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Work Packages: Description

Work Packages

The AWARE project is organized into six different but complementary work packages:


Work Package      Description Leader      Participants
WP1 Epidemiological studies LMU RIVM, UB
WP2 Setup of Sampling Campaign UB LMU, RIVM
WP3 Characterization of ESBL, CPE, and full resistomes      UGOT RIVM, UB
WP4 Exposure modelling RIVM LMU
WP5 Dissemination of Results LMU UB, RIVM, UGOT
WP6 Project Management and Coordination RIVM RIVM

Responsible Institutions

The responsible institutions are:

  • RIVM: National Institute for Public Health and the Environment (the Netherlands).
  • LMU: University of Munich (Germany).
  • UB: University of Bucharest (Romania).
  • UGOT: University of Gothenborg (Sweden).



This figure shows the succession of work packages and research activities during AWARE- WWTP.
Kick Off (KO), Progress Meeting (PM) and Final Meeting (FM) are indicated and expected to take place in May 2017, September 2018 and November 2019, respectively.

Work Package 1: Epidemiological studies

Work Package 1: Epidemiological studies 

Leader: LMU
Participants: RIVM, UB.

It is currently unknown to what extent environmental exposures to AMR enhance human colonization. WWTPs represent an ideal study case for this question, because due to high amounts of AMR occurring in wastewater, workers and nearby residents are possibly highly exposed.

In WP1, an epidemiological study of carriage of ESBL, CPE and resistance genes in workers working at WWTPs and in residents living in different distances to WWTPs will be conducted.
Relation with objectives
This WP contributes mainly to the objectives 1 and 2 (occupational and environmental health impact of exposure to ARB/ARG).

Work Package 2: Setup of Sampling Campaign

Work Package 2: Setup of Sampling Campaign 

Leader: UB
Participants: LMU, RIVM.

The combination of epidemiological studies in WWTP workers and nearby residents with studies of the occurrence and transmission of AMR in the WWTP environment requires careful alignment of sample selection and sampling procedures.

In WP2, sampling plans and protocols will be set up for 3 countries with low and high AMR, including human and environmental sampling.

Work Package 3: Characterization of ESBL, CPE, and full resistomes

Work Package 3: Characterization of ESBL, CPE, and full resistomes

Leader: UGOT
Participants: RIVM, UB.

The link between environmental and workers'/residents' resistomes in WWTP is currently unknown. Full characterization of resistomes and ESBL/CPE isolates in both humans and environmental matrices allows strengthening the link between exposure and carriage.

in WP3, bacterial isolates and metagenomic DNA of environmental and human samples will be characterized in depth (also to identify novel resistance genes), and in addition, the treatment efficiency of different WWTP processes with respect to AMR will be established.

Work Package 4: Exposure modeling

Work Package 4: Exposure modeling

Leader: RIVM
Participants: LMU.

The degree of exposure to AMR from WWTPs through ingestion and inhalation is largely unknown.

In WP4, exposure models and geospatial analyses will be established that describe WWTP exposure to ESBL and CPE by inhalation and ingestion. In combination with data from WP1, dose-response relations will be generated.

Work Package 5: Dissemination of Results

Work Package 5: Dissemination of Results

Leader: LMU
Participants: LMU, UB, RIVM, UGOT.

Public and professional awareness of the relevance of environmental exposures to AMR is limited.

In WP5, results of AWARE-WWTP are effectively disseminated to relevant stakeholders and the wider public.

Work Package 6: Project Management and Coordination

Work Package 6: Project Management and Coordination

Leader: RIVM

WP6 lays out the project management and project coordination.