- Open Access
Microplastics, environment and child health
Italian Journal of Pediatrics volume 47, Article number: 75 (2021)
The substantial increase in scientific studies  in recent years has clarified and evidenced that the use of plastic material, widely employed in daily life due to the advantages it offers with respect to other materials, can cause environmental damage. In particular, several studies have focused on microplastics (MPs), defined on the basis of a size smaller than 5 mm. MPs are subdivided into two groups : primary MPs, used both industrially as plastic pellets and in personal care products (i.e. toothpastes, nail polishes, sun creams, scrubs, bath gels)  and secondary MPs, derived from the plastic waste dispersed into the environment which undergoes progressive degradation because of photo and thermo-oxidative processes and mechanical abrasion . These latter derive mainly from industrial packaging and textile fibers released into the washing water from machine-washed clothing . Overall, it is estimated that between 75,000 and 300,000 t of microplastics are released into the environment each year in the EU alone . It must also be borne in mind that MPs can release complex mixtures of chemicals into the environment as many types of additives are used in the industrial production of plastics to provide specific features (for example flame retardants, UV stabilizers, heat stabilizers, and plasticizers) . Moreover, due to their hydrophobic surface, MPs can adsorb and concentrate to a high degree hydrophobic organic contaminants (HOCs) such as polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides and polychlorinated biphenyls (PCBs) . They also accumulate heavy metals such as cadmium, zinc, nickel, and lead .
Several studies have shown the presence of MPs in marine waters , in terrestrial soil , in the air  and in tap water  in highly populated areas as in regions far from inhabited centers . In other words, MPs are so ubiquitous  that scientists have suggested that they will represent an index of the geological era we are experiencing that some geologists define as anthropocene . In addition, various researches have recently shown that MPs can be introduced into the human body, and are found in human organs and tissues .
Most commonly MPs are introduced into the body orally, and have been detected in several foods. Most studies have focused on foods of marine origin including invertebrates, crustaceans, and fish [17, 18] but MPs have been found also in sea salt coming from different countries , primarily fragments but also filaments and films. Moreover, polyethersulfone and polysulfone have been reported as common types of MPs detected in branded milk samples  and have been found in bottled water, honey, beer, plastic teabags and soft drinks in addition [21,22,23] as well as in fruit and vegetables (particularly in apples and carrots) . Moreover, MPs have been identified in the feces of human volunteers . Based on the consumption of foodstuff, bottled water and on inhalation it has been estimated that a person’s yearly intake in the USA is within a range from 39000 to 121000 particles of MPs . The second mode of introduction of the MPs into the body is through inhalation. Using a Breathing Thermal manikin, Vianello et al.  concluded that MPs represent a non-negligible fraction of indoor airborne particulate, which can be both inhaled and ingested. Finally, the possibility of skin absorption should be considered even if there is no definitive evidence to prove this. Further experiences/studies on this aspect would be useful and are warranted .
At this stage the logical and fundamental question is: “what are the real risks of disease for humans having ascertained the presence of MPs within the body?” Based on current knowledge this question remains unanswered. However, although currently we are unable to give an exact answer, one must take into consideration the wide range of results obtained from studies in vitro and in animals, including mammals, that have allowed to understand how ingested microplastics pass the intestinal barrier leading to the hypothesis of possible negative effects on human health.
Some recent papers have reviewed in detail the most significant results of this research [29, 30]. As exhaustively summarized by Plata et al. , the experimental data have shown that the toxic action occurs by causing: chronic inflammation, changes in the immune response, neurotoxic effects and/or serving as a vector for mycroorganisms and /or toxic chemicals. It should be mentioned also that these actions may require a bioaccumulation phase and do not present in a short frame-time. Moreover, a very unexplored field, that must be investigated, are possible changes induced by MPs on the human microbiota which today is considered of great importance for the effects it can have on various immunological and metabolic disorders [31, 32].
Therefore, today there is a need to develop research on the impact that MPs can have on human health, avoiding easy mass-media alarmism and setting up work based on shared methodologies [33, 34] that also take into account the total exposure (exposome) that an individual can have towards plastic substances in general and /or towards chemical substances contained in plastics but not only in these .
As pediatricians, however, we must emphasize that research must also take into account the peculiarities of the developmental age. Children and adolescents have different sensitivity to chemicals than adults and this varies in the different stages of life [36,37,38]. supporting the need for specific methodologies .
Particular attention must be given to fetal life. It has been shown for the first time  that MPs can pass the placenta barrier which we already know is permeable to various potentially toxic substances .
In conclusion, current knowledge on the possible short and long term consequences of exposure to MPs on the health of children and adults should prompt to deepen further the relationships between environment and health. It would be desirable for pediatric scientific societies to take greater responsibility towards environmental issues both at the research level and at the training level of pediatricians.
Finally, it may be useful to remember that even at this time when the viral pandemic is rightly attracting the maximum attention a question to be asked is whether and how the spread of the virus could also be favored by environmental pollution [45, 46]. The necessary use of face-masks has also opened the issue of these being a source of microplastics [47, 48].
Availability of data and materials
Qin F, Du J, Gao J, Liu G, Song Y, Yang A, et al. Bibliometric profile of global microplastics research from 2004 to 2019. Int J Environ Res Public Health. 2020;5(17):5639–54.
Wu P, Huang J, Zheng Y, Yang Y, Zhang Y, He F, et al. Environmental occurrences, fate, and impacts of microplastics. Ecotoxicol Environ Saf. 2019;184:109612–28. https://doi.org/10.1016/j.ecoenv.2019.109612.
Napper IE, Bakir A, Rowland SJ, Thompson RC. Characterisation, quantity and sorptive properties of microplastics extracted from cosmetics. Mar Pollut Bull. 2015;99(1-2):178–85. https://doi.org/10.1016/j.marpolbul.2015.07.029.
Song YK, Hong SH, Jang M, Han GM, Jung SW, Shim WJ. Combined effects of UV exposure duration and mechanical abrasion on microplastic fragmentation by polymer type. Environ Sci Technol. 2017;51(8):4368–76. https://doi.org/10.1021/acs.est.6b06155.
Communication from the commission to the european parliament, the council,the european economic and socialcommittee and the committee of thr regions A European Strategy for Plastics in a Circular Economy Brussels, 16.1.2018 COM. 2018; 28 final.
Smith M, Love DC, Rochman CM, Neff RA. Microplastics in seafood and the implications for human health. Curr Environ Health Rep. 2018;3:375–86.
Scopetani C, Cincinelli A, Martellini T, Lombardini E, Ciofini A, Fortunati A, et al. Ingested microplastic as a two-way transporter for PBDEs in Talitrus saltator. Environ Res. 2018;167:411–7. https://doi.org/10.1016/j.envres.2018.07.030.
Wright SL, Kelly FJ. Plastic and human health: a micro issue? Environ Sci Technol. 2017;12:6634–47.
Barboza LGA, Dick Vethaak A, Lavorante BRBO, Lundebye AK, Guilhermino L. Marine microplastic debris: an emerging issue for food security, food safety and human health. Mar Pollut Bull. 2018;133:336–48. https://doi.org/10.1016/j.marpolbul.2018.05.047.
Rillig MC, Lehmann A. Microplastic in terrestrial ecosystems. Science. 2020;368(6498):1430–1.
Chen G, Feng Q, Wang J. Mini-review of microplastics in the atmosphere and their risks to humans. Sci Total Environ. 2020;10:703.
Tong H, Jiang Q, Hu X, Zhong X. Occurrence and identification of microplastics in tap water from China. Chemosphere. 2020;252:126493–500. https://doi.org/10.1016/j.chemosphere.2020.126493.
Bergmann M, Mützel S, Primpke S, Tekman MB, Trachsel J, Gerdts G. White and wonderful? Microplastics prevail in snow from the Alps to the Arctic. Sci Adv. 2019;8:1157–67.
Barnes DK, Galgani F, Thompson RC, Barlaz M. Accumulation and fragmentation of plastic debris in global environments. Philos Trans R Soc Lond Ser B Biol Sci. 2009;1526:1985–98.
Zalasiewicz J, Waters CN, Do Sul IJA, Corcoran PL, Barnosky AD, Cearreta A, et al. The geological cycle of plastics and their use as a stratigraphic indicator of the Anthropocene. Anthropocene. 2016;13:4–17.
Campanale C, Massarelli C, Savino I, Locaputo V, Uricchio VF. A detailed review study on potential effects of microplastics and additives of concern on human health. Int J Environ Res Public Health. 2020;4:1212–27.
Carbery M, O'Connor W, Palanisami T. Trophic transfer of microplastics and mixed contaminants in the marine food web and implications for human health. Environ Int. 2018;115:400–9. https://doi.org/10.1016/j.envint.2018.03.007.
Rochman CM, Tahir A, Williams SL, Baxa DV, Lam R, Miller JT, et al. Anthropogenic debris in seafood: plastic debris and fibers from textiles in fish and bivalves sold for human consumption. Sci Rep. 2015;24:14340–50.
Karami A, Golieskardi A, Keong Choo C, Larat V, Galloway TS, Salamatinia B. The presence of microplastics in commercial salts from different countries. Sci Rep. 2017;6:46173–82.
Kutralam-Muniasamy G, Pérez-Guevara F, Elizalde-Martínez I, Shruti VC. Branded milks - are they immune from microplastics contamination? Sci Total Environ. 2020;20:714–23.
Wang YL, Lee YH, Chiu IJ, Lin YF, Chiu HW. Potent impact of plastic Nanomaterials and micromaterials on the food chain and human health. Int J Mol Sci. 2020;5:1727–40.
Shruti VC, Perez-Guevara F, Elizalde-Martínez I, Kutralam-Muniasamy G. First study of its kind on the microplastic contamination of soft drinks, cold tea and energy drinks-future research and environmental considerations. Sci Total Environ. 2020;726:138580–9. https://doi.org/10.1016/j.scitotenv.2020.138580.
Toussaint B, Raffael B, Angers-Loustau A, Gilliland D, Kestens V, Petrillo M, et al. Review of micro-and nanoplastic contamination in the food chain. Food Addit Contam. 2019;36(5):639–73. https://doi.org/10.1080/19440049.2019.1583381.
Oliveri Conti G, Ferrante M, Banni M, Favara C, Nicolosi I, Cristaldi A, et al. Micro- and nano-plastics in edible fruit and vegetables. The first diet risks assessment for the general population. Environ Res. 2020;187:109677–83.
Schwabl P, Köppel S, Königshofer P, Bucsics T, Trauner M, Reiberger T, et al. Detection of various microplastics in human stool: a prospective case series. Ann Intern Med. 2019;171(7):453–7. https://doi.org/10.7326/M19-0618.
Cox KD, Covernton GA, Davies HL, Dower JF, Juanes F, Dudas SE. Human consumption of microplastics. Environ Sci Technol. 2019;53(12):7068–74. https://doi.org/10.1021/acs.est.9b01517.
Vianello A, Jensen RL, Liu L, Vollertsen J. Simulating human exposure to indoor airborne microplastics using a breathing thermal manikin. Sci Rep. 2019;17:8670–80.
Prata JC, da Costa JP, Lopes I, Duarte AC, Rocha-Santos T. Environmental exposure to microplastics: an overview on possible human health effects. Sci Total Environ. 2020;702:134455–13463. https://doi.org/10.1016/j.scitotenv.2019.134455.
Chang X, Xue Y, Li J, Zou L, Tang M. Potential health impact of environmental micro- and nanoplastics pollution. J Appl Toxicol. 2020;4:4–15.
Jiang B, Kauffman AE, Li L, McFee W, Cai B, Weinstein J, et al. Health impacts of environmental contamination of micro- and nanoplastics: a review. Environ Health Prev Med. 2020;25(1):29–44. https://doi.org/10.1186/s12199-020-00870-9.
Fackelmann G, Sommer S. Microplastics and the gut microbiome: how chronically exposed species may suffer from gut dysbiosis. Mar Pollut Bull. 2019;143:193–203. https://doi.org/10.1016/j.marpolbul.2019.04.030.
Lu L, Luo T, Zhao Y, Cai C, Fu Z, Jin Y. Interaction between microplastics and microorganism as well as gut microbiota: a consideration on environmental animal and human health. Sci Total Environ. 2019;667:94–100. https://doi.org/10.1016/j.scitotenv.2019.02.380.
Jeong J, Choi J. Adverse outcome pathways potentially related to hazard identification of microplastics based on toxicity mechanisms. Chemosphere. 2019;231:249–55. https://doi.org/10.1016/j.chemosphere.2019.05.003.
Shruti VC, Pérez-Guevara F, Elizalde-Martínez I, Kutralam-Muniasamy G. Toward a unified framework for investigating micro (nano) plastics in packaged beverages intended for human consumption. Environ Pollut. 2021;268(Pt A):115811–23. https://doi.org/10.1016/j.envpol.2020.115811.
Rist S, Carney Almroth B, Hartmann NB, Karlsson TM. A critical perspective on early communications concerning human health aspects of microplastics. Sci Total Environ. 2018;626:720–6. https://doi.org/10.1016/j.scitotenv.2018.01.092.
Etzel RA. The special vulnerability of children. Int J Hyg Environ Health. 2020;227:113516–123. https://doi.org/10.1016/j.ijheh.2020.113516.
Grandjean P, Abdennebi-Najar L, Barouki R, Cranor CF, Etzel RA, Gee D, et al. Timescales of developmental toxicity impacting on research and needs for intervention. Basic Clin Pharmacol Toxicol. 2019;125(Suppl 3):70–80. https://doi.org/10.1111/bcpt.13162.
Smerieri A, Testa C, Lazzeroni P, Nuti F, Grossi E, Cesari S, et al. Di-(2-ethylhexyl) phthalate metabolites in urine show age-related changes and associations with adiposity and parameters of insulin sensitivity in childhood. PLoS One. 2015;10(2):e0117831. https://doi.org/10.1371/journal.pone.0117831.
Tanner E, Lee A, Colicino E. Environmental mixtures and children's health: identifying appropriate statistical approaches. Curr Opin Pediatr. 2020;32(2):315–20. https://doi.org/10.1097/MOP.0000000000000877.
Ragusa A, Svelato A, Santacroce C, Catalano P, Notarstefano V, Carnevali O, et al. Plasticenta: first evidence of microplastics in human placenta. Env Int. 2021;146:106274–82. https://doi.org/10.1016/j.envint.2020.106274.
Street ME, Bernasconi S. Endocrine-disrupting Chemicals in Human Fetal Growth. Int J Mol Sci. 2020;21(4):1430–41. https://doi.org/10.3390/ijms21041430.
Goyal D, Limesand SW, Goyal R. Epigenetic responses and the developmental origins of health and disease. J Endocrinol. 2019;242(1):T105–19. https://doi.org/10.1530/JOE-19-0009.
Heindel JJ, Vom Saal FS, Blumberg B, Bovolin P, Calamandrei G, Ceresini G, et al. Parma consensus statement on metabolic disruptors. Environ Health. 2015;14(1):54–60. https://doi.org/10.1186/s12940-015-0042-7.
Street ME, Angelini S, Bernasconi S, Burgio E, Cassio A, Catellani C, et al. Current knowledge on endocrine disrupting chemicals (EDCs) from animal biology to humans, from pregnancy to adulthood: highlights from a National Italian Meeting. Int J Mol Sci. 2018;19(6):1647. https://doi.org/10.3390/ijms19061647.
Parashar N, Hait S. Plastics in the time of COVID-19 pandemic: protector or polluter? Sci Total Environ. 2020;759:144274–89.
Gallo M, Street ME, Guerra F, Fanos V, Marcialis MA. A review of current knowledge on pollution, cigarette smoking and covid-19 diffusion and their relationship with inflammation. Acta Biomed. 2020;91:e2020148.
Dharmaraj S, Ashokkumar V, Hariharan S, Manibharathi A, Show PL, Chong CT, et al. The COVID-19 pandemic face mask waste: a blooming threat to the marine environment. Chemosphere. 2021;272:129601. https://doi.org/10.1016/j.chemosphere.2021.129601.
Anastopoulos I, Pashalidis I. Single-use surgical face masks, as a potential source of microplastics: do they act as pollutant carriers? J Mol Liq. 2021;326:115247. https://doi.org/10.1016/j.molliq.2020.115247.
Ethics approval and consent to participate
Consent for publication
Both authors have read the final version and consent for publication.
The Authors have no conflict of interest related with this commentary.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Street, M.E., Bernasconi, S. Microplastics, environment and child health. Ital J Pediatr 47, 75 (2021). https://doi.org/10.1186/s13052-021-01034-3