Antimicrobial resistance and karst groundwater systems: A policy gap analysis for addressing water quality and contaminants of emerging concern

Abstract

Aquifers are a significant drinking water source for the United States. Although vital to human well-being, development, and economies, these systems, specifically karst, either have minimal protections or are entirely overlooked in federal and state-level water quality policies and regulations. A lack of policies and regulations for the protection of karst groundwater resources is problematic, especially because these systems are characterized by distinctive landforms such as interconnected networks of underground rivers, sinkholes, springs and caves, and are extremely susceptible to contamination from polluted overland flows. This study considers policy approaches to improve water quality in groundwater, specifically karst systems, especially with regard to emerging contaminants of concern (CECs) and health threats, such as antimicrobial resistance (AMR). The study reviews and evaluates groundwater and karst groundwater quality and AMR policy gaps in federal water legislation (including the U.S. Clean Water Act and the Safe Drinking Water Act), and state-level programs in 44 states to provide recommendations for future policy development. Presently, there is limited federal and state-level protection for groundwater systems and minimal state-level for karst throughout the U.S. Also, there are neither federal nor state regulations for AMR mitigation in water resources. There is a need for policies and monitoring and regulatory programs that support water quality protection and management strategies for water resources with distinctive hydrology. Addressing water quality policy gaps for groundwater resources – especially karst aquifers – and prioritizing emerging contaminants in research, monitoring, and policymaking, are critical to safeguard the public against nascent public and environmental health threats.