Modeling and simulation of source separation in sanitation systems for reducing emissions of antimicrobial resistances

Abstract

Antimicrobial resistance (AMR) is identified by the World Health Organization (WHO) as one of the top ten threats to public health worldwide. In addition to public health, AMR also poses a major threat to food security and economic development. Current sanitation systems contribute to the emergence and spread of AMR and lack effective AMR mitigation measures. This study assesses source separation of blackwater as a mitigation measure against AMR. A source-separation-modified combined sanitation system with separate collection of blackwater and graywater is conceptually described. Measures taken at the source, such as the separate collection and discharge of material flows, were not considered so far on a load balance basis, i.e., they have not yet been evaluated for their effectiveness. The sanitation system described is compared with a combined system and a separate system regarding AMR emissions by means of simulation. AMR is represented in the simulation model by one proxy parameter each for antibiotics (sulfamethoxazole), antibiotic-resistant bacteria (extended-spectrum beta-lactamase E. Coli), and antibiotic resistance genes (blaTEM). The simulation results suggest that the source-separation-based sanitation system reduces emissions of antibiotic-resistant bacteria and antibiotic resistance genes into the aquatic environment by more than six logarithm steps compared to combined systems. Sulfamethoxazole emissions can be reduced by 75.5% by keeping blackwater separate from graywater and treating it sufficiently. In summary, sanitation systems incorporating source separation are, to date, among the most effective means of preventing the emission of AMR into the aquatic environment.