{"title":"Antibiotic waste as an emerging environmental contaminant: Indirect pathways linking antibiotic pollution to childhood stunting in low- and middle-income countries","authors":"Ikhwan Yuda Kusuma, Muhammad Jayyid Zidan, Nahla Habibah Hilmi, Nelly Maryanti, Prasanti Adriani","doi":"10.1016/j.coesh.2026.100746","DOIUrl":"10.1016/j.coesh.2026.100746","url":null,"abstract":"<div><div>Childhood stunting persists in low- and middle income countries (LMICs), indicating the potential contribution of additional, insufficiently addressed determinants beyond nutrition and infection. This review proposes that antibiotic waste, residues and antimicrobial resistance (AMR) determinants from medical, agricultural, and domestic sources, may represent a neglected environmental risk rather than a confirmed primary cause. The narrative review synthesizes evidence across disciplines to: (i) characterize antibiotic waste contamination, (ii) map exposure pathways, (iii) describe mechanisms along an Antibiotic Waste Microbiome Growth axis, (iv) appraise epidemiological evidence and gaps, and (v) outline policy and research priorities. Antibiotic residues pervade water, soil, and biota, with microplastics amplifying exposure. Chronic low dose exposure disrupts infant gut microbiota, reduces short chain fatty acids (SCFAs), impairs gut barrier integrity, and promotes subclinical inflammation and environmental enteric dysfunction (EED), hindering growth. However, direct population-level evidence linking environmental antibiotic residues to stunting remains unavailable, underscoring that this framework is hypothesis-driven and highlighting a critical research gap. Policy priorities include effluent control, safe water access, microbiota directed foods, and integrated AMR nutrition surveillance.</div></div><div>Childhood stunting persists in low- and middle income countries (LMICs), indicating the potential contribution of additional, insufficiently addressed determinants beyond nutrition and infection. This review proposes that antibiotic waste, residues and antimicrobial resistance (AMR) determinants from medical, agricultural, and domestic sources, may represent a neglected environmental risk rather than a confirmed primary cause. The narrative review synthesizes evidence across disciplines to: (i) characterize antibiotic waste contamination, (ii) map exposure pathways, (iii) describe mechanisms along an Antibiotic Waste Microbiome Growth axis, (iv) appraise epidemiological evidence and gaps, and (v) outline policy and research priorities. Antibiotic residues pervade water, soil, and biota, with microplastics amplifying exposure. Chronic low dose exposure disrupts infant gut microbiota, reduces short chain fatty acids (SCFAs), impairs gut barrier integrity, and promotes subclinical inflammation and environmental enteric dysfunction (EED), hindering growth. However, direct population-level evidence linking environmental antibiotic residues to stunting remains unavailable, underscoring that this framework is hypothesis-driven and highlighting a critical research gap. Policy priorities include effluent control, safe water access, microbiota directed foods, and integrated AMR nutrition surveillance.</div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"52 ","pages":"Article 100746"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148657113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antibiotics and microbial resistance genes removal in constructed wetlands","authors":"Ewa Felis, Sylwia Bajkacz, Adam Sochacki","doi":"10.1016/j.coesh.2026.100747","DOIUrl":"10.1016/j.coesh.2026.100747","url":null,"abstract":"<div><div>The aims of this literature review were to assess the potential of constructed wetlands (CWs) to remove antibiotics as β-lactams, macrolides, fluoroquinolones, sulfonamides, and tetracyclines, to determine the main mechanisms responsible for their removal, and to assess the potential of CWs to remove selected antibiotic resistance genes (ARGs). The results of this review suggest that vertical-flow CWs are more efficient at removing both antibiotics and ARGs than horizontal-flow CWs. Aerobic biodegradation and adsorption were identified as the dominant processes responsible for antibiotic removal. These processes can be enhanced by increasing oxygen transfer and supplementing the substrate (i.e. filtration bed) with specific sorbents. The primary mechanisms of ARGs removal have not been clearly identified, but it can be hypothesized that ARGs elimination may be mediated by multiple factors that can produce a synergistic effect in CWs, although this is related to the conditions prevailing in CWs. This literature review has shown that there is a need for further expansion of knowledge in this area, especially in the context of a better understanding of the mechanisms involved in the removal of ARGs in CWs.</div></div><div>The aims of this literature review were to assess the potential of constructed wetlands (CWs) to remove antibiotics as β-lactams, macrolides, fluoroquinolones, sulfonamides, and tetracyclines, to determine the main mechanisms responsible for their removal, and to assess the potential of CWs to remove selected antibiotic resistance genes (ARGs). The results of this review suggest that vertical-flow CWs are more efficient at removing both antibiotics and ARGs than horizontal-flow CWs. Aerobic biodegradation and adsorption were identified as the dominant processes responsible for antibiotic removal. These processes can be enhanced by increasing oxygen transfer and supplementing the substrate (i.e. filtration bed) with specific sorbents. The primary mechanisms of ARGs removal have not been clearly identified, but it can be hypothesized that ARGs elimination may be mediated by multiple factors that can produce a synergistic effect in CWs, although this is related to the conditions prevailing in CWs. This literature review has shown that there is a need for further expansion of knowledge in this area, especially in the context of a better understanding of the mechanisms involved in the removal of ARGs in CWs.</div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"52 ","pages":"Article 100747"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148735670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toward mechanistic and comparable assessment of micro- and nanoplastics barrier hazards","authors":"V.C. Shruti, Gurusamy Kutralam-Muniasamy","doi":"10.1016/j.coesh.2026.100748","DOIUrl":"10.1016/j.coesh.2026.100748","url":null,"abstract":"<div><ul><li><span>•</span><span><div>Micro- and nanoplastic toxicity through epithelial portal formation is reframed.</div></span></li><li><span>•</span><span><div>Barrier hazard is quantified using the particle-resolved Portal Index.</div></span></li><li><span>•</span><span><div>Particle-induced disruption, persistence, and stress amplification are captured.</div></span></li><li><span>•</span><span><div>Comparative, model-independent evaluation of barrier vulnerability is enabled.</div></span></li></ul></div><div><div>Micro- and nanoplastics (MPs/NPs) are pervasive across ecosystems and human exposure pathways, yet their epithelial barrier hazards remain difficult to evaluate and compare across studies. Reported outcomes—including barrier disruption, particle translocation, and inflammatory signaling—are commonly treated as independent endpoints and interpreted using bulk exposure metrics, limiting mechanistic integration and obscuring how barrier vulnerability emerges over time under environmentally realistic conditions. Barrier hazard can instead be understood as arising from portal formation: the probabilistic emergence of localized, persistent regions of epithelial vulnerability driven by sustained, time-dependent particle–interface interactions. Within this view, epithelial stress reflects an emergent population-level state rather than a deterministic property of individual particles. The Portal Index captures this state by integrating the time-varying probabilities of mechanical barrier perturbation, interface persistence, and conditional inflammatory amplification into a unified functional measure of barrier stress. Because the framework operates at the level of particle populations and explicitly incorporates temporal dynamics, it is applicable to both monodisperse and heterogeneous MPs/NPs and supports temporally resolved comparison across materials, exposure scenarios, and experimental systems. Framing epithelial barrier disruption as a quantifiable functional state thus provides a mechanistic and comparable basis for future experimental design, cross-study synthesis, and sustainability-relevant evaluation under environmentally realistic exposure conditions.</div></div><div>Micro- and nanoplastics (MPs/NPs) are pervasive across ecosystems and human exposure pathways, yet their epithelial barrier hazards remain difficult to evaluate and compare across studies. Reported outcomes—including barrier disruption, particle translocation, and inflammatory signaling—are commonly treated as independent endpoints and interpreted using bulk exposure metrics, limiting mechanistic integration and obscuring how barrier vulnerability emerges over time under environmentally realistic conditions. Barrier hazard can instead be understood as arising from portal formation: the probabilistic emergence of localized, persistent regions of epithelial vulnerability driven by sustained, time-dependent particle–interface interactions. Within this view, epithelial","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"52 ","pages":"Article 100748"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148735671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Synergistic interplays of emerging contaminants: Rethinking water security, risk, and resilience in a changing world","authors":"Manish Kumar, Kashyap K. Dubey, Keisuke Kuroda, Sanjeeb Mohapatra, Vivek Agarwal, Rakesh Kumar","doi":"10.1016/j.coesh.2026.100734","DOIUrl":"10.1016/j.coesh.2026.100734","url":null,"abstract":"","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"51 ","pages":"Article 100734"},"PeriodicalIF":6.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thanigaivelan Arumugham, Delal E. Al Momani, Zainab Al Ansari, Shadi W. Hasan
{"title":"Recent advances in membrane technologies for disinfection by-product control: Hybrid systems, challenges, and future perspectives","authors":"Thanigaivelan Arumugham, Delal E. Al Momani, Zainab Al Ansari, Shadi W. Hasan","doi":"10.1016/j.coesh.2026.100721","DOIUrl":"10.1016/j.coesh.2026.100721","url":null,"abstract":"<div><div>Membrane technology is pivotal in water reuse for limiting disinfection byproduct (DBP) formation in surface water and wastewater, enabling safe potable and non-potable applications. Wastewater effluents, rich in dissolved organic matter (DOM), act as major DBP precursors, posing challenges for water reclamation. Pretreatment-enhanced or hybrid membrane systems have emerged as essential strategies to control DBP formation and ensure water quality. This mini review critically examines recent advances in microfiltration (MF), ultrafiltration (UF), nanofiltration (NF), and reverses osmosis (RO) membranes for controlling DBP formation. While NF and RO can achieve up to 90–99 % removal of dissolved organic matter (DOM) and effectively reduce DBP formation potential (DBPFP) by over 80 %, MF and UF alone are limited in NOM/DBPFP removal and typically require integration with coagulation or other pretreatment processes for significant DBP control. However, low-molecular-weight neutral DBPs like NDMA remain challenging, with rejection rates frequently below 40 %. Hybrid systems, including ozonation-NF and photocatalytic membrane processes, show enhanced DBP removal efficiencies of up to 95 %, while offering benefits in fouling control and operational stability. Despite these advances, challenges persist in scalability, cost, and the environmental sustainability of emerging membrane materials. Future research should prioritize the integration of advanced nanomaterials, machine learning-driven membrane design, and life cycle assessments to enable safe and economically viable DBP management in water treatment and reuse.</div></div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"51 ","pages":"Article 100721"},"PeriodicalIF":6.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Environmental risks associated with PFAS contamination in water: Challenges and emerging management strategies","authors":"Monika Mahajan , Rajneesh Kumar Gautam , Himanshu K. Pathak , Rajeev Pratap Singh , Edza Aria Wikurendra","doi":"10.1016/j.coesh.2026.100705","DOIUrl":"10.1016/j.coesh.2026.100705","url":null,"abstract":"<div><div>Per and polyfluoroalkyl substances are durable synthetic organofluorines, and their toxicity has led to a worldwide environmental and public health dilemma. While their ubiquitous presence in air, water, food, and human serum is well documented, there are significant inequalities in how these substances are monitored, regulated, and managed, especially in developing areas where systems are inadequate or nonexistent. Current review underlines how technical deficiencies, poor governance, and socioeconomic barriers escalate PFAS risks throughout the Global South. This review covers remediation technologies such as adsorption, membrane separation, advanced oxidation, plasma treatment, and biochar based solutions, highlighting their potential and their challenges. Bridging data and treatment gaps will necessitate region-specific fate-and-transport models, open-access monitoring, and AI/ML driven predictive tools for flexible solutions. International binding agreements, technology transfer, and polluter pays strategies are essential. The management of PFAS necessitates a global approach that incorporates interdisciplinary methods and emphasizes justice-oriented solutions.</div></div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"50 ","pages":"Article 100705"},"PeriodicalIF":6.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antibiotic residues, resistant bacteria, and resistance genes in hospital wastewater from upper middle-income countries: A systematic review","authors":"Ikhwan Yuda Kusuma , Hening Pratiwi , Afriza Pujiati , Septi Nurkhasanah , Dian Ayu Eka Pitaloka","doi":"10.1016/j.coesh.2026.100707","DOIUrl":"10.1016/j.coesh.2026.100707","url":null,"abstract":"<div><div>Hospital wastewater in upper middle-income countries (UMICs) is a major source of antibiotic residues, resistant bacteria, and resistance genes due to limited treatment and surveillance. This review synthesizes evidence to assess the scale of the problem, highlight knowledge gaps, and guide strategies to curb antimicrobial resistance spread. Conducted under PRISMA guidelines, the review analyzed studies from 2015 to 2025 on antibiotic residues, resistant bacteria, and resistance genes in hospital wastewater from UMICs, with emphasis on treatment technologies and public health risks. Fifty-seven studies showed that hospital wastewater in UMICs contains high levels of antibiotic residues, resistant bacteria, and resistance genes, even after conventional treatment. Multidrug-resistant pathogens such as <em>E. coli</em>, <em>K. pneumoniae</em>, <em>P. aeruginosa</em>, and <em>A. baumannii</em> were frequently reported, with resistance to last resort antibiotics including carbapenems and colistin. Findings underscore limitations of conventional treatment, risks of horizontal gene transfer, and urgent need for advanced technologies and stronger public protection measures.</div></div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"50 ","pages":"Article 100707"},"PeriodicalIF":6.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146154148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emerging higher-carbon nitrogenous disinfection byproducts: A brief review of structures, occurrence, and research needs","authors":"Siavash Mohamadi, Christian A. Werner, Ning Dai","doi":"10.1016/j.coesh.2025.100690","DOIUrl":"10.1016/j.coesh.2025.100690","url":null,"abstract":"<div><div>Disinfection/oxidation byproducts (DBPs) are formed during water treatment. Nitrogenous DBPs (N-DBPs) are generally more toxic than the DBPs without nitrogen. Recently, DBPs of more than two carbons (“higher-carbon DBPs”) have been reported, but the status of higher-carbon N-DBP research has not been reviewed. This review assembled 355 individual compounds/structures of emerging higher-carbon N-DBPs and summarized the occurrence, precursors, and oxidation treatment for the 12 major classes (196 compounds/structures), including halogenated aromatic/cyclic compounds (nitrophenols, anilines, benzoquinone imines, pyridines, pyrroles, imidazoles, indoles, and nucleobases), as well as aliphatic/aromatic/cyclic compounds featuring nitrile, amide, and imide functional groups. Almost half of the major higher-carbon N-DBPs were confirmed by standards, but mass spectrometry-based identification is also common. Chlorination was the most studied disinfection method for higher-carbon N-DBPs, followed by chloramination and pre-ozonation, while chlorine dioxide and UV were not commonly considered. The levels of higher-carbon N-DBPs in real water samples ranged from <0.1 to ∼100 ng/L based on the limited studies, but their global occurrence remains unknown. Preliminary toxicity assessment showed that higher-carbon N-DBPs were more toxic than their non-nitrogenous analogues and the regulated DBPs. Potential synergy between the research of DBPs and contaminants of emerging concern (CECs) was discussed, as CECs can serve as a significant but previously overlooked source of precursors for both higher-carbon N-DBPs and the high-priority small-molecule DBPs. Strengthening the synergy between the research on DBPs and advanced oxidation processes (AOPs), especially regarding nitrogen-incorporation during AOP, will contribute to our understanding on the formation of higher-carbon N-DBPs.</div></div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"49 ","pages":"Article 100690"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Brominated and iodinated disinfection by-products: Recent advances in formation, characterization, and toxicity","authors":"Justine Criquet","doi":"10.1016/j.coesh.2025.100692","DOIUrl":"10.1016/j.coesh.2025.100692","url":null,"abstract":"<div><div>The formation of brominated and iodinated disinfection by-products is of concern due to impaired water quality, taste- and odor-issues, and health concerns. Progress in the identification of precursors among the complex organic matter reveals that low-molecular-weight by-products are the main toxicity drivers. These by-products could, however, originate from the degradation of high-molecular-weight organic matter, especially in the presence of iodide during chlorination or chloramination and algal bloom events. Alternative oxidants such as peracids or periodate reach different levels of assessment, considering the formation of by-products, demonstrating breakthroughs in this field but also remaining gaps to be filled.</div></div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"49 ","pages":"Article 100692"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syed Shabi Ul Hassan Kazmi , Muhammad Azeem , Hafiz Sohaib Ahmed Saqib , Zaher Mundher Yaseen , Gang Li
{"title":"The plastisphere as an engine of environmental change: Impacts on biogeochemical cycling and pollutant fate","authors":"Syed Shabi Ul Hassan Kazmi , Muhammad Azeem , Hafiz Sohaib Ahmed Saqib , Zaher Mundher Yaseen , Gang Li","doi":"10.1016/j.coesh.2025.100703","DOIUrl":"10.1016/j.coesh.2025.100703","url":null,"abstract":"<div><div>Plastic pollution is now a major microbiological and biogeochemical challenge. This review critically evaluates the plastisphere, the microbial biofilm colonizing plastic debris, and establishes its role as an engine of environmental change. We posit the central hypothesis that the plastisphere functions as a mobile hotspot of microbial activity that disrupts natural biogeochemical cycles and introduces novel pollutant dynamics. To evaluate this, we investigate three key questions: (1) how does the metabolic core of the plastisphere reconcile high <em>in vitro</em> enzymatic potential with limited <em>in situ</em> degradation efficacy? (2) what is the dual role of the plastisphere in pollutant fate, acting as both a transport vector and a bioreactor? (3) how are these functions intensified by global change drivers? Our synthesis concludes that the plastisphere collective metabolism short-circuits natural elemental cycles and introduces novel pollutant vectors. Addressing this multidimensional threat requires interdisciplinary research to inform both mitigation policies and the transition to a circular plastic economy.</div></div>","PeriodicalId":52296,"journal":{"name":"Current Opinion in Environmental Science and Health","volume":"49 ","pages":"Article 100703"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}