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How Indoor Air Quality Management Can Decrease the Spread of Antibiotic Resistance

Updated: Oct 10, 2023

closeup of microbes

Influence of the indoor environment on health is coming into focus.

Traditional germ theory states that all microbes are bad - but in 2012 the Human Microbiome Project found that the number of microbes living within the human body are far greater than the number of human cells - and that they contribute an estimated 2 to 20 million genes (a huge number in comparison to the 20,000 human genes)[1]. Further research found that 95% of these identified bacteria are beneficial to human health - it’s the remaining 5% that need to be kept in check given their ability to evolve to survive in different conditions.

Genetic analysis tools called metagenomics have revolutionized our understanding of the relationship between human health and microorganisms. They have shown us that there are far more bacteria, fungus, and virus types in existence than we thought, and that many of them make up an ecosystem of microorganisms within the human body and most of them actually support health.

However, components of indoor air pollution such as particulate matter and ozone (among others) can cause inflammation in our airways, and exacerbate respiratory infections. In addition, antibiotic resistant bacteria (ARB) and gene fragments that carry resistance (ARG) can be carried by PM2.5 in outdoor air.

[1] Annual Review of Genomics and Human Genetics. 13:1, 151-170

Indoor Air Pollution and Spread of Antibiotic Resistance (ARB)

In 2018, scientists learned that antibiotic resistant genes could spread over long distances through the air and be passed laterally to other airborne pathogens in the process, which instantly confers resistance to treatment. Treatment resistant bacteria caused by widespread antibiotic use has already been on the minds of doctors and researchers, but now the World Health Organization states that reducing the use of antibiotics alone will not be enough to reverse this trend; treatment resistance can spread through the air.

Graphic of relationhips between indoor air pollutants and disease from antibiotic resistant genes

FIGURE 1: The relationship between indoor air pollutants and disease from antibiotic resistant bacteria and genes (c. B4H Inc. via Biorender).

How can IAQ Solutions help control the spread of treatment-resistant pathogens?

Since we have found that PM2.5 both carries ARB and ARG as well as weakens the innate defenses of the respiratory system it follows that addressing Indoor air quality (IAQ) can also address this problem.

As a fuller picture becomes clear about the extent of antibiotic resistant microbes, it has become obvious that improving IAQ doesn’t just support health in the short term by preventing infection, but also by limiting the potential ARG and ARB to spread. At Building4Health, we’ve created an innovative IAQ standard and holistic solution to maintain a healthy indoor ecosystem and supporting the human defenses that prevent viral or bacterial infections.

Learn more about our medically-based IAQ Solution.

Note: This article was adapted from the original article published in Engineered Systems, March 16, 2022 by Stephanie Taylor, MD.


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