Abstract
BACKGROUND: Antimicrobial resistance (AMR)—specifically antibiotic resistance—is a rapidly growing global health challenge affecting the treatment of serious and common bacterial infections. Concerned policymakers are beginning to question how the natural environment contributes to the development of resistant bacteria in humans and animals; yet, the area remains under researched. OBJECTIVE: In response to concerns about AMR in the environment, this thesis focused on the risks of soilborne AMR in crop production systems, aiming to elucidate any gaps between current scientific evidence and policy solutions. A bilateral research question addressed both risk assessment and risk management perspectives: first seeking answers on if or how AMR elements can transfer from soil and into food crops, and subsequently, information on if or how European countries are addressing such risks in AMR strategies. METHODS: Aligning with the research question, the qualitative study included two phases: first, a scoping review of scientific and grey literature to identify key risks related to soilborne AMR; and second, a document analysis of AMR National Action Plans (NAPs). Each phase followed a systematic process to increase the validity and reliability of results. RESULTS: The scoping review identified 42 pieces of literature, including peer-reviewed journal articles and reports from leading intergovernmental organizations. Current scientific evidence demonstrates how commonly used fertilization and irrigation practices contaminate soil with antibiotic residue, along with resistant bacteria and their genes; however, the overall risks are not fully understood. While concrete links have not been established between soilborne AMR and specific human health outcomes, current scientific evidence shows that soilborne AMR elements can indeed transfer to crops; therefore, concerns about human health risks are valid. The document analysis included nine (9) European NAPs and found that current AMR strategies rarely, if at all, discuss soilborne AMR. Importantly, the NAPs offered no risk management solutions for soilborne AMR, indicating a widening gap between scientific knowledge and action. CONCLUSION: Soilborne AMR is a potentially important contributing factor to the growth of AMR in humans and animals. A greater focus on soilborne AMR, as well as the environment more broadly, should be a priority of future NAPs.