NEW RESEARCH HAS suggested that there could be a link between rising air pollution levels and growing antibiotic resistance.

Almost half a million premature deaths in 2018 were linked to antibiotic resistance potentially resulting from air pollution.

It also shows that the relationship between the two has strengthened over time, with increases in air pollution levels coinciding with larger increases in antibiotic resistance in more recent years.

The findings, published in the Lancet Planetary Health journal, indicate that controlling air pollution could greatly reduce deaths and economic costs stemming from antibiotic-resistant infections.

Analysis of data across 116 countries between 2000 and 2018 shows that north Africa, the Middle East and South Asia have the highest levels of antibiotic resistance, while Europe and North America have the lowest.

Misuse and overuse of antibiotics are the main drivers of antibiotic resistance, but evidence suggests air pollution also contributes to the spread of antibiotic-resistant bacteria and resistance genes.

The study is the first of its kind, as there is limited existing data on how antibiotic resistant genes are carried via air pollution.

Some potential modes of transmission include hospitals, farms, and sewage-treatment facilities that emit and spread antibiotic resistant particles through the air and across distances.

Lead author Professor Hong Chen, of Zhejiang University, China, said: “Antibiotic resistance and air pollution are each in their own right among the greatest threats to global health.

“Until now, we didn’t have a clear picture of the possible links between the two, but this work suggests the benefits of controlling air pollution could be two-fold: not only will it reduce the harmful effects of poor air quality, it could also play a major role in combatting the rise and spread of antibiotic-resistant bacteria.”

The research compiled data on antibiotic usage, sanitation services, economics, health spend, population, education, climate and air pollution to investigate the influence of these factors on levels of antibiotic resistance.

The authors’ modelling of possible future scenarios indicates that if there were no changes to current policies on air pollution, by 2050, levels of antibiotic resistance worldwide could increase by 17%. The annual premature death toll linked to antibiotic resistance would rise to around 840,000, with the greatest increases in sub-Saharan Africa.

In other scenarios, such as increasing health spending, controlling air pollution, improving drinking water and reducing antibiotic usage, the level of antibiotic resistance could be greatly reduced.

The authors noted that there was a lack of data in some countries, particularly low- and middle-income countries, which are most affected by antibiotic resistance, and this may have affected their analysis.