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.

中文翻译：

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表征LCA中的抗生素—回顾当前实践并提出包括耐药性在内的新方法

目的

由于抗生素抗药性（ABR）被描述为对人类健康的日益增加的负担，因此本研究回顾了LCA中抗生素使用的毒理学影响如何以及在多大程度上被包括在LCA中，并通过两种新颖的方法将ABR（抗生素使用的结果）纳入LCA框架。

方法

我们回顾了有关抗生素毒理学方面的现有LCA研究，以评估如何表征抗生素的这些影响。然后，我们提出了两种新颖的方法，可将ABR相关的影响纳入生命周期影响评估（LCIA）。第一种方法基于对病原菌的最低选择性浓度，将环境区室中ABR富集的潜力表征为中点指标。第二种方法是使用抗生素使用与人类福祉之间的定量关系，将人类健康影响作为终点指标。

结果和讨论

我们的发现表明，迄今为止，没有LCA研究能够解释与ABR相关的影响。作为回应，我们证明了我们新颖的中点指标方法可以通过允许对环境区隔进行ABR影响表征来解决此问题。我们还建立了抗生素使用，ABR和人类福祉之间的因果关系途径，其产生的结果可与USEtox和人类毒理学的大多数终点影响评估方法相媲美。

结论

我们提出的方法表明，作为围绕已建立的影响模型USEtox建立的强大的表征方法，可以在LCA框架内捕获ABR富集环境中当前被忽略的影响。但是，需要大量当前无法获得的数据来计算向环境中排放的抗生素，为非病原菌确定最小的选择性浓度以及量化AB的使用对人体健康的潜在影响。