Air pollution (PM2.5) can be a direct vector of antibiotic resistant bacteria, and caused approx 0.5M deaths in 2018, per new study.

Just published in The Lancet Planetary Health (peer-reviewed scientific journal):
"Association between particulate matter (PM)2·5 air pollution and clinical antibiotic resistance: a global analysis" (by Zhenchao Zhou, PhD, Xinyi Shuai, BSc, et al.)
https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(23)00135-3/fulltext

"The major air pollutant, in the form of particulate matter (PM)2.5, has been shown to contain diverse antibiotic-resistant bacteria and antibiotic-resistance genes, which are transferred between environments and directly inhaled by humans, causing respiratory-tract injury and infection. [7, 8, 9] PM2.5 could also increase cell-membrane permeability to enhance the efficiency of horizontal gene transfer, accelerating the evolution and exchange of antibiotic-resistance elements in bacterial pathogens. [10, 11]"

@collapse