Characterizing antibiotics in LCA—a review of current practices and proposed novel approaches for including resistance

Abstract

Purpose With antibiotic resistance (ABR) portrayed as an increasing burden to human health, this study reviews how and to what extent toxicological impacts from antibiotic use are included in LCAs and supplement this with two novel approaches to include ABR, a consequence of antibiotic use, into the LCA framework. Methods We review available LCA studies that deal with toxicological aspects of antibiotics to evaluate how these impacts from antibiotics have been characterized. Then, we present two novel approaches for including ABR-related impacts in life cycle impact assessments (LCIAs). The first approach characterizes the potential for ABR enrichment in the environmental compartment as a mid-point indicator, based on minimum selective concentrations for pathogenic bacteria. The second approach attributes human health impacts as an endpoint indictor, using quantitative relationships between the use of antibiotics and human well-being. Results and discussion Our findings show that no LCA study to date have accounted for impacts related to ABR. In response, we show that our novel mid-point indicator approach could address this by allowing ABR impacts to be characterized for environmental compartments. We also establish cause-effect pathways between antibiotic use, ABR, and human well-being that generate results which are comparable with USEtox and most endpoint impact assessment approaches for human toxicology. Conclusions Our proposed methods show that currently overlooked impacts from ABR enrichment in the environment could be captured within the LCA framework as a robust characterization methodology built around the established impact model USEtox. Substantial amounts of currently unavailable data are, however, needed to calculate emissions of antibiotics into the environment, to develop minimum selective concentrations for non-pathogenic bacteria, and to quantify potential human health impacts from AB use.

Occurrence and toxicity impact of pharmaceuticals in hospital effluents: Simulation based on a case of study

“…Specifically, amoxicillin presented an effect more than 30,000 times greater than ampicillin, so in case of doubt between the application of one or the other, the antibiotic ampicillin is recommended from the point of view of FE. Nyberg also confirmed this effect (Nyberg et al, 2021), in their freshwater ecotoxicity studies they found that of the 40 antibiotics studied, amoxicillin had the most negative effects on freshwater ecotoxicity Amoxicillin is expected to pose adverse effects for cyanobacteria, suggesting potential ecological risks, whereas ibuprofen pose a small potential for adverse effects to invertebrates and fish, respectively (Gómez-Canela et al, 2019;Kovalakova et al, 2020).…”

“…The endpoint methods are applied to the indicator to express the current damages while the mid-point methods are applied to the characterization factor in order to measure the impact (Fernández-Marchante et al, 2021;Nyberg et al, 2021). The ReCiPe mid-point method includes the following impact categories: particulate matter formation, ozone formation (human health), ionizing radiation, stratospheric ozone depletion, human toxicity (cancer), human toxicity (non-cancer), global warming, water use, freshwater ecotoxicity, freshwater eutrophication, ozone formation (terrestrial ecosystems), terrestrial ecotoxicity, terrestrial acidification, land use, marine ecotoxicity, mineral resource depletion and fossil energy consumption (Su et al, 2021).…”

Cutting‐edge technologies for detecting and controlling fish diseases: Current status, outlook, and challenges

“…The results from this approach are pretty similar to those obtained previously by C‐PCR. However, to get high sensitivity, two‐step PCR is necessary, which is expensive and time‐consuming (Nyberg et al, 2021).…”

Integration of environment and nutrition in life cycle assessment of food Items: opportunities and challenges

“…So far, established life cycle impact assessment methods and models have not accounted for the development and spread of AMR due to antibiotic emissions into the environment. Nyberg et al (2021) recently proposed a novel approach to characterize the potential for AMR enrichment in the environment as a midpoint indicator, and another conceptual approach to directly link the total use of antibiotics in a given region to human health impacts at the endpoint damage level (DALY/kg antibiotic used). Similarly, Emara et al (2021) derive minimum selective concentrations from widely available antibiotic susceptibility data and determine hazardous concentrations (HCs) for more than 140 antibiotics that reflect an antibiotic-specific threshold for resistance selection in the environment.…”