Meeting report: risk assessment of tamiflu use under pandemic conditions.
On 3 October 2007, 40 participants with diverse expertise attended the workshop Tamiflu and the Environment: Implications of Use under Pandemic Conditions to assess the potential human health impact and environmental hazards associated with use of Tamiflu during an influenza pandemic. Based on the identification and risk-ranking of knowledge gaps, the consensus was that oseltamivir ethylester-phosphate (OE-P) and oseltamivir carboxylate (OC) were unlikely to pose an ecotoxicologic hazard to freshwater organisms. OC in river water might hasten the generation of OC-resistance in wildfowl, but this possibility seems less likely than the potential disruption that could be posed by OC and other pharmaceuticals to the operation of sewage treatment plants. The work-group members agreed on the following research priorities: a) available data on the ecotoxicology of OE-P and OC should be published; b) risk should be assessed for OC-contaminated river water generating OC-resistant viruses in wildfowl; c) sewage treatment plant functioning due to microbial inhibition by neuraminidase inhibitors and other antimicrobials used during a pandemic should be investigated; and d) realistic worst-case exposure scenarios should be developed. Additional modeling would be useful to identify localized areas within river catchments that might be prone to high pharmaceutical concentrations in sewage treatment plant effluent. Ongoing seasonal use of Tamiflu in Japan offers opportunities for researchers to assess how much OC enters and persists in the aquatic environment.
Singer
Andrew C
AC
Centre for Ecology & Hydrology, Oxford, United Kingdom. acsi@ceh.ac.uk
Howard
Bruce M
BM
Johnson
Andrew C
AC
Knowles
Chris J
CJ
Jackman
Simon
S
Accinelli
Cesare
C
Caracciolo
Anna Barra
AB
Bernard
Ian
I
Bird
Stephen
S
Boucard
Tatiana
T
Boxall
Alistair
A
Brian
Jayne V
JV
Cartmell
Elise
E
Chubb
Chris
C
Churchley
John
J
Costigan
Sandra
S
Crane
Mark
M
Dempsey
Michael J
MJ
Dorrington
Bob
B
Ellor
Brian
B
Fick
Jerker
J
Holmes
John
J
Hutchinson
Tom
T
Karcher
Franz
F
Kelleher
Samuel L
SL
Marsden
Peter
P
Noone
Gerald
G
Nunn
Miles A
MA
Oxford
John
J
Rachwal
Tony
T
Roberts
Noel
N
Roberts
Mike
M
Saccà
Maria Ludovica
ML
Sanders
Matthew
M
Straub
Jürg Oliver
JO
Terry
Adrian
A
Thomas
Dean
D
Toovey
Stephen
S
Townsend
Rodney
R
Voulvoulis
Nikolaos
N
Watts
Chris
C
D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy*; D053139:Oseltamivir / Q000627:therapeutic use*; D018570:Risk Assessment
D053139:Oseltamivir