Application of a spatially resolved model to contextualise monitoring data for risk assessment of down-the-drain chemicals over large scales.

Many regulatory screening level exposure assessments are based on simple large scale conceptual scenarios. However, exposure, and therefore risks associated with chemicals, are characterised by high spatial variability. The Scenario assembly tool (ScenAT) is a global screening level model to enable spatially resolved local predictions of environmental concentrations of home and personal care chemicals. It uses the European Union Technical Guidance Document (TGD) equation to predict local scale freshwater concentrations (predicted environmental concentrations - PECs) of chemicals discharged via wastewater. ScenAT uses Geographic Information System (GIS) layers for the underlying socio-economic (population) and environmental parameters (per capita water use, sewage treatment plant connectivity, dilution factor). Using a probabilistic approach, we incorporate sources of uncertainty in the input data (tonnage estimation, removal in sewage treatment plants and seasonal variability in dilution factors) for two case-study chemicals: the antimicrobial triclosan (TCS) and the anionic surfactant linear alkylbenzene sulphonate (LAS). We then compare model estimates of wastewater and freshwater concentrations of TCS and LAS to UK monitoring data. Comparison showed that modeled PECs were on average higher than mean measured data for TCS and LAS by a factor 1.8 and 1.4, respectively. Considering the uncertainty associated with both model and monitoring data, the use of a probabilistic approach using the ScenAT model for screening assessment is reasonable. The combination of modelled and monitoring data enables the contextualisation of monitoring data. Spatial PECs can be used to identify areas of elevated concentration for further refined assessment.

Molecular epidemiology of a Pseudomonas aeruginosa hospital outbreak driven by a contaminated disinfectant-soap dispenser.

BACKGROUND AND OBJECTIVE: Pseudomonas aeruginosa infection represents a main cause of morbidity and mortality among immunocompromised patients. This study describes a fatal epidemic of P. aeruginosa that occurred in a hematology unit in Italy. METHODS: Retrospective cohort study, prospective surveillance, auditing, extensive testing on healthcare workers and environmental investigation were performed to define the dynamics and potential causes of transmission. RAPD, macrorestriction analyses and sequence typing were used to define relationships between P. aeruginosa isolates. RESULTS: Eighteen cases of infection were identified in the different phases of the investigation. Of these, five constitute a significant molecular cluster of infection. A P. aeruginosa strain with the same genetic fingerprint and sequence type (ST175) as clinical isolates strain was also isolated from a heavily contaminated triclosan soap dispenser. DISCUSSION AND CONCLUSIONS: Our results are consistent with the hypothesis that patients became indirectly infected, e.g., during central venous catheter handling through contaminated items, and that the triclosan soap dispenser acted as a common continuous source of P. aeruginosa infection. Since P. aeruginosa is intrinsically unsusceptible to triclosan, the use of triclosan-based disinfectant formulations should be avoided in those healthcare settings hosting patients at high risk of P. aeruginosa infection.