Environmental contamination in a high-income country (France) by antibiotics, antibiotic-resistant bacteria, and antibiotic resistance genes: Status and possible causes.

Antimicrobial resistance (AMR) is a major global public health concern, shared by a large number of human and animal health actors. Within the framework of a One Health approach, actions should be implemented in the environmental realm, as well as the human and animal realms. The Government of France commissioned a report to provide policy and decision makers with an evidential basis for recommending or taking future actions to mitigate AMR in the environment. We first examined the mechanisms that underlie the emergence and persistence of antimicrobial resistance in the environment. This report drew up an inventory of the contamination of aquatic and terrestrial environments by AMR and antibiotics, anticipating that the findings will be representative of some other high-income countries. Effluents of wastewater treatment plants were identified as the major source of contamination on French territory, with spreading of organic waste products as a more diffuse and incidental contamination of aquatic environments. A limitation of this review is the heterogeneity of available data in space and time, as well as the lack of data for certain sources. Comparing the French Measured Environmental Concentrations (MECs) with predicted no effect concentrations (PNECs), fluoroquinolones and trimethoprim were identified as representing high and medium risk of favoring the selection of resistant bacteria in treated wastewater and in the most contaminated rivers. All other antibiotic molecules analyzed (erythromycin, clarithromycin, azithromycin, tetracycline) were at low risk of resistance selection in those environments. However, the heterogeneity of the data available impairs their full exploitation. Consequently, we listed indicators to survey AMR and antibiotics in the environment and recommended the harmonization of sampling strategies and endpoints for analyses. Finally, the objectives and methods used for the present work could comprise a useful example for how national authorities of countries sharing common socio-geographic characteristics with France could seek to better understand and define the environmental dimension of AMR in their particular settings.

French infant total diet study: Exposure to selected trace elements and associated health risks.

A total diet study (TDS) was conducted between 2010 and 2016 to assess the risk associated with chemicals in food of non-breast-fed children under three living in France. 291 composite food samples were prepared "as consumed" and analyzed for 16 trace elements: aluminium (Al), antimony (Sb), arsenic (As), barium (Ba), cobalt (Co), chromium (Cr), gallium (Ga), germanium (Ge), lead (Pb), mercury (Hg), nickel (Ni), silver (Ag), strontium (Sr), tellurium (Te), tin (Sn), vanadium (V). Dietary exposure was assessed for 705 representative children using food consumptions recorded through a 3-consecutive-days record. For inorganic mercury, chromium III, and antimony, the exposure levels were lower than the health-based guidance values and the risk was considered tolerable. Conversely, the exposure levels to inorganic arsenic, lead and nickel were higher than the health-based guidance values for a part of children and were considered as a concern, requiring management measures to reduce the exposure. For aluminium, methylmercury, strontium, chromium VI, cobalt, and barium, a risk could not be ruled out because of uncertainty sources. As a precautionary measure, reducing the exposure is recommended. For chemicals without robust health-based guidance value (organic arsenic, gallium, germanium, silver, tin, tellurium and vanadium), additional data are needed for risk assessment.

Assessment of dietary exposure to bisphenol A in the French population with a special focus on risk characterisation for pregnant French women.

Bisphenol A (BPA) is used in a wide variety of products and objects for consumers use (digital media such as CD's and DVD's, sport equipment, food and beverage containers, medical equipment). Here, we demonstrate the ubiquitous presence of this contaminant in foods with a background level of contamination of less than 5 µg/kg in 85% of the 1498 analysed samples. High levels of contamination (up to 400 µg/kg) were found in some foods of animal origin. We used a probabilistic approach to calculate dietary exposure from French individual consumption data for infants under 36 months, children and adolescents from 3 to 17 years, adults over 18 years and pregnant women. The estimated average dietary exposure ranged from 0.12 to 0.14 µg/kg body weight per day (bw/d) for infants, from 0.05 to 0.06 µg/kg bw/d for children and adolescents, from 0.038 to 0.040 µg/kg bw/d for adults and from 0.05 to 0.06 µg/kg bw/d for pregnant women. The main sources of exposure were canned foods (50% of the total exposure), products of animal origin (20%) and 30% as a background level. Based on the toxicological values set by the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) for pregnant women, the risk was non negligible. Thus, we simulated scenarios to study the influence of cans and/or food of animal origin on the BPA-related risk for this specific population.

Ecological risk assessment of the presence of pharmaceutical residues in a French national water survey.

In this study, we focused on the list of 33 chemicals that was established through a French national prioritisation strategy. Assessing the potential risks to the environment was a step-wise procedure: (i) we determined the Predicted Environmental Concentration (PEC) of all molecules measured in the national survey based on the highest recommended dose used, (ii) we used the Measured Environmental Concentration (MEC) and the Predicted No-Effect Concentration (PNEC) to establish the Risk Quotient (RQ) based on either a PEC/PNEC (estimated risk) or MEC/PNEC (real risk) ratio. The risk assessment was performed using a binary ecological classification suggesting that appreciable risk is likely (RQ⩾1). Of the 15 molecules quantified in the survey, 12 had a PEC higher than the action limit value of 0.01µg/L. According to the EU Guideline, environmental risk was estimated as likely for the following five compounds: acetaminophen (RQ=1.6), ibuprofen (RQ=600), diclofenac (RQ=15), oxazepam (RQ=2.1) and carbamazepine (RQ=3.2). Only ibuprofen was identified as posing real environmental risk based on its MEC (RQ=1.9).

Organic UV filter concentrations in marine mussels from French coastal regions.

The accumulation of EHMC, OCT and OD-PABA, three common UV filter compounds, was investigated in marine mussels. Wild Mytilus edulis and Mytilus galloprovincialis were sampled in ten sites along the French Atlantic and Mediterranean coasts from June to November. In mussel tissues, 100% of the samples had quantifiable EHMC concentrations ranging from 3 to 256ngg(-1) dry weight, while 55% of the samples had detectable OCT concentrations ranging from under 2 to 7 112ngg(-1) dry weight. These concentrations significantly increased with the rising air temperature in summer, the recreational pressure and the geomorphological structure of the sampling sites (its lack of openness to the wide). This is the first study to report bioaccumulation of UV filters in marine mussels, thus highlighting the need for further monitoring and assessment.

Bioconcentration of two pharmaceuticals (benzodiazepines) and two personal care products (UV filters) in marine mussels (Mytilus galloprovincialis) under controlled laboratory conditions.

Bioaccumulation is essential for gaining insight into the impact of exposure to organic micropollutants in aquatic fauna. Data are currently available on the bioaccumulation of persistent organic pollutants, but there is very little documentation on the bioaccumulation of pharmaceuticals and personal care products (PPCPs). The bioconcentration of selected PPCPs was studied in marine mussels (Mytilus galloprovincialis). The selected PPCPs were two organic UV filters, i.e., 2-ethylhexyl-4-trimethoxycinnamate (EHMC) and octocrylene (OC), and two benzodiazepines (BZP), i.e., diazepam (DZP) and tetrazepam (TZP). Laboratory experiments were performed in which M. galloprovincialis was exposed to these compounds either directly from water, for the less lipophilic substances (BZP) or via spiked food for lipophilic UV filters. M. galloprovincialis uptook and eliminated BZP following first-order kinetics. The biological half-life (t (1/2)) of TZP was 1.4 days, resulting in a bioconcentration factor of 64 and 99 mL g(-1) dry weight (dw), respectively, for 2.3 and 14.5 µg L(-1) of exposure, while the biological half-life (t (1/2)) of DZP was 0.4 days, resulting in a bioconcentration factor of 51 mL g(-1) dw for 13.2 µg L(-1) of exposure. The uptake of UV filter was rapid in mussels, followed by elimination within 24 h. EHMC increased from 15 to 138 ng g(-1) dw in 1 h and decreased to 25 ng g(-1) after 24 h for 11.9 µg L(-1) exposure. OC reached 839 ng g(-1) dw after 1 h and decreased to 33 ng g(-1) after 24 h for 11.6 µg L(-1) exposure. However, EHMC and OC were slightly accumulated in 48 h, i.e., 38 and 60 ng g(-1) dw, respectively.

Monitoring organic contaminants in small French coastal lagoons: comparison of levels in mussel, passive sampler and sediment.

In this study, the distribution of organic contaminants was investigated in the particular context of three Mediterranean coastal lagoons, where pollution input was hypothesised to come mainly from sediments resuspension. Mussels and semi-permeable membrane devices (SPMDs) were exposed to the water column for one month and then their content in estrogen-, benzo[a]pyrene- and dioxin-like substances as well as polycyclic aromatic hydrocarbons (PAH), polychlorinated biphenyls and alkylphenols was determined with biological and chemical analyses. PAH concentration was high in sediments (up to 1028 ng g(-1) dry weight), however the aqueous PAH concentrations estimated from SPMD data could be considered below the levels inducing adverse effects according to the environmental quality standards proposed by the Water Framework Directive. Dioxin-like activity was observed in sediments but not in mussels and SPMDs. In the two sewage-impacted lagoons, nonylphenols could be quantified in sediments, SPMDs and mussels. Nonylphenol concentrations in mussels were among the highest found in the literature. However, since nonylphenols contributed only to a small part of the estrogenic activities observed, natural or synthetic steroids originating from wastewater discharges could be also implicated in these responses in sediments.