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How plastics are harming our health

By Dr Hugh Stirling – Doctor, Science Writer and One5 Health Content Creator


Plastic Free July is a global movement started in Western Australia in 2011 by the Plastic Free Foundation. The initiative empowers millions worldwide to be part of the solution to plastic pollution by providing resources and education about how to reduce single-use plastic waste (see link below). Single-use plastics make up a large proportion of plastic pollution globally, with detrimental effects on marine and terrestrial ecosystems, as well as human health.


Here at One5 Health, we are passionate about environmentally responsible business and aim to reduce our environmental impact across all operations. We are proud to support Plastic Free July and are working hard to reduce single-use plastics in our clinics. In addition, as preventative medicine specialists we want to raise awareness of the human health implications of plastic products and plastic pollution, as both have significant effects on our long-term health.


How plastics effect health


The devastating consequences of plastic pollution for wildlife and ecology are well known, but the equally concerning implications for human health are less often discussed. The effects of plastics on health are now well-studied and whilst further research is needed, the plastics we use in our everyday lives are likely having a lasting impact on our health. As preventative and lifestyle medicine practitioners, we believe it is important to highlight these facts to our readers as proactive changes in our lifestyle today, can improve our health for years to come.


The impacts of plastics on health can be broadly divided into two categories: the effects related to Endocrine Disrupting Chemicals (EDCs), which are chemicals often contained within or emitted by plastics, and effects related to small particles of plastics (microplastics) which make their way into our bodies from the environment. Let’s look at each in turn.


What are EDCs?


EDCs are exogenous substances that alter the normal function of the human endocrine (hormonal) system [1]. People are exposed to EDCs primarily via their diet, although air, dust and water are other potential sources. EDCs are found in many everyday products including plastics, cosmetics and certain foods and beverages, as well as pesticides and industrial chemicals [2][3]. EDCs are released into the environment (air, soil and water) when products are used and ultimately thrown away [4]. In fact, EDCs are now so common in the environment that exposure to them is almost universal; studies repeatedly show that most people have EDCs present in their bodies [5][6]. Exposure to EDCs and associated hormonal dysregulation can cause many diseases including diabetes, thyroid disorders, reproductive disorders, neurodevelopmental disorders and cancers including breast, prostate, ovarian, testicular and endometrial cancers [4][6][7][8].


The health effects of EDCs are dependent on the chemical in question, the hormone pathway affected, the degree of exposure and whether exposure occurs at a sensitive time of development, such as pregnancy or puberty [6][7][9]. From a health economics perspective, the estimated cost of EDC exposure in the USA and Europe combined, exceeds $550 billion (US) [10]. However, due to the prevalence of EDCs in everyday products, their regulation is complex and non-standardised, with some countries taking a risk-based approach to specific EDCs and others banning individual chemicals completely [11]. This is further complicated by a lack of standardisation in the testing methods used for EDCs or agreement on precise levels of exposure that are harmful to health.


Establishing clear causative links between EDCs and specific diseases is difficult due to long latency periods between exposure and detectable effects, as well as the limited number of hormonal pathways that can be investigated using current methods. Additionally, the presence of confounding factors such as previous exposure to similar chemicals and lifestyle factors that influence disease development, such as diet and exercise, complicates research into EDCs further [11][12].


EDCs in plastics


Plastics may contain many different EDCs dependent on the type of plastic. EDCs in plastics may be structural building blocks of the material itself (bisphenols) or additives that enhance desirable properties, such as plasticisers which improve flexibility (phthalates), flame retardants (brominated flame retardants) or colourants (often containing heavy metals). Recycling of plastics can further concentrate specific toxins (phthalates) and even produce new super toxic chemicals (dioxins) [2][6][13].


The case of BPA


One well known EDC commonly found in plastics is BPA (bisphenol A). BPA is a structural building block of many polycarbonate plastics used to make food containers and water bottles, as well as epoxy resins used to coat the inside of metal food cans, bottle tops and water pipes. Whilst exposure is most commonly via ingestion, BPA is also found in thermal paper used for printing receipts and even some medical and sports equipment. BPA can also leach from landfill sites into ground water, which may subsequently contaminate household drinking water [13][14][15]. Studies suggest that even very low levels of BPA exposure may have significant health effects, such as increased risk of certain cancers including breast, prostate, ovarian and endometrial [16][17][18][19].


BPA is also known to affect brain development and behaviour, with exposure associated with neurodevelopmental disorders in foetuses, as well as higher levels of anxiety, depression and inattention [17][19] [20]. Moreover, through effects exerted at the genetic and epigenetic level, BPA has also been linked to adverse reproductive outcomes, including dysfunctional cell division in egg cells, reduced sperm count & quality, Polycystic Ovarian Syndrome and disruption of normal foetal development [17][20][21].


Concerningly, rates of exposure to BPA amongst Western populations are extremely high. The 2003-4 National Health and Nutrition Examination Survey (NAHNES III) conducted by the US Centres of Disease Control (CDC) found detectable levels of BPA in over 90% of 2517 urine samples tested from participants aged 6 and over* [22]. These figures are considered representative of the general population of the United States, with similar levels reasonably expected in European populations [14]. Furthermore, BPA has been shown to bioaccumulate, building up in the body’s tissues and exerting ongoing negative effects, even after prolonged periods of non-exposure [22][23].


Many modern plastics are marketed as ‘BPA-free’ and were previously thought to be less harmful to health. However recent animal studies suggest that this may not be true, as alternative plastics contain alternative bisphenols (also EDCs) with similar harmful effects to BPA [24][25]. Additionally, many bioplastics (bio-degradable plastics) contain similar levels of toxic chemicals. Whilst these plastics may biodegrade faster, they still leach EDCs into the environment, posing significant challenges for even cutting edge pollution clean-up technologies, such as bioremediation [5][26].


*Please note that One5 Health do not offer urine, blood or other testing for BPA levels at this time.


Microplastics


Microplastics are tiny particles of plastic defined as less than 5mm diameter but often much smaller, that are found in the environment. Microplastics may be designed for specific commercial uses such as in personal care products or cosmetics, but most often result from the breakdown of larger plastic items in the environment. Microplastics may also be shed as microscopic fibres from synthetic textiles and clothing, making their way into water systems when clothes are washed, and released into the air when clothes are worn and machine dried. The sheer amount of microplastics now present in the environment mean that they contaminate our food and drinking water, accumulating in our bodies and exerting negative effects on health. Like EDCs, microplastics have been linked to metabolic and reproductive disorders, as well as certain cancers.


Unfortunately, the average person consumes considerable amounts of microplastics every day. A 2019 report from the World Wildlife Foundation details research undertaken by the University of Newcastle Australia which found that an average person globally may be ingesting up to 5g of plastic per week, through food, beverages and inhaled air [27]. That’s a credit card’s worth of plastic each week. The report states that the majority of plastic consumed is through diet, with drinking water accounting for the greatest proportion on average (bottled more than tap), a fact corroborated by other studies into microplastic ingestion [28][29]. Common food sources mentioned in the study include seafood (shellfish especially), beer and salt. Other studies into human microplastic consumption suggest highly processed foods and canned food and drink as other important sources [30]. Less obvious sources include water boiled in plastic kettles, plastic-containing teabags or coffee capsules and heating food in plastic containers [31][32]. The everyday prevalence of microplastics mean that they have been found in samples of human faeces and urine, and more recently blood, lung and even placental tissue [33][34][35].


So, what are the health implications of ingesting microplastics? At present, the long-term impacts are not well understood, but a substantial body of evidence points towards significant harm. In addition to leaching EDCs once inside the body, microplastics may carry other environmental pollutants from soil, water or air. For example, airborne microplastics in urban areas have been found to carry Polycyclic Aromatic Hydrocarbons (PAHs), toxins created from burning fossil fuels, tar and organic substances, some of which are known to cause cancer and other diseases [36][37]. Furthermore, some studies suggest that when other environmental toxins are combined with microplastics their toxicity is compounded, creating super-toxic particles [38]. In addition, microplastics have been shown to act as reservoirs for harmful bacteria and viruses in the environment, which may ‘hitch-hike’ their way into our bodies when microplastics are ingested, although the health risks associated with this phenomenon remain unclear [39][40].


Top tips for reducing EDC & microplastic exposure


So, what can you do to reduce your exposure to EDCs and microplastics? Despite the prevalence of plastics in our everyday lives, there are many practical steps you take to reduce personal exposure. Here’s our top ten:


1. Avoid drinking bottled water - opt for tap water instead (where drinkable). Add activated charcoal pieces to re-usable bottles and jugs to help reduce the taste of chlorine.


2. Avoid heating, microwaving or purchasing hot foods in plastic containers - including take-aways! Opt for glass, ceramic or steel containers/utensils, especially when used for hot foods and liquids


3. Switch to plastic-free kitchen appliances - particularly those used to heat food and drink (kettles, coffee machines, air-fryers, toastie makers, slow-cookers etc) and appliances that may shear off small plastic particles (food mixers and blenders)


4. Avoid single-use plastic food wrapping