and Tsz-Wun Tsang
Int. J. Environ. Res. Public Health 2022, 19(9), 5724; https://doi.org/10.3390/ijerph19095724 - 8 May 2022
Cited by 8 | Viewed by 2468
Abstract
Indoor air quality (IAQ) standards have been evolving to improve the overall IAQ situation. To enhance the performances of IAQ screening models using surrogate parameters in identifying unsatisfactory IAQ, and to update the screening models such that they can apply to a new [...] Read more.
Indoor air quality (IAQ) standards have been evolving to improve the overall IAQ situation. To enhance the performances of IAQ screening models using surrogate parameters in identifying unsatisfactory IAQ, and to update the screening models such that they can apply to a new standard, a novel framework for the updating of screening levels, using machine learning methods, is proposed in this study. The classification models employed are Support Vector Machine (SVM) algorithm with different kernel functions (linear, polynomial, radial basis function (RBF) and sigmoid), k-Nearest Neighbors (kNN), Logistic Regression, Decision Tree (DT), Random Forest (RF) and Multilayer Perceptron Artificial Neural Network (MLP-ANN). With carefully selected model hyperparameters, the IAQ assessment made by the models achieved a mean test accuracy of 0.536–0.805 and a maximum test accuracy of 0.807–0.820, indicating that machine learning models are suitable for screening the unsatisfactory IAQ. Further to that, using the updated IAQ standard in Hong Kong as an example, the update of an IAQ screening model against a new IAQ standard was conducted by determining the relative impact ratio of the updated standard to the old standard. Relative impact ratios of 1.1–1.5 were estimated and the corresponding likelihood ratios in the updated scheme were found to be higher than expected due to the tightening of exposure levels in the updated scheme. The presented framework shows the feasibility of updating a machine learning IAQ model when a new standard is being adopted, which shall provide an ultimate method for IAQ assessment prediction that is compatible with all IAQ standards and exposure criteria. Full article
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16 pages, 6000 KiB  
Article
Large-Scale Mercury Dispersion at Sea: Modelling a Multi-Hazard Case Study from Augusta Bay (Central Mediterranean Sea)
by Mario Sprovieri, Andrea Cucco, Francesca Budillon, Daniela Salvagio Manta, Fabio Trincardi and Salvatore Passaro
Int. J. Environ. Res. Public Health 2022, 19(7), 3956; https://doi.org/10.3390/ijerph19073956 - 26 Mar 2022
Cited by 5 | Viewed by 2189
Abstract
This contribution discusses an example of potential multi-hazard effects resulting from an earthquake in a highly seismogenic area of the Mediterranean Sea, the Augusta Bay, which presents high levels of contamination in sediments and seawater, due particularly to high-concentrations of mercury as a [...] Read more.
This contribution discusses an example of potential multi-hazard effects resulting from an earthquake in a highly seismogenic area of the Mediterranean Sea, the Augusta Bay, which presents high levels of contamination in sediments and seawater, due particularly to high-concentrations of mercury as a result of a long-term industrial exploitation. In particular, a high-resolution hydrodynamic and transport model is used to calculate the effects of enhanced mercury spreading in the open sea after significant damage and collapse of the artificial damming system confining the embayment where a very high concentration of Hg occurs in seafloor sediments and seawater. Coupling high-resolution 3D dynamic circulation modelling and sediment–seawater Hg fluxes calculated using the HR3DHG diffusion–reaction model for both inorganic and organic Hg species offers a valuable approach to simulating and estimating the effects of spatial dispersion of this contaminant due to unpredictable hazard events in coastal systems, with the potential attendant enhanced effects on the marine ecosystem. The simulated scenario definitely suggests that a combination of natural and anthropogenic multi-hazards calls for a thorough re-thinking of risk management in marine areas characterised by significant levels of contamination and where a deep understanding of the biogeochemical dynamics of pollutants does not cover all the aspects of danger for the environment. Full article
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16 pages, 13558 KiB  
Article
Impact of Biochar Amendment on Soil Properties and Organic Matter Composition in Trace Element-Contaminated Soil
by José M. De la Rosa, Arturo Santa-Olalla, Paloma Campos, Rafael López-Núñez, José A. González-Pérez, Gonzalo Almendros, Heike E. Knicker, Águeda Sánchez-Martín and Elena Fernández-Boy
Int. J. Environ. Res. Public Health 2022, 19(4), 2140; https://doi.org/10.3390/ijerph19042140 - 14 Feb 2022
Cited by 11 | Viewed by 2948
Abstract
The application of biochar as an organic amendment in polluted soils can facilitate their recovery by reducing the availability of contaminants. In the present work, the effect of biochar application to acid soils contaminated by heavy metal spillage is studied to assess its [...] Read more.
The application of biochar as an organic amendment in polluted soils can facilitate their recovery by reducing the availability of contaminants. In the present work, the effect of biochar application to acid soils contaminated by heavy metal spillage is studied to assess its effect on the quantity and composition of soil organic matter (SOM), with special attention given to soil humic acids (HAs). This effect is poorly known and of great importance, as HA is one of the most active components of SOM. The field experiment was carried out in 12 field plots of fluvisols, with moderate and high contamination by trace elements (called MAS and AS, respectively), that are located in the Guadiamar Green Corridor (SW Spain), which were amended with 8 Mg·ha−1 of olive pit biochar (OB) and rice husk biochar (RB). The results indicate that 22 months after biochar application, a noticeable increase in soil water holding capacity, total organic carbon content, and soil pH were observed. The amounts of oxidisable carbon (C) and extracted HAs in the soils were not altered due to biochar addition. Thermogravimetric analyses of HAs showed an increase in the abundance of the most thermostable OM fraction of the MAS (375–650 °C), whereas the HAs of AS were enriched in the intermediate fraction (200–375 °C). Spectroscopic and chromatographic analyses indicate that the addition of biochar did not alter the composition of the organic fraction of HAs, while Cu, Fe, and as were considerably accumulated at HAs. Full article
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10 pages, 2308 KiB  
Article
The Interaction Effects of Aeration and Plant on the Purification Performance of Horizontal Subsurface Flow Constructed Wetland
by Xinyi Chen, Fei Zhong, Yue Chen, Juan Wu and Shuiping Cheng
Int. J. Environ. Res. Public Health 2022, 19(3), 1583; https://doi.org/10.3390/ijerph19031583 - 30 Jan 2022
Cited by 4 | Viewed by 2877
Abstract
Aeration and plants exhibit influence on the water purification performance in constructed wetlands (CWs). However, the interaction between aeration and plants on enhancing performance of domestic sewage treatment is unclear. Our study aims to optimize the combination of aeration position and plant species, [...] Read more.
Aeration and plants exhibit influence on the water purification performance in constructed wetlands (CWs). However, the interaction between aeration and plants on enhancing performance of domestic sewage treatment is unclear. Our study aims to optimize the combination of aeration position and plant species, promoting the extensive and effective application of CWs. Herein, six horizontal subsurface flow (HSSF) CWs small scale plots were established and divided into two groups according to the plant (i.e., Canna indica and Iris sibirica). To adjust the distribution of dissolved oxygen (DO) in CWs, each group had three plots of HSSF CWs. One plot was aerated at the bottom of the first quarter of the filtration chamber, one plot was aerated at the bottom of the inflow chamber, and the remaining plot was not aerated as a control. Results showed that aeration at the bottom of the first quarter filtration chamber could contribute to the highest removal efficiency of chemical oxygen demand (COD), ammonium nitrogen (NH4+-N) and total nitrogen (TN). The COD, NH4+-N, and TN removal percentages decreased with the drop in temperature. However, the plot aerated at the bottom of the first quarter filtration chamber with I. sibirica exhibited the best average CODCr, NH4+-N and TN removal percentages in both the warm season (83.6%, 82.7% and 76.8%) and the cool season (66.3%, 44.1% and 43.8%). Therefore, this study indicated that the combination of aerating at the bottom of the first quarter filtration chamber and planting with I. sibirica in the HSSF CWs would be a promising way forward for wastewater treatment, especially in low temperature seasons. Full article
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17 pages, 2006 KiB  
Article
Enhanced Biodegradation of Phenylurea Herbicides by Ochrobactrum anthrophi CD3 Assessment of Its Feasibility in Diuron-Contaminated Soils
by Lara-Moreno Alba, Morillo Esmeralda and Villaverde Jaime
Int. J. Environ. Res. Public Health 2022, 19(3), 1365; https://doi.org/10.3390/ijerph19031365 - 26 Jan 2022
Cited by 12 | Viewed by 2949
Abstract
The phenylurea herbicides are persistent in soil and water, making necessary the de-velopment of techniques for their removal from the environment. To identify new options in this regard, bacterial strains were isolated from a soil historically managed with pesticides. Ochrobactrum anthropi CD3 showed [...] Read more.
The phenylurea herbicides are persistent in soil and water, making necessary the de-velopment of techniques for their removal from the environment. To identify new options in this regard, bacterial strains were isolated from a soil historically managed with pesticides. Ochrobactrum anthropi CD3 showed the ability to remove completely herbicides such as diuron, linuron, chlorotoluron and fluometuron from aqueous solution, and up to 89% of isoproturon. In the case of diuron and linuron, their main metabolite, 3,4-dichloroaniline (3,4-DCA), which has a higher toxicity than the parent compounds, was formed, but remained in solution without further degradation. O. anthropi CD3 was also tested for bioremediation of two different agricultural soils artificially contaminated with diuron, employing bioremediation techniques: (i) biostimulation, using a nutrient solution (NS), (ii) bioaugmentation, using O. anthropi CD3, and iii) bioavailability enhancement using 2-hydroxypropyl-β-cyclodextrin (HPBCD). When bioaugmentation and HPBCD were jointly applied, 50% of the diuron initially added to the soil was biodegraded in a range from 4.7 to 0.7 d. Also, 3,4-DCA was degraded in soil after the strain was inoculated. At the end of the soil biodegradation assay an ecotoxicity test confirmed that after inoculating O. anthropi CD3 the toxicity was drastically reduced. Full article
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18 pages, 4971 KiB  
Article
Liver-Based Probabilistic Risk Assessment of Exposure to Organophosphate Esters via Dust Ingestion Using a Physiologically Based Toxicokinetic (PBTK) Model
by Jiaqi Ding, Wenxin Liu, Hong Zhang, Lingyan Zhu, Lin Zhu and Jianfeng Feng
Int. J. Environ. Res. Public Health 2021, 18(23), 12469; https://doi.org/10.3390/ijerph182312469 - 26 Nov 2021
Cited by 5 | Viewed by 2434
Abstract
Organophosphate esters (OPEs) are widely used and harmful to organisms and human health. Dust ingestion is an important exposure route for OPEs to humans. In this study, by integrating ToxCast high-throughput in vitro assays with in vitro to in vivo extrapolation (IVIVE) via [...] Read more.
Organophosphate esters (OPEs) are widely used and harmful to organisms and human health. Dust ingestion is an important exposure route for OPEs to humans. In this study, by integrating ToxCast high-throughput in vitro assays with in vitro to in vivo extrapolation (IVIVE) via physiologically based Toxicokinetic (PBTK) modeling, we assessed the hepatocyte-based health risk for humans around the world due to exposure to two typical OPEs (TPHP and TDCPP) through the dust ingestion exposure route. Results showed that the health guidance value of TPHP and TCDPP obtained in this study was lower than the value obtained through animal experiments. In addition, probabilistic risk assessment results indicate that populations worldwide are at low risk of exposure to TPHP and TDCPP through dust ingestion due to low estimated daily intakes (EDIs) which are much lower than the reference dose (RfDs) published by the US EPA, except in some regional cases. Most margin of exposure (MOE) ranges of TDCPP for children are less than 100, which indicates a moderately high risk. Researchers should be concerned about exposure to TDCPP in this area. The method proposed in this study is expected to be applied to the health risk assessment of other chemicals. Full article
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Review

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29 pages, 1740 KiB  
Review
Impact of Anthropogenic Activities on the Dissemination of ARGs in the Environment—A Review
by Małgorzata Czatzkowska, Izabela Wolak, Monika Harnisz and Ewa Korzeniewska
Int. J. Environ. Res. Public Health 2022, 19(19), 12853; https://doi.org/10.3390/ijerph191912853 - 7 Oct 2022
Cited by 18 | Viewed by 2948
Abstract
Over the past few decades, due to the excessive consumption of drugs in human and veterinary medicine, the antimicrobial resistance (AR) of microorganisms has risen considerably across the world, and this trend is predicted to intensify. Many worrying research results indicate the occurrence [...] Read more.
Over the past few decades, due to the excessive consumption of drugs in human and veterinary medicine, the antimicrobial resistance (AR) of microorganisms has risen considerably across the world, and this trend is predicted to intensify. Many worrying research results indicate the occurrence of pools of AR, both directly related to human activity and environmental factors. The increase of AR in the natural environment is mainly associated with the anthropogenic activity. The dissemination of AR is significantly stimulated by the operation of municipal facilities, such as wastewater treatment plants (WWTPs) or landfills, as well as biogas plants, agriculture and farming practices, including animal production and land application of manure. These activities entail a risk to public health by spreading bacteria resistant to antimicrobial products (ARB) and antibiotic resistance genes (ARGs). Furthermore, subinhibitory concentrations of antimicrobial substances additionally predispose microbial consortia and resistomes to changes in particular environments that are permeated by these micropollutants. The current state of knowledge on the fate of ARGs, their dissemination and the complexity of the AR phenomenon in relation to anthropogenic activity is inadequate. This review summarizes the state-of-the-art knowledge on AR in the environment, in particular focusing on AR spread in an anthropogenically altered environment and related environmental consequences. Full article
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