Microplastics entry routes into Humans, possible health effects, laws, and policies: A review

1. Introduction

Plastics have become an integral part of human everyday life (Yang et al., 2021). They are used practically in everything from furniture to furnishing, clothing to utensils, food packaging to water bottles, carry bags, wraps, straps, detergents, and personal care products. Plastics are omnipresent across the environment, including terrestrial, aquatic, aerosol, and biota on land and water (Haque and Fan, 2023; Kumar et al., 2023). Plastics are known to cause severe environmental pollution when not properly handled and recycled (Alsabri et al., 2022). They degrade over time into small pieces of less than 5 mm, known as microplastics (MPs) (Lee et al., 2023). MPs are any synthetic solid polymers with regular or irregular shapes and a size ranging from 1 μm to 5,000 μm (Frias and Nash, 2019). The MPs can be of either primary or secondary origin.

The MPs are microscopic with variable density; some of them are buoyant in seawater, have a low glass transition temperature (Rossatto et al., 2023; Gunaalan et al., 2024), and cannot be easily filtered out of the environment (Hale et al., 2020). According to an estimate by Eriksen et al. (2014), there were 35,500 metric tons of MPs floating in the ocean among the estimated 5.25 trillion plastic particles and almost 50% of the global wastewater influent of 3,562,082 × 10⁵ m³ remains untreated. Some conservative estimates indicate that treated effluent disposal can add around 1.47 × 10¹⁵ m³ MPs annually, whereas the discharge of untreated effluent is likely to add a staggering 3.85 × 10¹⁶ m³ MPs annually to the aquatic environments (Uddin et al., 2020).

Most published literature shows that MPs are found in all environmental compartments, such as terrestrial, atmospheric, and marine, which can end up in the human system. In a study conducted by Zhang et al. (2021), MPs were discovered in the faeces of adult and newborn babies. Research has indicated that MPs between 1-10 μm may be attached to lipid membranes, that are the last protective barrier of a cell from the environment (Wang et al., 2022b), while others have indicated that <10 μm MPs can pass through cell membranes and enter the bloodstream (Wu et al., 2019). In another experimental study in mice, it was observed that particles of ≤ 1.14 μm cross the brain-blood-barrier (Kopatz et al., 2023). Other studies have successfully identified the presence of MPs in the heart, blood, and lungs of human beings (Chen et al., 2022; Leslie et al., 2022; Yang et al., 2023). However, there are limited studies on what mechanisms could be responsible for health issues caused by MPs. Some studies suggest that MPs and associated additives or adsorbed pollutants may have toxic effects on human cells, tissues, and organs. Investigating their potential toxicity is crucial for risk assessment and public health protection (Lee et al., 2023).

To reduce the health risks threats that MPs pose to humans, regulations and laws that control their presence are imperative (Carlos et al., 2021; Sorensen et al., 2023). Aside from ensuring less MP (plastic) pollution, effective laws and regulations also encourage safer production methods and proper trash disposal, all of which protect public health and preserve natural habitats for future generations. There are, however, few studies that address MP law and regulations.

This review paper aims to give an in-depth analysis of all the pathways by which MPs enter the human body and their potential health impacts, laws and policies for MP regulation. This information will be helpful to improve our understanding of MP pathways in humans their health implications. Determining the precise health consequences linked to MP exposure requires an understanding of the intricate interactions between size-specific MPs, the chemicals associated with them and cellular barriers. We aim to illustrate how MPs and human health are related, aiding in the development of techniques to lessen the potential risks of entry.

2. Material and methods

2.1. Data selection and categorization

Original research articles from PubMed, Google Scholar, the Nature database, and Web of Science were chosen, analyzed, and discussed to elucidate the MP pathway in humans and the related health impacts, regulations, and policies (Fig. 1; Clarivate, 2024). A cross-sectional methodology was employed to choose recent original research publications that described human MP health impacts, legislation, and regulations, as well as the sources of MPs in humans. Not every article that search engines recommended was taken into account for this study's discussion (Chia et al., 2023a). Original studies that do not provide a sufficient explanation for the sources of MP in humans and the effects of MP occurrence on human health, laws, and policies are excluded. These procedures guaranteed equitable representation and accessibility of the chosen papers, which helped to ensure that the goal of this study was achieved without bias (Chia et al., 2023b).

Fig. 1.

The systematic method employed to choose scientific publications in this study.

Papers published between 2014 and 2024 were chosen based on keywords like “microplastic in humans,” “microplastic effect in humans”, “pathways of microplastic in humans,” “sources of microplastic in humans,” plastic control laws,” “policy for microplastic,” and “microplastic laws,”. A total of 507 manuscripts were identified [150 articles (search term: microplastic in humans {excluded correction papers, meeting papers, letters, proceeding papers, and early access papers}) + 71 articles (search term: microplastic effect in humans) + 13 articles (search term: pathways of microplastic in humans) +41 articles (search term: sources of microplastic in humans) + 15 articles (search term: policy for microplastic) + 135 articles (search term: plastic control laws) + 3 articles (search term: microplastic laws)].

At the beginning of the investigation, all of the original research publications were selected using thirteen different database categories, specifically “Marine Freshwater Biology,” “Toxicology,” “Food Science Technology,” “Ecology,” “Oceanography,” “Fisheries,” “Public Environmental Occupational Health,” “Chemistry Multidisciplinary,” “Soil Science,” “Engineering Environmental,” “Green Sustainable Science Technology,” “Environmental Studies,” “Water Resources,” from PubMed, Google Scholar, Nature’s database, and Web of Science (WoS).

To assure the accuracy of the 428 papers obtained, all studies underwent a rigorous screening process that included only original research articles with a certain degree of acceptable error. The majority of the selected articles omitted studies that could not provide evidence of human MP pathways and the related health impacts, legislation, and regulations. Moreover, original research studies that did not demonstrate the direct sources of MP pollution or its effects on humans but merely documented MP contamination in humans were disregarded. After the 428 publications were filtered, 106 were selected as the main dataset to address human MP pathways and related health impacts, as well as legislation, policies, and future directions for research (Fig. 1).

3. Results and discussion

3.1. Microplastic pathways into humans by ingestion

One of the most basic routes through which MP particles enter the human body is by ingestion. The ingestion of MPs by humans can be through various products such as; food, beverages, water bottles, drinking water, and more (Fig. 2). The ingestion of MPs can occur through the following common pathways: contaminated food and water, inhalation of airborne particles, and personal health products.

Fig. 2.

Entry pathways of microplastics to the human body. (a) Nose by inhalation: both indoor and outdoor atmospheric air fallout; (b) Mouth by ingestion: Fish, meat, salt, honey, water and chicken; and (c) Skin by dermal contact: hygienic items like toothpaste, body cleansers, and scrubs.

3.1.1. Drinks and bottles

Various studies have documented the presence of MPs in beer, drinking water, and other beverages (Table 1). This can be attributed to the tendency of drinking water to be exposed to pollution from natural sources, air deposition, wastewater discharge, plastic manufacturing and packaging, and contamination during bottling or brewing (Lee et al., 2023; Bhardwaj et al., 2024; Haleem et al., 2024). Water that is produced and processed using plastic caps, containers, and other packaging materials consist of MP particles. Also, MPs can be introduced during the brewing and bottling operations of beverages, such as beer (Jin et al., 2021; Crosta et al., 2023). This can be associated with exposure to plastic equipment or packing materials which come into direct contact with the beer and increase the likelihood that MPs will be present in the finished product (Cha et al., 2023).

Table 1.

A synopsis of the studies on entry pathways that the systematic review included.

In a study conducted by Oßmann et al. (2018), water from all types of bottles, including glass and single-use and reusable polyethylene terephthalate (PET) and PET-based bottles, was found to contain MPs. In glass bottles, the number of MPs in the mineral water ranged from 6,292 ± 10,521 per litre to 2,649 ± 2,857 per litre in single-use PET bottles (Oßmann et al., 2018). A similar study in China on the prevalence of MPs in tap water found that tap water contained varying amounts of MPs, ranging from 0 to 1,247 particles L^-1 and the main MPs comprised polyethylene and polypropylene (Mintenig et al., 2019; Tong et al., 2020). Also, research by Mintenig et al. (2019) shows the abundance of MPs in drinking water from groundwater sources.

3.1.2. Food

Food is one of the body's main sources of energy, so by eating, humans ingest MPs from contaminated food sources. A few major causes of the MP contamination of these foods are the use of wastewater for irrigation, sludge application in agriculture fields, bioaccumulation, processing and packaging, plastic mulching, and air deposition (Schell et al., 2022; Udovicki et al., 2022; Hassan et al., 2023). According to numerous studies, MPs can seep into food from packaging materials (made from plastic), which increases the risk of human consumption (Habib et al., 2022). The handling and processing of food also plays a role in the contamination of MPs, particularly in areas where plastic packaging is widely used. Strict laws governing food packaging materials are necessary, as evidenced by the persistence of MPs in food products.

The use of MPs in plastic mulching to improve crop growth can result to MP deposition in soils (Bläsing and Amelung, 2018). Microplastics in soil can pass through plant roots and move to other areas of the plant, including the edible sections (Wang et al., 2022a). MPs may appear in fruits and vegetables as a result of this process, called bioaccumulation (Oliveri et al., 2020). A study on the prevalence of MPs in fruits and vegetables shows that apples were the most contaminated fruit and carrots were the most contaminated vegetable. The carrots samples contained the smallest MPs (1.51 μm), whereas the lettuce samples had the largest MPs (2.52 μm) (Oliveri et al., 2020). Recent studies on the presence of MPs in milk, beer, and honey shows that the MP concentration ranged from 10 to 100 MPs/L, with an average of about 40 MPs/L (Diaz-Basantes et al., 2020; Zhang et al., 2020; Milne et al., 2024). The presence of MPs in honey can be linked to the processing, packaging, use of plastic in beehives, and airborne MPs. MPs can enter the environment through the water and air and eventually settling on soil and plants (Chia et al., 2023c). Bees may come into contact with MPs on the surfaces of flowers and plants when they are foraging for nectar and pollen. In a study, the MP concentration ranged from 10 to 100 MPs/L, with an average of about 40 MPs/L, and fragments between 2.48 and 247.54 μm found in honey were confirmed based on Fourier transform infrared spectroscopy (FTIR) composition analysis (Diaz-Basantes et al., 2020).

Salt is also one of the sources of MPs (Gündoğdu, 2018; Kuttykattil et al., 2023; Canga et al., 2024). According to the study results, the MP particle content was 16-84 item/kg in sea salt, 8-102 items/kg in lake salt, and 9-16 items/kg in rock salt. The most common plastic polymers were polyethylene (22.9%) and polypropylene (19.2%) (Gündoğdu, 2018). The principal reasons that MPs are found in salt are associated with air deposition, marine activities, pollution in the environment, and contamination during salt harvesting and processing (Peixoto et al., 2019; Kuttykattil et al., 2023). MPs may be introduced via the processing and shipping of salt products, particularly in regions where plastic is widely used. During these procedures, the salt could become contaminated by MP particles from the packaging materials (Karami et al., 2017).

A similar study was also carried out in Spain on the prevalence of MPs in salt, and the reported MP content found was 50-280 MPs/kg of salt, with polyethylene-terephthalate (PET) being the most frequently found polymer, followed by polypropylene (PP) and polyethylene (PE) (Iñiguez et al., 2017). Similarly, a study by Yang et al. (2015) found that in sea salts, the MPs content was found to be 550-681 particles/kg, while in lake salts it was 43-364 particles/kg, and in rock/well salts it was 7-204 particles/kg. In contrast to pellets and sheets, fragments and fibres were the most common types of particles found in sea salts. The majority of the particles, or 55% of all the MPs, were smaller than 200 μm. The most prevalent MPs in sea salts were polyethylene terephthalate, followed by polyethylene and cellophane (Yang et al., 2015).

Humans rely on the aquarine environment as one of the sources of food which serves as a pathway for MP transfer through trophic levels. A study by Alfaro-Núñez et al. (2021) points out the MP pollution of seawater and marine organisms and reports that marine organisms and water samples contained MP particles. The majority of the MP particles ranged in size from 150 to 500 μm (Alfaro-Núñez et al., 2021). Widespread plastic contamination in the aquatic environment has resulted in the occurrence of MPs in marine creatures, including fish. MPs in marine creatures are largely derived from a variety of sources, including plastic breakdown in the ocean, atmospheric deposition, plastic waste in water bodies, and ingestion by plankton and rivers as conduits of MPs from inland areas to seas. Fish may ingest MPs and tiny pieces of plastic that mimic prey directly and it may consume these particles believing them to be food (Eryaşar et al., 2022).

The ingestion of MPs by marine organisms in a study in India discovered that the average concentrations of MP in sediment, water, finfish, shellfish, and zooplankton were 0.93 ± 0.59 particles per m³, 45.17 ± 25.23 particles per kilogram, 0.12 ± 0.07 pieces per zooplankter, and 10.65 ± 7.83 particles per specimen, respectively (Goswami et al., 2020). In the zooplankton community, a high level of MP retention was found. Carangoides malabaricus adults were found to consume the most MPs (Goswami et al., 2020; James et al., 2020). A recent study in Portugal by Barboza et al. (2020) reveals that the ingestion of MPs by fish shows that, of the 150 fish examined (50 for each species), 49% had MP. Within the gastrointestinal tract, gills, and dorsal muscle of fish belonging to the three species, MP was discovered. A total of 0.054 ± 0.099 MP items/g, or 32% of the 150 fish that were analyzed, had MP in their dorsal muscle (Barboza et al., 2020). In another study in Kuwait, MPs were reported in the gastrointestinal tract of eight most consumed fish species in Persian Gulf (Al-Salem et al., 2020). However, the occurrences were very low, with only three fragments detected within the guts of Acanthopagrus latus, Eleutheronemaa tetradactylum and Lutjanus quinquelineatus, despite their preference for staying in muddy waters and sheltered lagoons, which have comparatively higher MP concentrations. Microplastics were also reported from Chelon aurata and Rutilus kutum, the two fish species that account for over 50% of the total Caspian Sea catch. Out of the 111 individual samples analysed, 67.56% were positive for MPs, with an average of 2.29 MP/Fish (Zakeri et al., 2020). The dominant spare reported was fibres (≈50%) and fragments (≈30%).

In a similar study by Habib et al. (2022), fish samples showed a range of MP contamination: from 0.014 ± 0.024 to 2.6 ± 2.8 particles per gram, and from 0.03 ± 0.04 to 1.19 ± 0.72 particles per gram of meat in chicken. A variety of factors, including environmental contamination, feed, water, and human activity, can cause MPs to enter the food chain and eventually make their way into chicken and meat. By consuming contaminated feed, water, livestock including chickens, may swallow MPs, which eventually end up on human tables and cause discomfort to the human system. It was determined that the plastic cutting board made of polyethene, which was used to cut the food, was the source of the MPs. When food was cut from the bone rather than the fillets itself, and the fillets were prepared on surfaces other than plastic, there was more MP contamination present (Habib et al., 2022).

Meat, chicken and dairy products are contaminated by packaging materials. According to Kedzierski et al. (2020), food products are contaminated with MPs at a level that varies from 4.0 to 18.7 MP/kg of packaged meat. These MPs are most likely from the PS trays, according to analysis. These particles are probably cooked before consumption and are challenging to remove with simple washing (Kedzierski et al., 2020). Chicken as a source of food is one of the main entry pathways of MPs into the human body. As per on study in Pakistan, 1,227 MP particles in all were discovered in 24 samples (gizzards and chicken crops) that came from the 8 chicken farms. A total of 24 chicken crops contained 429 MP particles, with a mean of 17.8 ± 12.1 MPs/crop. On the other hand, 24 chicken gizzards exhibited 798 MP particles, with a mean of 33.25 ± 17.8 MPs/gizzard. Particles measuring between 300 and 500 μm were found to be more common (63%) than those with sizes between 300 and 150 μm (21%) and 150 and 50 μm (16%) (Bilal et al., 2023).

4. Microplastic exposure impacts on human health

In recent years, research articles on the effects of MPs on organisms have received widespread attention (Szymańska and Obolewski, 2020; Daghighi et al., 2023). However, few clinical and laboratory studies have been conducted on the effects of MPs on human health (Fig. 3). Most research studies are based on in vivo and in vitro clinical trials on mice and simulated effects of possible consequences for the human health system (Table 2).

Fig. 3.

Impacts of microplastics on human health.

Table 2.

A synopsis of the studies on health-related effects that the systematic review included.

5. Laws and policies on microplastics and plastics

Global environmental concerns over MPs have led to the implementation of laws and policies by many countries to alleviate their negative effects (Table 3). To reduce pollution, the European Union has adopted measures, passing laws on purposefully inserted MPs in a range of goods. In the US, several states have placed limitations on the use of microbeads in personal hygiene products, and federal legislation deals with more general concerns related to marine debris. A proposed nationwide plan to eliminate plastic pollution was released by the United States Environmental Protection Agency (USEPA) in April 2023. Three objectives are included in this draft strategy, one of which is to particularly stop MPs and nanoplastics from getting into waterways (Table 3). In 2018, Canada began to forbid the production and importing of any toiletries that include microbeads. Moreover, in 2020, Canada suggested a new approach for managing plastic waste. The ultimate objective of this all-inclusive management system is to lower the quantity of MPs and their discharge into the environment. Australia began to phase out the use of microbeads in rinse-off cosmetics and personal hygiene products in 2020. Launched in 2021, the Australian National Plastics Plan lays out a strategy to eventually phase plastics out of the Australian economy completely. It entails doing away with harmful plastics, clearing plastic from beaches and the oceans, passing laws ensuring trash accountability, funding recycling infrastructure, funding research, and maintaining recycling support (Table 3).

Table 3.

Summary laws and guidelines on microplastics and plastics in certain countries.

Several Organisation for Economic Co-operation and Development (OECD) and non-OECD nations have implemented measures to reduce the amount of plastics that leak into the environment in response to growing concerns about the risks associated with plastic pollution. These include better waste management practices, outlawing frequently littered single-use plastic items, and placing limitations on the production and distribution of specific personal care and cosmetic products that contain MPs. Despite making up a sizable portion of all releases into the environment, MPs released from automobile tyres and textile items are still primarily outside the purview of current regulatory frameworks. This is mostly explained by the new nature of research into mitigation methods and the technological difficulty of preventing unintended losses of MPs during product use (Shardul et al., 2023).

To address plastic pollution, particularly MPs, the United Kingdom has outlawed the production of rinse-off personal care products containing microbeads (Table 3). This is indicated in the Environment Bill. Recently, the United Kingdom Water Industry Research (UKWIR) suggested intervention control for the wastewater sector. This covers modifications to labelling, increased producer accountability, prohibitions, grants, and subsidies for reusable items, as well as adjustments to public infrastructure like the provision of disposal containers for garbage. Recognizing the damaging impacts of MPs on the environment, nations like China, Japan, and Korea (Republic of) are putting regulations to manage plastic waste into place throughout Asia. For instance, the Chinese government has been increasingly concerned about plastic pollution at both the national and subnational levels since the early 2000s, and this concern has increased significantly since 2016. In order to limit plastic pollution and provide alternatives to plastics, China has rules under the Law on the Prevention and limit of Environmental Pollution by Solid Wastes (LPCEPSW) that classify plastic pollution under solid waste. In addition to encouraging a circular economy, the restrictions forbid the disposal of plastics in aquatic environments. The Chinese province of Hainan, for instance, declared that non-biodegradable plastic products will be prohibited after 2025. Certain African nations, like the Democratic Republic of the Congo and Cameroon, have outlawed the production and import of plastic packaging. Increasingly, countries are enacting policies to limit the use and discharge of MPs into the environment as the international community recognizes the need to eliminate this pollution (Table 3).

Current legislation and industry-led initiatives have mostly concentrated on laying the groundwork for comprehensive and empirically supported mitigation frameworks. These frameworks frequently include a variety of components, such as funding for research projects, to fill in knowledge and data gaps regarding the prevalence of MPs in the environment and the risks they pose to human and environmental health. Additionally, efforts to raise consumer awareness and educate them about sustainable product usage are being made in an effort to change consumer behavior by encouraging the adoption of methods that reduce the emission of MPs during product use. Furthermore, a crucial component of these regulations has been enabling the exchange of data and information through multistakeholder platforms in order to promote research and encourage cooperation across industries.

In the process of designing policy, it may be necessary to provide more specific information about the working mechanisms. It will be beneficial to understand the precise level of MP infestation in the human body to develop trustworthy and efficient policy measures regarding the effects of MPs on human health. Reliable quantification of MP concentrations in human tissues may result in improved health and safety recommendations and regulations, as well as well-informed policy decisions.

6. Conclusion and recommendations for future studies

Three primary routes exist for MPs to enter the human body: ingestion, inhalation, and dermal contact. Of these, ingestion is the most frequent entry point, according to this review paper. In vivo or in vitro studies made up the bulk of research on the effects of MPs on human health. Although the reviewed studies exhibit heterogeneity, there is a dearth of research articles explaining the primary cause of various illnesses as MPs. Larger studies that investigate various aspects of the invasion consequences of MPs into the human body are suggested to be necessary by the review's findings. In-depth knowledge regarding potential risks associated with MP accumulation is provided by this review paper to individuals, educators, institutions, and policy makers.

In terms of global MP research activities and initiatives, China holds the top spot. As the world's second-biggest economy, China produces a lot of plastic goods for both domestic and international markets. Nowadays, China has a very well-established legislative system that aims to reduce pollution from plastic through increased infrastructure and solid waste management, an overhaul of city planning, and the circular economy as a whole. China has made tremendous progress in source control capability in recent years by progressively establishing a marine plastic pollution prevention system. It was also observed that many African nations lack feasible research initiatives related to MPs. To sum up, while this work advances our knowledge of MPs pathways and their possible health effects on the human system, further research is still needed to fill in the knowledge gaps on the degree to which MP infestations drive human system disorders. The following investigations are necessary:

1) To determine whether any demographic group is more susceptible than others to the buildup of MPs.

2) More research is needed to determine which human organs are more vulnerable to MP buildup.

3) To assess MP exposure's long-term health effects and whether MPs serve as carriers of other pollutants or illnesses.

4) To assess the intricate connection between MPs and detrimental health outcomes in the human body, future research should include longitudinal investigations.

5) To assess MPs in Africa because inadequate knowledge could impede the worldwide understanding of MP pollution's spread and impact because of the region's distinct environmental and socioeconomic characteristics, which may have varied effects on MP pollution and distribution.

Acknowledgments

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (No.2019R1A6A1A03033167). This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (RS-2024-00352562).

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