Air pollution (PM2.5) can be a direct vector of antibiotic resistant bacteria, and caused approx 0.5M deaths in 2018, per new study.
Just published in The Lancet Planetary Health (peer-reviewed scientific journal):
“Association between particulate matter (PM)2·5 air pollution and clinical antibiotic resistance: a global analysis” (by Zhenchao Zhou, PhD, Xinyi Shuai, BSc, et al.)
https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(23)00135-3/fulltext
“The major air pollutant, in the form of particulate matter (PM)2.5, has been shown to contain diverse antibiotic-resistant bacteria and antibiotic-resistance genes, which are transferred between environments and directly inhaled by humans, causing respiratory-tract injury and infection. [7, 8, 9] PM2.5 could also increase cell-membrane permeability to enhance the efficiency of horizontal gene transfer, accelerating the evolution and exchange of antibiotic-resistance elements in bacterial pathogens. [10, 11]”
[continued]
"Findings
The final dataset included more than 11.5 million tested isolates. Raw antibiotic-resistance data included nine pathogens and 43 types of antibiotic agents. Significant correlations between PM2.5 and antibiotic resistance were consistent globally in most antibiotic-resistant bacteria (R^2=0.42–0.76, p<0.0001), and correlations have strengthened over time. Antibiotic resistance derived from PM2.5 caused an estimated 0.48 (95% CI 0.34–0.60) million premature deaths and 18.2 (13.4–23.0) million years of life lost in 2018 worldwide, corresponding to an annual welfare loss of US$395 (290–500) billion due to premature deaths."