Meeting Report: Risk Assessment of Tamiflu Use Under Pandemic Conditions
Meeting Report: Risk Assessment of Tamiflu Use Under Pandemic Conditions
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DOI：
10.1289/ehp.11310
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发表时间：
2008-11-01
影响因子：
10.4
通讯作者：
Watts, Chris
中科院分区：
文献类型：
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作者：
Singer, Andrew C.;Howard, Bruce M.;Watts, Chris
2007年10月3日，40名具有不同专业知识的与会者参加了达菲与环境研讨会：在大流行条件下使用达菲的影响，以评估在流感大流行期间使用达菲可能对人类健康造成的影响和环境危害。根据对知识差距的识别和风险排序，一致认为奥司他韦磷酸乙酯(OE-P)和奥司他韦羧酸盐(OC)不太可能对淡水生物构成生态毒理危害。河水中的OC可能会加速野禽对OC的抗性，但这种可能性似乎比OC和其他药物可能对污水处理厂的运行造成的潜在干扰更小。工作组成员商定了以下研究优先事项：a)应公布OE-P和OC的生态毒理学现有数据；b)应评估受OC污染的河水在野禽体内产生耐OC病毒的风险；c)应调查因神经氨酸酶抑制剂和其他抗菌剂在大流行期间使用的微生物抑制而导致的污水处理厂的运转情况；e)应制定现实的最坏情况暴露情景。额外的模型将有助于确定河流集水区内可能容易导致污水处理厂污水中药物浓度较高的局部区域。在日本，持续的季节性使用达菲为研究人员提供了机会，以评估有多少OC进入并持续存在于水环境中。
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 e 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.