Pharmaceutical usage during an influenza pandemic: implications for sewage treatment plant function

PREPARE’s second workshop was aimed at identifying and risk ranking hazards that are posed by pharmaceutical usage during a pandemic to the operation of sewage treatment plants. This workshop was held at Somerville College, University of Oxford, 3 March 2009.  The list of attendees can be found here (Final PREPARE workshop attendees). The workshop agenda (PREPARE workshop programme), and the presentations with audio can be found here. The workshop, “Pharmaceutical usage during an influenza pandemic: implications for sewage treatment plant function” had the following objectives:

  • To define the range of pharmaceuticals to be used to treat primary and secondary infections during an influenza pandemic in the UK.
  • To make an assessment of the fate and behaviour of these pharmaceuticals in sewage treatment plants.
  • To identify the chemical and microbial processes of principal concern, and their potential responses to pandemic pharmaceutical concentrations.
  • To assess the implications of seasonal and temporal variations in waste load and composition.
  • To evaluate the potential for sewage treatment plant failure, and contingency planning for such a scenario.

Breakout discussions addressed the following questions. All participants were invited to offer a score between 1 and 5 on a post-it note. Participants were asked to provide a brief reason for their score to be written on the back of the note.

  1. Do we have sufficient information to confirm that the antibiotic use associated with a flu pandemic will not cause a problem to sewage treatment performance?
  2. What does existing knowledge tell us about the magnitude of a reduction in sewage treatment plant function?
  3. What are the key factors that would determine a reduction in function (or failure) of sewage treatment performance during a pandemic?

Clarifying questions:

Q: What type of sewage treatment plant / process are we to consider?

A: The most sensitive kind of sewage treatment plant / process.

Q: What stage in the pandemic are we considering? What level of pharmaceutical usage?

A: The stage with the highest concentrations of antibiotics / the mix of antibiotics that is most likely to have an effect.

Q: Are we just concerned with antibiotics?

A: Yes .

Q: What kind of time period are we considering for impairment of function – a few hours or a few months?

A: Get the group to define this

Q: What do we mean by ‘modest’?

A: Ask the water industry what they would consider to be modest

Q: How long is failure for it to be complete?

A: Ask the water industry or a public health expert to advise. If in doubt, suggest more than a day

Conclusion:  The results of these discussions were summarised and a consensus Policy Brief was prepared, which can be accessed here (PREPARE Policy Briefing).