Risk assessment of biosolids-borne ciprofloxacin and azithromycin

Ciprofloxacin (CIP) and azithromycin (AZ) are commonly prescribed antibiotics for various infections in humans and are frequently detected in biosolids. Ecological and human health risks from biosolids-borne CIP and AZ are not well understood, but necessary for formulating policies on safe use and management of biosolids. A tiered integrated risk assessment (IRA), based on the World Health Organization (WHO) framework and the USEPA Part 503 Biosolids Rule, was conducted to assess human and ecological health risks from biosolids-borne CIP and AZ. The IRA utilized the hazard quotient (HQ) approach to evaluate risks to various receptors of concern (including humans, animals, and birds) in sixteen exposure pathways and three conservative biosolids land application scenarios. The scenarios consisted of (i) single-heavy (100 Mg ha^-1) land application of biosolids containing 95th percentile concentrations of CIP or AZ (USEPA, 2009), (ii) long-term (annual for 40-y) land application of biosolids containing typical (median; USEPA, 2009) CIP or AZ concentrations, and (iii) long-term (annual for 40-y) land application of biosolids containing the 95th percentile concentrations of CIP or AZ. The unrealistically conservative screening level (Tier 1) assessment identified three pathways of potential concern: biosolids → soil → plant (CIP); biosolids → soil → soil organism (CIP and AZ); and biosolids → soil → soil organism → predator (CIP and AZ). Subsequent tier (refined; more realistic) assessments and pollutant limits (calculated based on the USEPA Part 503 Biosolids Rule) suggested negligible human and ecological health risks from biosolids-borne CIP and AZ under real-world biosolids application scenarios. Pollutant concentration limits were 12 mg CIP kg^-1 and 2.2 mg AZ kg^-1; suggesting that pollutant load tracking is not needed for the majority (75% for CIP and 90% for AZ) of USA biosolids. Biosolids-borne antibiotic resistance (currently not addressed in any risk assessment model) is the principal uncertainty limiting risk assessment of biosolids-borne antibiotics including CIP and AZ.