Science of the Total Environment 777 (2021) 146094

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Science of the Total Environment

journal homepage: www.elsevier.com/locate/scitotenv

A One Health perspective of the impacts of microplastics on animal,

human and environmental health
Joana C. Prata a,⁎, João P. da Costa a, Isabel Lopes b, Anthony L. Andrady c,
Armando C. Duarte a, Teresa Rocha-Santos a
a
Centre for Environmental and Marine Studies (CESAM), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
b
Centre for Environmental and Marine Studies (CESAM), Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
c
Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695, USA

H I G H L I G H T S G R A P H I C A L A B S T R A C T

• Microplastics threaten multiple systems

from organism to population and pro-
cesses.
• Microplastics pose interconnected risks
to environmental, human, and animal
health.
• A transdisciplinary approach under One
Health is recommended.
• Greater collaboration between experts
of different fields is required.

a r t i c l e i n f o a b s t r a c t

Article history: Microplastics contamination is widespread in the environment leading to the exposure of both humans and other
Received 11 December 2020 biota. While most studies overemphasize direct toxicity of microplastics, particle concentrations, characteristics
Received in revised form 28 January 2021 and exposure conditions being used in these assays needs to be taken into consideration. For instance, toxicity assays
Accepted 20 February 2021
that use concentrations over 100,000 times higher than those expected in the environment have limited practical
Available online 27 February 2021
relevance. Thus, adverse effects on animal and human health of current environmental concentrations are identified
Editor: Damia Barcelo as a knowledge gap. Conversely, this does not suggest the lack of any significant effects of microplastics on a global
scale. The One Health approach provides a novel perspective focused on the intersection of different areas, namely
Keywords: animal, human, and environmental health. This review provides a One Health transdisciplinary approach to
Human health microplastics, addressing indirect effects beyond simple toxicological effects. Microplastics can, theoretically, change
Human exposure the abiotic properties of matrices (e.g., soil permeability) and interfere with essential ecosystem functions affecting
Abiotic effects of microplastics ecosystem services (e.g., biogeochemical processes) that can in turn impact human health. The gathered information
Microplastics toxicity suggests that more research is needed to clarify direct and indirect effects of microplastics on One Health under en-
vironmentally relevant conditions, presenting detailed knowledge gaps.
© 2021 Elsevier B.V. All rights reserved.

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2. Impacts of microplastics on animal health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

⁎ Corresponding author at: Centre for Environmental and Marine Studies (CESAM), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal.
E-mail addresses: pratajc@ua.pt (J.C. Prata), jpintocosta@ua.pt (J.P. da Costa), ilopes@ua.pt (I. Lopes), aduarte@ua.pt (A.C. Duarte), ter.alex@ua.pt (T. Rocha-Santos).

https://doi.org/10.1016/j.scitotenv.2021.146094
0048-9697/© 2021 Elsevier B.V. All rights reserved.
J.C. Prata, J.P. da Costa, I. Lopes et al. Science of the Total Environment 777 (2021) 146094

3. Impacts of microplastics on human health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

4. Impacts of microplastics on environmental health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
5. A One Health perspective on microplastics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
6. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
CRediT authorship contribution statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Declaration of competing interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Acknowledgement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1. Introduction One Health recognizes the interdependence and interconnectedness

Plastics are an essential material for humans, leading to an
increasing production, reaching 359 million tons worldwide in 2018
(“Plastics - the Facts 2019”, 2019). However, misuse and mismanage-
ment of plastic waste is leading to environmental problems.
Microplastics, plastic particles <5 mm, originating from intentional pro-
duction (primary microplastics) or fragmentation of larger pieces (sec-
ondary microplastics), are widespread and persistent environmental
contaminants (Rocha-Santos and Duarte, 2015). These anthropogenic
contaminants now populate the globe, being found in freshwater
(Z. Wang et al., 2019), seawater (Aliabad et al., 2019), sediment (Joana
C. Prata et al., 2020b), soil (Garcés-Ordónez et al., 2019), air (Vianello
et al., 2019) and even biota (Digka et al., 2018). Over 20,000
microplastics km−2 has been reported in surface water of the Atlantic
Subtropical Gyre (Law et al., 2010). It is estimated that over 5 trillion
plastic particles are floating in the oceans (Eriksen et al., 2014), a num-
ber expected to increase mostly due to the transport of mismanaged
plastics, originating in high population density or highly industrialized
areas, from land to sea through rivers (Lebreton et al., 2017). Accumula-
tion will also occur due to the slow degradation of plastics, which deems
them as persistent contaminants. Indeed, plastics may suffer fragmenta-
tion into progressively smaller secondary microplastics caused
by exposure to O2, temperature, UV radiation, and abrasion, but com-
plete degradation (mineralization) occurs only at a very slow rate
(Andrady, 2017). Adverse effects of microplastics on biota have been
reported, such as feeding disruption, reproductive impairment, changes
in metabolism, and interaction with other contaminants (Anbumani
and Kakkar, 2018).
Despite growing evidence, the extent to which microplastics impact
organisms in the environment it is still not clear. Even though the per-
spective presented by Burton (Burton, 2017) of the overstatement of
microplastic toxicity when organisms are exposed to concentrations
thousands of times higher than environmental concentrations may be
true, there is also the need to acknowledge the precautionary principle
and the lack of scientific maturity of the field (Backhaus and Wagner,
2019). Despite recognizing knowledge gaps, other authors also
argue that the presence of microplastics in numerous systems
(e.g., freshwater, saltwater) can potentially have negative effects on
ecosystems requiring growing collaborative efforts to address their
presence, effects, and mitigation measures (Rochman et al., 2016;
Wagner et al., 2014). Thus, there is a need to interpret threats posed
by microplastics based on their abundance, as well as to consider biotic
and abiotic effects on ecosystem, potentially leading to irreversible
global changes. Abiotic effects, the negative impact of non-living factors
on organisms such as irreversible changes in properties of matrices, and
functions of ecosystems, have been a marginal issue in microplastic
research and may be one of their most impactful consequences.
For instance, permanent changes in soil or sediment properties
(e.g., thermal conductivity, water loss) due to the accumulation of plas-
tic particles are not yet well understood. A wider perspective of the im-
pacts of environmental contamination with microplastics is needed.
Therefore, this review has been conducted under the perspective of
One Health, a transdisciplinary approach to the potential impacts of
microplastics in animal, human and environmental health, which are
all interdependent.
of the ecosystem health with that of animals and humans. This requires
a transdisciplinary approach that combines multiple areas of expertise
and improves communication between professionals. A global chal-
lenge addressed by One Health is climate change, where transdisciplin-
ary surveillance and mitigation could integrate the expected complex
changes, such as environmental modifications, the novel distribution
of species which may carry pathogens, and food security dependent
on the tolerance of crops and livestock to high temperatures, which ul-
timately poses new public health threats (Zinsstag et al., 2018). This ap-
proach is also recommended when dealing with other complex
environmental problems, such as understanding how land use may con-
tribute to human health problems, such as exposure to particulate mat-
ter and infectious agents from livestock farms (Heederik, 2019). For
trace elements, animal biomonitoring should be added to human bio-
monitoring, as well as attempting to find relationships with environ-
mental exposure hotspots and farm practices, improving the overall
food safety and avoiding crossing threshold concentrations at an earlier
stage (Frazzoli et al., 2015). This concept can also be expanded to other
contaminants, by using animals as sentinels for human environmental
health hazards, including those involving chemical and physical hazards
(Rabinowitz et al., 2005). Thus, the One Health approach is recom-
mended when dealing with complex environmental problems which
may have widespread consequences across disciplines.
Microplastics require a One Health approach because they can affect
multiple systems, either from their particle toxicity, release of leachates
and sorption of hydrophobic compounds, or changes in processes or
populations (e.g., introduction of alien species), resulting in potential
ecosystem-level impacts that ultimately threaten public health
(Barboza et al., 2018a). A One Health approach to microplastics is neces-
sary as the evaluation of repercussion and mitigation requires the inter-
vention of multiple partners with wide expertise. Thus, the objective of
this review is not to offer detailed information on each area but to pro-
vide a comprehensive perspective over the effects of microplastics
under the One Health approach, first providing a background assess-
ment of known adverse effects and then discussing areas of intersection,
identifying knowledge gaps and subjects which should be addressed
under a transtransdisciplinary approach. Thus, this manuscript is di-
vided in the following sections: i) animal health, addressing exposure
and toxicity at the animal level; ii) human health, addressing exposure
and effects at the human level, highly based on model organisms and
in vitro studies; iii) environmental health, addressing effects of abiotic
changes and on ecosystems; iv) One Health, discussing the effects of
microplastics at intersections of the previous levels and how a transdis-
ciplinary approach can contribute to the development of the field.
2. Impacts of microplastics on animal health
Following the widespread contamination of natural systems,
microplastics were found in biota. For instance, between 70 and 100%
of sampled fish (Pseudosciaena polyactis, Pleuronichthys cornutus,
Sebastes schlegeli, Liza haematocheila) and mussels (Mytillus
galloprovincialis, Mactra veneriformis, Ruditapes philippinarum) from
Qingdao and Dongying, China (n = 80), contained microplastics, but
the number per individual was low (1.2–3.9) (Ding et al., 2019). A re-
cent review estimated that 60% of fish had internalized microplastics

2
J.C. Prata, J.P. da Costa, I. Lopes et al.
from 198 species in 24 countries (Sequeira et al., 2020). Cases reporting
microplastics in the digestive system of animals in poor body conditions
(e.g., beached marine mammals) do not clarify if the ingestion of
microplastics occurs due to starvation or if starvation is caused by
microplastics, which seems unlikely based on the numbers found.
Moreover, exposure does not necessarily translate into adverse effects
on the survival of the individual, highlighting the need for in vivo assays,
dependent also on concentrations, testing conditions, and relevant
endpoints. For example, in the microalgae Chlorella pyrenoidosa,
microplastics led to morphological changes, reduced growth, and re-
duced photosynthetic activity (>10 mg L−1 0.1 and 1 μm PS, polysty-
rene) (Mao et al., 2018). In the planktonic crustacean Daphnia magna,
microplastics caused immobilization (>12.5 mg L−1 1 μm PE, polyethyl-
ene) (Rehse et al., 2016), mortality (>0.01 mg L−1 2 μm PS) (Aljaibachi
and Callaghan, 2018), reproduction impairment (>0.02 mg L−1 1–5 μm
proprietary polymer) (Pacheco et al., 2018), including transgenerational
effects of reduced growth and reproduction (>0.1 mg L−1 1–5 μm pro-
prietary polymer) (Martins and Guilhermino, 2018). In mussels Mytilus
spp., microplastic exposure affected the homeostasis with the produc-
tion of stress and immune-related proteins and consequent increased
energy expenditure (>4.6 × 105 microplastics L−1 1–50 μm HDPE,
high-density PE) (Détrée and Gallardo-Escárate, 2018), reduced attach-
ment strength (>0.8 mg L−1 0.5–316 μm HDPE) (Green et al., 2019), im-
pacted key metabolism enzymes, and lead to the upregulation of
biomarkers for antioxidant response (>1.5 × 107 microplastics L−1
1–50 μm HDPE) (Détrée and Gallardo-Escárate, 2017). Testing in juve-
niles of European seabass (Dicentrarchus labrax) revealed that
microplastics (>0.7 mg L−1 1–5 μm proprietary polymer) are neuro-
toxic, alter the energy-related enzymes (lactate dehydrogenase,
isocitrate dehydrogenase) (Barboza et al., 2018c), induce negative ef-
fects of swimming performance (Barboza et al., 2018d), and led to oxi-
dative stress, and lipid peroxidation (Barboza et al., 2018b, 2018c).
Similarly, in vitro studies revealed internalization of microplastics, re-
duced viability, affected gene expression, increased pro-inflammatory
response, and morphological changes (>10 mg L−1 44 and 100 nm
PS) (Forte et al., 2016). Smaller particles, especially nanoparticles (for
which environmental concentration are not yet known), have been
found under laboratory conditions to translocate from the originally ex-
posed tissues (respiratory and digestive system) to internal tissues,
such as in mussels Mytilus edulis (i.e., hemolymph) (Browne et al.,
2008), and even in crabs Carcinus maenas (i.e., hemolymph, hepatopan-
creas, ovary) after ingestion of contaminated mussels (Farrell and
Nelson, 2013). However, little evidence for trophic transfer has been
found so far identified in wild organisms (Nelms et al., 2018), similar
to bioaccumulation and biomagnification (Duis and Coors, 2016;
Miller et al., 2020). Some evidence has now been described for trophic
transfer in aquatic systems. This is the case of the presence of
microplastics in the stomach content of the fish Pleuronectes platessa
along with its prey, the fish Ammodytes tobianus, but with no evidence
of accumulation (Welden et al., 2018). Additionally, microplastics
have been found in the regurgitates and faecal samples of wild Eurasian
dippers Cinclus cinclus (D'Souza et al., 2020) and in captive grey seals
Halichoerus grypus and in their wild prey Atlantic mackerel Scomber
scombrus (Nelms et al., 2018).
Microplastics do not solely induce biological responses due to their
physical action. The surface characteristics of small plastic particles
can lead to either the adsorption of persistent organic pollutants
(POPs) from the environment (Teutan et al., 2007) or the release of
monomers and additives from plastic, including endocrine disrupting
plasticizers (Law and Thompson, 2014). Indeed, contaminants such as
polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls
(PCBs), hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichlo-
roethane (DDT) have been identified in microplastics collected from
beaches around the world (Frias et al., 2010; Ogata et al., 2009). More-
over, pharmaceuticals (e.g., diclofenac, paracetamol, tramadol), pesti-
cides (e.g., diazinon, carbendazim, imidacloprid) (Picó et al., 2020),
3
Science of the Total Environment 777 (2021) 146094
and metals (e.g., Fe, Al, Zn) (Vedolin et al., 2018) have been identified
in microplastics collected from the environment. The interaction of
these substances with microplastics could modulate their toxicity to or-
ganisms. For instance, the presence of microplastics increased the toxic-
ity, decreasing the EC50, of the antibiotic doxycycline for the marine
microalgae Tetraselmis chuii (growth rate, chlorophyl) (Prata et al.,
2018) and of the illicit drug methamphetamine in green algae Chlorella
pyrenoidosa (growth rate) as well as in the freshwater snail
Cipangopaludian cathayensis (mortality) (Qu et al., 2020). However,
these changes are often observed only at concentrations, of both
microplastics and chemicals, much higher than typically encountered
in the environment. Moreover, the role of microplastics in the exposure
of organisms to contaminants is likely very low compared to that from
other pathways, such as via water, air, and food (Bakir et al., 2016;
Koelmans et al., 2016). Despite this hypothesis, the continuous expo-
sure of the gastrointestinal system to microplastics, through ingestion
and egestion, can lead to long-term exposure to these substances. For
instance, a significant correlation was found between the number of
ingested microplastics and total bisphenol concentration in the muscle
and liver of wild North Atlantic fish (Dicentrarchus labrax, Trachurus
trachurus, Scomber colias) (Barboza et al., 2020). This single result is
not a definitive proof of microplastics causing higher exposure to con-
taminants, but clearly highlights the lack of consensus in this area,
mostly fueled by multiple knowledge gaps (reviewed by Rodrigues
et al. (2019)). Conversely, in some situations microplastics may have a
‘cleaning effect’, strongly adsorbing contaminants reducing their bio-
availability (Koelmans et al., 2013). Therefore, it should motivate fur-
ther research in this area, namely the assessing the presence of
microplastics on the exposure and adverse effects of other contami-
nants under realistic conditions (including comparison with other
routes of exposure), multiple combinations, and the inter-generational
effects of endocrine disruptor compounds.
The high specific surface area of microplastics offers a substrate
for the growth of unique communities of microorganisms
(Oberbeckmann et al., 2015), including potentially pathogenic
species, such as Vibrio spp. (Kirstein et al., 2016) and Aeromonas
salmonicida (Viršek et al., 2017). Moreover, biogenic particles and
organic materials adhering to the surface of microplastics may
contribute to their function as a substrate (Michels et al., 2018).
The formation of biofilms and colonization of plastics with epibionts,
that function as a surface ecosystem, is sometimes called the
“Plastisphere” (Zettler et al., 2013). The presence of microorganisms
on the surface of microplastics may also contribute to their (extremely
slow) biodegradation (Andrady, 2017) while ingestion or inhalation of
these particles may cause micro-lesions (ulcers, abrasions) (Jeong and
Choi, 2019) that may favor the infection by pathogenic or opportunistic
microorganisms. Moreover, microplastics, due to their characteristics or
the presence of biofilms in their surface, can affect the gut microbiota of
organisms, which potentially translates into health impacts (Lu et al.,
2019). Marine litter, especially plastic debris, can even change popula-
tion dynamics of species or act as a vector for invasive species in an eco-
system, and is differentiated from natural litter due to their high
occurrence and persistence (Rech et al., 2016). For instance, the pres-
ence of plastic pellets was used as an oviposition site by the ocean insect
Halobates micans, potentially having a positive effect on their abundance
(Majer et al., 2012).
Despite the apparent seriousness of these effects on animal health,
concentrations of microplastics at which these adverse effects have
been demonstrated do not always translate into reduced survival rates
and are generally very high compared to environmental concentrations.
For instance, tested concentration of microplastics in aquatic organisms
in 10 studies published in 2019 and 2020 had a median concentration of
400 μg L−1 (1.5–100,000 μg L−1) (Chae and An, 2020; Choi et al., 2020;
Cormier et al., 2019; Hamed et al., 2019; Li et al., 2020; Limonta et al.,
2019; Pannetier et al., 2020; Peixoto et al., 2019; Qiao et al., 2019; J.
Wang et al., 2019; Yin et al., 2019), while the median environmental
J.C. Prata, J.P. da Costa, I. Lopes et al. Science of the Total Environment 777 (2021) 146094

concentration reported in 3 studies covering 13 locations was
0.003 μg L−1 (0–3 μg L−1) (Doyle et al., 2011; Goldstein et al., 2012;
Lacerda et al., 2019). This is equivalent to exposing organisms to con-
centrations of microplastics that are over 100,000 times higher than
what they are naturally exposed to in the environment. Similarly, in
2016, Lenz et al. (2016) reported that microplastics concentrations
used in toxicity studies to be 2 to 7 orders-of-magnitudes higher than
environmental concentrations. Following an extensive literature review
on the adverse effects of microplastics, Burns and Boxall (2018) also
concluded that currently measured environmental concentrations are
3 orders of magnitude lower that the estimated 5% hazard concentra-
tion for aquatic organisms (8.5 vs. 6.4 × 104 particle L−1), determined
by a species sensitivity distribution, supporting a limited environmental
risk. While reported environmental concentrations depend on geo-
graphic locations and on analytical methods used (e.g., limits of detec-
tion), these variations are small and do not justify the use of such high
concentrations in laboratory studies. Even though small microplastics
(<100 μm) are being underreported, despite being the most numerous
size class, these small particles only comprise a small fraction of total
mass (Lindeque et al., 2020). Considering estimated real concentrations
≤1 μg L−1 (Lenz et al., 2016), several toxicity assays including these con-
centrations have been compiled on Table 1, revealing that effects can
sometimes be found on lower levels of organization but are not always
translated to less sensitive endpoints (e.g. mortality) nor necessarily in
reduced survival or ecologically relevant impacts. For marine debris,
Rochman et al. (2016) found that only 11% of the reviewed studies
pertained to effects at organismal and ecological levels of organization,
with most conducted on suborganismal levels, limiting interpretations
on ecological impacts. Moreover, few studies embark in testing real en-
vironmental concentrations, most likely due to the underreporting of
negative results, likely caused also by selection of endpoints. For in-
stance, from the 30 original articles so far published in 2020 referring
to “microplastics” + “aquatic” + “toxicity” using weight per volume
units, retrieved from Web of Science on June 2020, none tested concen-
trations ≤1 μg L−1 and only 4 (13.3%) tested concentrations ≤100 μg L−1
(Revel et al., 2020b; Roda et al., 2020; Sıkdokur et al., 2020; Yang et al.,
2020). Regarding studies considering environmentally relevant concen-
trations (including ≤1 μg L−1), results vary greatly depending on spe-
cies, endpoints, and polymer characteristics. For instance, no adverse
effects have been found for the Pacific oyster Crassostrea gigas (Revel
et al., 2020a) and the Blue mussel Mytilus spp. (Revel et al., 2019),
while the black-lip pearl oyster Pinctada margaritifera suffered effects
on energy balance and reproduction ability (Gardon et al., 2018). For
the nematode Caenorhabditis elegans, studies show a trend for increased
intestinal permeability and reactive oxygen species (ROS) production
with increasing concentrations of microplastics, not yet translated into
mortality (Dong et al., 2018; Zhao et al., 2017), with greater toxicity in
acs-22 mutants with increased intestinal permeability, emphasizing
the role of translocation in increased ROS production (Qu et al., 2018).
These studies show that is possible to conduct toxicity assays under en-
vironmentally relevant concentrations of microplastics, sometimes
even finding crucial adverse effects on more sensitive endpoints and
species. Finally, estimations situate Predicted No Effect Concentration
(PNEC) for pelagic marine organisms at 6650 particles m−3, which is ex-
pected to be occasionally exceeded in hotspot areas (Everaert et al.,
2018), and for freshwater organisms at 740,000 particles m−3, for
which ecological risk could not be excluded (Adam et al., 2019). There
is a need to further estimate PNEC for other populations and account
for microplastic characteristics (e.g. shape, polymer, size), as well as to
conduct risk assessment based on higher concentration for smaller par-
ticle sizes (e.g. 18 microplastics L−1 in Aveiro Lagoon, Portugal, for
microplastics ≥2 μm (Prata et al., 2020a)).
Most toxicity assays tested concentrations as weight per volume
(e.g. μg L−1), while most environmental concentrations are
reported as particle number per volume (e.g. particle L−1), making
risk assessment difficult. For instance, evaluation of 30 publications on
toxicity assays from 2020 (until June) for the keyword
“microplastics” + “aquatic” + “toxicity” revealed that 18 reported
tested concentrations as weight per volume, 4 as particle per volume,
and 8 as both weight and particle per volume, which is the recom-
mended practice. Moreover, toxicity testing often does not account for
the heterogeneity of microplastics, which varies widely in terms of

Table 1
Toxicity studies conducted in aquatic organisms under environmentally relevant concentrations (including concentrations ≤1 μg L−1).

Species Microplastics Effect Authors

Polymer Size Concentration

(μm) (μg L−1)

Crassostrea gigas PE 0.4–500 0.008–100 No effect on deposition of particles on tissues, gametogenesis, mortality, clearance rate, increase (Revel et al.,
+ PP in CAT, SOD, and GST in gills and digestive gland, gene expression for antioxidant enzymes (Gpx, 2020a)
(1:1) GST, SOD, CAT), immune parameters (acid phosphatase activity), nor increased DNA damage
(comet assay).
Mytilus spp. PE 0.4–950 0.008–100 No effect on histological parameters, ROS production, clearance rate, amylase activity, gene (Revel et al.,
+ PP expression of antioxidant enzymes (Gpx, SOD, CAT). 2019)
(1:1) 0.008–10 μg L−1: increased CAT and SOD in digestive gland, increased immune parameters (acid
phosphatase activity).
10–100 μg L−1: DNA damage (comet assay).
100 μg L−1: decreased GST on digestive gland; increased CAT and SOD in gills.
Pinctada PS 6, 10 0.25–25 No effect on ingestion rate, oxygen consumption, shell growth, gonad development (Gardon et al.,
margaritifera ≥0.25 μg L−1: decrease in mean energy balance, gametogenesis regression. 2018)
25 μg L−1: decrease in digestive assimilation efficiency.
Caenorhabditis PS 0.002 0.01–1 No effect on locomotion behavior, brood size, ROS production, and on molecular basis of oxidative (Dong et al.,
elegans stress. 2018)
Caenorhabditis PS 0.1 1–10,000 ≥1 μg L−1: decreased intestinal barrier. (Zhao et al.,
elegans ≥10 μg L−1: decreased locomotion behavior, and reduced brood size, prolonged defecation cycle 2017)
length.
≥100 μg L−1: transgenerational increase in intestinal ROS production, decrease in locomotion
behavior, and reduction in brood size.
Caenorhabditis PS 0.1 0.1–10 No effect on mortality, nor on transcription of sod-1, sod-3, sod-4, sod-5, mev-1, gas-1. (Qu et al.,
elegans (acs-22 ≥1 μg L−1: increased intestinal ROS production, accumulation in gonad and intestinal cells, 2018)
mutant) increased transcription of sod-2, ctl-1, ctl-2, ctl-3, clk-1, isp-1, skn-1, gst-4, induction of Nrf
signaling pathway (SKN-1-GST-4).
≥ 10 μg L−1: decrease in locomotion behavior.

PE: polyethylene, PP: polypropylene, PS: polystyrene. Gpx: glutathione peroxidase, GST: glutathione-S-transferase, SOD: superoxide dismutase, CAT: catalase, ROS: reactive oxygen
species.

4
J.C. Prata, J.P. da Costa, I. Lopes et al.
polymer type, chemical composition, crystallinity, surface chemistry,
shape, size, color, weathering state, and adsorption capacity (Lambert
et al., 2017), with most studies testing a single polymer type in its virgin
state. For instance, generally smaller particles have a higher toxicity
(Ziajahromi et al., 2018), while variable toxicity responses were ob-
served when testing mixtures of microplastics collected from beaches,
likely resulting from their polymer composition, extent of sorbed con-
taminants and of weathering (Pannetier et al., 2020). Expected toxicity
under environmental conditions will also be dependent on the size dis-
tribution of microplastics as well as other characteristics that may mod-
ulate their chance of interaction with organisms (e.g. color, size) (Ma
et al., 2020). In in vivo tests, organisms are often exposed solely to
microplastics without their natural food source. The presence of food
often decreases microplastic ingestion, suggesting organisms are capa-
ble of selective feeding (Scherer et al., 2017). Moreover, organisms
have evolved to deal with natural particles with mechanisms to miti-
gate their effects when ingested or inhaled. Thus, comparing the toxic-
ity of microplastics against natural particulate materials (i.e., positive
controls), such as kaolin or diatomite powders (Scherer et al., 2020),
can clarify the true impact of these anthropogenic residues in the
biota. Additionally, identification of plastic particles used in toxicity as-
says is often accomplished through fluorescent labels. However, tissues
can have autofluorescence or be stained by leaching fluorophores, lead-
ing to overestimation and incorrect conclusions about translocation
(Catarino et al., 2019), and the ingestion rates of fluorescently labelled
microplastics may differ from that of comparable unlabeled particles,
for instance, by acquiring different color or taste. Finally, more tests
are needed to better evaluate different responses based on low and
high concentrations over different periods of time, and even over
generations.
Considering current knowledge, clear evidence that microplastics
cause direct adverse effects on numerous species at the population
level under known environmental concentrations is lacking. It is the
large disparity between tested and environmental concentrations that
excessively raises the alarm on the ill effects of microplastics on the eco-
system. Nonetheless, study limitations regarding concentrations,
microplastic characteristics, and testing conditions have been identified
as a significant knowledge gap that increases the uncertainty regarding
the impacts of this anthropogenic contaminant on animal health. Indi-
rect effects of microplastics on the health of individuals and populations
cannot be excluded. In addition to more detailed toxicity assays, ad-
dressing environmentally relevant concentrations, conditions, and
microplastic characteristics, as well as using a wider range of species
covering different environments, there is a need to look beyond obvious
toxicological responses and into more subtle effects of microplastics on
animal health.
3. Impacts of microplastics on human health
Plastics have contributed greatly to food security, improving packag-
ing materials that increased shelf-life and reduced food waste. The ma-
terial also helps maintain public health, reducing the spread of
infectious diseases through single-use medical supplies, such as face-
masks, syringes, and medical tubing (Prata et al., 2019b). However,
widespread use of plastics in daily use and the resulting environmental
contamination by post-use plastics will undoubtedly lead to human ex-
posure to microplastics. Exposure may occur due to ingestion of con-
taminated foodstuff (Galloway, 2015), with an estimated intake of
39,000–52,000 particles person−1 year−1 through this route (Cox
et al., 2019), which may be even higher if the settling dust on plates dur-
ing mealtimes is taken into account (Catarino et al., 2018). This level of
intake is not surprising as microplastics have been found to contaminate
salt (Seth and Shriwastav, 2018), drinking water (Pivokonsky et al.,
2018), bottled water, beer (Wiesheu et al., 2016), mussels (Berglund
et al., 2019) and fish (Neves et al., 2015). The contribution from other
sources, such as packaging containers, is still unknown (Rist et al.,
5
Science of the Total Environment 777 (2021) 146094
2018). Regarding food safety, microplastics are now considered signifi-
cant food contaminants and included as foreign bodies, being controlled
in the European Union by the European Commission's Rapid Alert Sys-
tem for Food and Feed (RASFF) and the European Food Safety Authority
(EFSA) (Barboza et al., 2018a).
After ingestion, particles travel through the gastrointestinal system,
reaching the intestine. Only particles capable of penetrating the intesti-
nal mucus, due to small size or the formation of a surface “corona” of
biocompatible coating, will reach intestinal cells. Here, microplastics
can be internalized by specialized M-cells, which cover the Peyer's
patches - a specialized lymphoid tissue (Ensign et al., 2012), or through
persorption, the paracellular transference of particles (Volkheimer,
1977), potentially achieving systemic circulation afterwards (Eyles
et al., 1995). In vitro testing reveals a potential effects of microplastics
in cells on gene expression, cell viability, and pro-inflammatory re-
sponses (Forte et al., 2016). On the other hand, in vivo testing on mice
revealed that ingestion of a concentration as low as 0.01 mg of 5 μm of
polystyrene microparticles per day caused a decrease in spermatogenic
cells as well as decreased sperm count after 42 days (Xie et al., 2020), a
lower amount than the estimated human ingestion of 5 g of
microplastics per week (Senathirajah and Palanisami, 2019).
Another route of exposure is inhalation of airborne microplastics.
Microplastics and synthetic fibers populate the air we breathe, leading
to an estimated exposure of 272 microplastics day−1 through inhalation
(Vianello et al., 2019). These particles are released from daily objects
and activities, being highly influenced by them in terms of concentra-
tions and characteristics (Prata, 2018a). Size and density of particles
will determine how deep in the respiratory system they deposit. If the
concentration of particles in air is high enough, they can induce a dust
overload response with intense release of chemotactic factors that in-
crease vascular permeability and prevent macrophage migration, lead-
ing to chronic inflammation (Donaldson et al., 2000). Indeed,
microplastics in lungs are pro-inflammatory and have high oxidant ac-
tivity (Brown et al., 2001). Chronic exposure to high concentrations of
airborne microplastics can lead to airway and interstitial lung disease,
potentially leading to the development of malignant lesions, as has
been observed in occupational exposure (Prata, 2018a).
Finally, dermal exposure cannot be excluded due to the widespread
presence of microplastics in the environment. It has been hypothesized
that plastics <100 nm could potentially cross the epithelial barrier
(Revel et al., 2018). Moreover, this is a topic worth exploring since sev-
eral personal care products, directly applied to the skin, still include
microplastics in their composition (Godoy et al., 2019). If internalization
does occur, human epithelial cells may suffer from cytotoxicity from ox-
idative stress (Schirinzi et al., 2017). Indeed, despite a lot of uncertainty
regarding the use of in vitro and in vivo models, a systematic interpreta-
tion of the available toxicological data through Adverse Outcome Path-
ways concluded that the formation of reactive oxygen species due to the
presence of microplastics, and consequent oxidative stress and inflam-
mation, are the major toxicological threats to both human and animal
health (Jeong and Choi, 2019).
As previously discussed for animal health, potentially dangerous
microorganisms can be found at the surface of microplastics and take
advantage of aggressions (e.g., erosion, ulcers, fissures) resulting from
these particles to cause infections. For instance, Vibrio spp., a genus
including bacteria often involved in foodborne diseases, has been
found in microplastics in the environment (Kirstein et al., 2016)
(Letchumanan et al., 2019). The respiratory system is exposed as well,
with suspended organisms potentially surviving longer when sheltered
by airborne particles in the atmosphere, such as microplastics (Prata,
2018a). More disconcerting is the role of marine plastic debris as a res-
ervoir of pathogens, with potential consequences to public health
(Keswani et al., 2016), especially since numerous microplastics origi-
nate from wastewater treatment plants (Prata, 2018b). For instance, se-
quencing of sterile polyethylene microparticles incubated in river water
in situ for 14 days identified the presence of potential human pathogens,
J.C. Prata, J.P. da Costa, I. Lopes et al.
namely Arcobacter spp., Clostridium perfringens, Enterobacter spp.,
Escherichia coli, and Helicobacter spp. (Murphy et al., 2020). Even though
these microorganisms could benefit from previous tissue damage
caused by microplastics, a minimal infective dose (i.e., the minimal
number of individuals needed to cause infection) may still be required,
with infection being dependent on the number of pathogenic or oppor-
tunistic microorganisms on the surface of microplastics. The role of
microplastics compared to other routes of exposure is also not well un-
derstood. Similarly, microplastics may have a limited role in the expo-
sure to monomers, additives, and POPs, compared to other sources.
For instance, Bisphenol A, a monomer used in plastics and an endocrine
disruptor, can be found in food, water, air, and dust, mostly originating
from objects made of polycarbonate plastic (Michałowicz, 2014). Thus,
exposure to POPs through microplastics is likely small compared to
these other routes. Further assessment of human exposure to
microplastics could also clarify to which extent they may pose a signif-
icant contribution when carrying those contaminants.
There is currently no evidence for direct adverse effects of
microplastics in human health. Available observations are mostly
based on in vitro or in vivo studies in model organisms, with the same
limitations described for the assessment of the effects of microplastics
on animal health. A similar conclusion was reached by the Science
Advice for Policy by European Academies, stating the lack of evidence
for effects of microplastic on human health under present environmen-
tally relevant concentrations, but still highlighting the need to fill
knowledge gaps (Science Advice for Policy by European Academies,
2019). The European Commission's Scientific Advice Mechanism also
states the need for an overarching perspective by comparing the seem-
ingly limited exposure and effects of microplastics with that of other
more abundant and harmful contaminants (Commission, 2018). It is
also worth considering the inclusion of microplastics in contaminant
categories, already being assessed for their impacts in human health
(e.g. particulate matter) (Prata et al., 2020). So far, the impact of
microplastics as vectors of microorganisms and chemicals also seem
limited compared to other routes of exposure and transport. Nonethe-
less, there are still large uncertainties regarding a lifetime of chronic
exposure to microplastics and their cumulative burden of multiple
stressors in the human body.
4. Impacts of microplastics on environmental health
Environmental health evaluates how aspects of the natural environ-
ment can have impacts in human and animal health that depends on its
resilience, which also includes threats to ecosystems and environmental
processes (Kelley, 2013). Microplastics can threaten natural systems,
and consequently environmental health, through several mechanisms.
One of which is through changes in organism populations due to
microplastics' direct or indirect effects. Direct effects in a single species
can have widespread consequences at the ecosystem level. For instance,
microalgae populations can benefit from microplastics if these reduce
populations of primary consumers, but can be harmed if microplastics
hinder the absorption of essential nutrients (Prata et al., 2019a). More-
over, the reduction of energy uptake in the clam Atactodea striata can
also affect energy transfer in the food web (Xu et al., 2017). Plastic litter
was also found to change community structures in benthic macrofauna,
leading to an increase in taxonomic abundance, richness, and diversity
(Clemente et al., 2018). Likewise, microbial communities colonizing
microplastics present distinct structure, composition, and functional
properties, which may have ecological impacts on diversity and biogeo-
chemical processes of ecosystems (Miao et al., 2019). The ecological role
and functionality of microplastics microbial communities is context-
dependent, and varies between different environments (Aria-Andres
et al., 2018). Invertebrates and microorganisms take advantage of
microplastics as an available and persistent substrate, that sustains
their dispersal to new regions (Reisser et al., 2014). Conversely, these
anthropogenic contaminants may be harming other species. For
6
Science of the Total Environment 777 (2021) 146094
instance, hermit crabs can become entrapped in plastic debris, leading
to population reductions, impacting detritus removal, seed dispersal,
and soil turbation, and indirectly have economic impacts through de-
creased tourism (Lavers et al., 2020). Indeed, keystone species that are
essential for ecosystem functioning can be threatened by the presence
of microplastics and plastic litter (Barboza et al., 2018a). Moreover,
the vector effect of microplastics in the dispersal of organisms can lead
to proliferation of invasive species (Hu et al., 2019). Indeed,
microplastics may have adverse effects on organism communities and
ecosystems through direct toxicity, by acting as substrates, benefiting
some species, or hindering others through their physical effects.
These effects are not only limited to population dynamics, but also to
changes in habitat properties. Microplastic accumulation in sediments
can decrease thermal diffusivity, increase heat capacity (resulting in
lower maximum temperatures), and increase permeability, with poten-
tial effects on egg hatching for numerous taxa, alteration of nutrient cy-
cling, and in temperature dependent sex-determination in animals,
such as sea turtles (e.g., 1.5% of plastics in sediment could decrease tem-
perature by 0.75 °C) (Carson et al., 2011). Indeed, loggerhead sea turtles
(Caretta caretta) nesting in beaches contaminated with plastic debris
has been reported in the USA (Garrison and Fuentes, 2019; Martin
et al., 2019) and in Cyprus (Duncan et al., 2018), causing hatchlings en-
tanglement and increased time to reach the ocean (Aguilera et al.,
2018), which may increase predation and decrease survival. Similarly,
microplastics in soil can increase rates of soil water evaporation and
desiccation cracking, mostly by creating channels for water movement,
which could lead to desertification (Wan et al., 2019). Changes in micro-
bial activity and soil bulk density were also reported for soils spiked
with microplastics, potentially causing functional changes (e.g., water
stable aggregates, microbial activity) that may also dependent on poly-
mer type, for instance with polyester fibers, but not polyacrylic fibers
and polyethylene fragments, causing a decrease in bulk density
(Machado et al., 2018). Conversely, the same study found that polyester
fibers may have a counterbalancing effect by increasing water holding
capacity of soil, yet decreasing water stable aggregates (Machado
et al., 2018). As microplastics can reach mass ratios up to 6.8% in soils
in industrial areas (Fuller and Gautam, 2016), these are environmen-
tally relevant effects considering tested concentrations of 0.5 and 1%
(Wan et al., 2019) and 0.05–0.4% (Machado et al., 2018). Microplastics
in agricultural soils could be originating from the application of sewage
sludge from wastewater treatment plants as a fertilizer, the fraction
retaining most microplastics from wastewater (Prata, 2018b). Posteri-
orly, earthworms (Lumbricus terrestris) can transport microplastics at
depth, also incorporating it in soil via casts, burrows, and egestion
(Rillig et al., 2017). Impacts of microplastics can also be felt by other
soil organisms, such as alteration of gut microbiota, inhibition of growth,
an reproduction in soil collembolans (Zhu et al., 2018), depending on
levels of exposure and their concentrations. Plants may also be affected,
with wheat seedlings (Triticum aestivum L.) exposed to microplastics in-
creasing growth but reducing absorption of micronutrients and chang-
ing their metabolic profiles (Lian et al., 2020). Finally, microplastics
may also be incorporated and concentrated in Artic sea ice, increasing
ice salinity, possibly by facilitating the migration of brine through the
ice structure, and ice albedo, with increased incident radiation absorp-
tion and consequent melting, as well as affecting light penetration
other processes occurring in sea ice (Geilfus et al., 2019).
Microplastics may have important effects on nutrient flux and essen-
tial ecosystem functions. For instance, a modeling approach estimates
that in some areas of the southern North Sea, secondary production
can be affected up to ±10% in the presence of microplastics (Troost
et al., 2018). In concentrations of 0.2–2% of weight, microplastics can
lead to reductions in sediment microalgae mass as well, with potentially
effects on nutrient flux (Green et al., 2016). Microplastics also aggregate
with marine snow, organic matter falling through the water column, in-
creasing or decreasing its sinking rates, potentially affecting the access
to nutrients and contaminating benthic ecosystems (Porter et al.,
J.C. Prata, J.P. da Costa, I. Lopes et al.
2018). A similar sinking effect could be observed for microplastics due
to the formation of surface biofilms (Kooi et al., 2017) and marine ag-
gregates (Zhao et al., 2018). It is not only the transport of nutrients
that can be affected by microplastics as other essential processes may
be influenced as well. For instance, methane production by microbial
communities is inhibited in the presence of nanoplastics in sewage
sludge (Fu et al., 2018), perhaps also in anaerobic digestion in natural
systems. Ammonia cycling can also be affected by the presence of
microplastics in sediments, with an increase in ammonium possibly
due to the interruption of bacterial denitrification or increased flux of
ammonium in pore water, potentially leading to eutrophication
(Cluzard et al., 2015). Nutrient cycling and biodiversity was also be af-
fected by microplastics in a seawater mesocosms, with context-
dependent effects on ecosystem function and diversity (Green et al.,
2017). Therefore, microplastic contamination may also affect essential
ecosystem functions, by directly affecting communities or by indirectly
affecting the physical properties of habitats.
In summary, depending on their properties and environmental con-
centrations, microplastics may threaten environmental processes and
communities, and consequently, human and animal health, through
several direct and indirect mechanisms. Of these, it is worth highlight-
ing the effects on species composition of communities and
ecosystems, changes in physical properties of habitats, and effects on
nutrient flux and essential ecosystem functions. These changes, or
their cumulative effect paired with other contaminants, may lead to de-
crease ecosystem resilience and great risk to Earth's natural systems.
Microplastics, due to their heterogeneity, widespread distribution, per-
sistence, and potential to interact with living systems through a myriad
of direct and indirect pathways, can be considered a threat to planetary
health. Indeed, Villarrubia-Gómez et al. (2018) have considered
microplastics as a planetary boundary threat due to their potential for
accumulation, owning to their persistency and irreversibility, as well
as for disruption of Earth system processes. Nonetheless, this informa-
tion must always be interpreted in the context of current environmental
concentrations, which may not yet have reached harmful levels. There is
Fig. 1. One Health challenges posed by microplastic contamination.
7
Science of the Total Environment 777 (2021) 146094
still a lot of uncertainty regarding large-scale effects of microplastics on
the environment and populations, requiring further research especially
involving up-scaled experiments (e.g., mesocosms studies) and field
studies.
5. A One Health perspective on microplastics
Some challenges posed by microplastics involve concomitantly
human, animal, and environmental health (Fig. 1). Both human and an-
imal health are susceptible to similar threats. For instance, the spreading
of pathogenic bacteria or of antibiotic resistant genes associated with
microplastics (Hu et al., 2019), as these particles are known to increase
the frequency of in vitro resistance plasmid transfer from E. coli to natu-
ral bacterial colonies (which contribute to antibiotic resistance) (Arias-
Andres et al., 2018). Or the increase in frequency and severity of harmful
algal blooms due to microplastics, which may have negative effects on
other organisms (Yokota et al., 2017), with potential impact on food
sources. For instance, count of antibiotic resistant bacteria was
100–5000 higher in microplastics in a marine aquaculture system
than the surrounding water, posing a risk to fish and human health
(Zhang et al., 2020). These issues could benefit from a transdisciplinary
approach. In the case of harmful algal blooms, information on environ-
mental variables could help predict the most frequently affected areas
and periods, considering also the influence of microplastics, while pro-
fessionals in animal and human health (e.g., veterinarians, physicians)
could help forecast and mitigate the effects of these events. Similarly,
antibiotic resistance could be prevented at multiple levels, from better
antimicrobial management in human and veterinary care, to wastewa-
ter treatment or mitigation measures for microplastics, if these indeed
are confirmed to contribute significantly to the problem.
Food security, the access to food, may also be threatened by
microplastics. For instance, direct and indirect impacts of microplastics
in fish populations can lead to human nutritional deficiencies, since
fish contribute to 20% of the total animal protein intake in the world
(Organization, 2020). Both aquaculture, which contributes to half of
J.C. Prata, J.P. da Costa, I. Lopes et al.
the fish consumed (States, 2019), and fisheries may suffer from the ad-
verse effects of microplastics to biota. This could result from the impair-
ment of digestive processes resulting from microplastic exposure,
causing enzyme modulation (e.g. trypsin, amylase) (Wen et al., 2018).
Adverse effects may have an impact in aquaculture gains as feeds based
on fish meal which are often contaminated with microplastics (Hanachi
et al., 2019) or wild fish populations, which are already known to inter-
nalize these particles (Sequeira et al., 2020). Similarly, aquatic ecosystems
may suffer from reduction in gains or survival of these organisms. More-
over, concerns over the presence of microplastics in seafood may also lead
to a reduction in their consumption, with potential negative effects on
human nutrition (Smith et al., 2018). In this case, collaboration between
environmental scientists, aquaculture managers, and biologists could
contribute to the assessment of the exposure and the effects of
microplastics in both farmed and wild seafood populations, while health
professionals could clarify and disseminate impacts on human health (if
any) and support to a sustainable healthy diet, which may include inges-
tion of aquatic organisms. Similarly, the presence of microplastics in other
foodstuff, originating from processes or packaging, should be further in-
vestigated, involving not only health professionals aimed at understand-
ing their impact, as well as designers and engineers responsible for the
developments of these processes and packaging.
Terrestrial ecosystem can also be impacted by microplastics. For in-
stance, ingestion of plastics by sacred cows in India led to their death
from starvation due to obstruction of the digestive system (Krulwich,
n.d.). If high amounts of plastics or microplastics are available in the en-
vironment, livestock or wild animals could suffer the same fate, and
humans would suffer from losses in nutritious and valuable animal
food products or ecosystem services provided by these animals
(e.g., vegetation management by grazing). While microplastics are not
expected to induce such effects on large livestock, they may produce
similar adverse effects on smaller organisms also providing ecosystem
services, such as detritivores. Changes in soil properties, such as water
permeability (Machado et al., 2018), or communities can also have im-
pacts on primary production, with adverse effects on the environment
by increasing the risk of desertification and ultimately compromising
the provisioning of both animals and humans, being a threat for food se-
curity. For instance, in agricultural soils, little is known regarding the
contribution of common practices, such as the application of wastewa-
ter sludge, fertilizers or grazing, on the concentrations of microplastics,
neither how these might impact soil permeability, soil communities,
crop development and quality, food safety, or contribute to the contam-
ination of nearby water courses. Other agricultural practices that might
contribute to microplastics in soils include the use of mulch films and
synthetic ropes. These questions can only be answered by a multidisci-
plinary team comprised, for instance, by agronomists, health profes-
sionals, veterinarians, biologists, and environmental engineers.
Even larger uncertainties surround the potential effects of
microplastics on ecosystem services, which human life relies upon.
Anthropogenic stressors are known to affect an ecosystem's productiv-
ity, such as the amount of a-chlorophyll in marine ecosystems (Johnston
et al., 2015). The effects of marine plastic debris affecting the ecosystem
services are so far expected in fisheries and aquaculture, heritage, and
recreation (Beaumont et al., 2019). Ecosystem services are intrinsically
related to human health and survival, such as in the provision of clean
water or climate regulation (Coutts and Hahn, 2015). Conservation of
biodiversity also contributes to human wellbeing (Naeem et al., 2016).
Another ecosystem wide repercussion of microplastics could result
from the modulation of microalgae populations, either by reduction
on the absorption of nutrients or changes in predator species popula-
tions (Prata et al., 2019a), potentially impacting the survival of these or-
ganisms responsible for 50% of the primary net production, for
maintaining water quality, multiple biogeochemical processes, and sig-
nificant O2 production (Barbosa, 2009). Likewise, interference of
microplastics in light penetration and other processes in sea ice
(Geilfus et al., 2019), could generate potentially negative effects to the
8
Science of the Total Environment 777 (2021) 146094
local ecosystem and global climate, affecting the environment, human,
and animal health. In coastal environments, dune systems may be af-
fected by plastic litter, including the effects of release of plastic leachates
that may alter seed germination, likely by mimicking phytohormones,
potentially impacting the dynamic dune formation (Menicagli et al.,
2019). Dunes are essential for the prevention of coastal erosion and
flooding (Hanley et al., 2014), and thus microplastic impacts can have
wider repercussions in geomorphology, economy, and health of these
regions. Again, all these potential impacts, which are so far not suffi-
ciently addressed, should involve biologists, chemists, geologists, cli-
mate scientists, and so on.
Microplastic contamination is not only an environmental problem,
but also a problem that has a bearing on public health and social justice.
Accumulation of microplastics and plastic litter may be a symptom of
larger public health problems in a community, such as the lack of
waste and wastewater management infrastructures. Waste and waste-
water are potential sources of infectious diseases, which without proper
management may lead to widespread epidemics (Hamer, 2003) and to
the release of pathogens and contaminants to ecosystems (Jasinska
et al., 2015). Plastic litter can also have other unexpected impacts on
health. It has been suggested that discarded containers collecting pud-
dles of water can be used by vectors of diseases to multiply (e.g. malaria
mosquitoes), or by clogging sewer and drainage systems, leading to in-
creased flooding (Clapp and Swanston, 2009). Floods have important
impacts on health, especially by causing psychological distress and in-
fectious disease outbreaks, especially in low-income countries (Hajat
et al., 2003). Finally, health is also influenced by a myriad of factors, in-
cluding economic factors (Oliveira et al., 2019), that may be impacted by
microplastics. For instance, in the USA, a refundable tax credit (earned
income tax credit) as a source of additional income was able to improve
the self-report health of the household by 6.9 to 8.9%, mostly through
improved food expenditures and better access to health care (Lenhart,
2019). The annual economic costs of reduced marine capital is esti-
mated to be up to $33,000 per tonne of marine plastic debris (up to
$2500 billion in 2011) (Beaumont et al., 2019). Reductions in tourism
caused by plastic debris could compromise the sustenance of numerous
communities and consequently their health (Clapp and Swanston,
2009). For instance, in 2016, adversities caused by marine litter, such
as repairs, lost productivity, and cleanup efforts, costed 710,698€
(0.02% of the Gross Domestic Product) to the Azores archipelago in
the North-East Atlantic (Rodríguez et al., 2020). By averting the ecolog-
ical and economic impacts of marine litter, and the less known impacts
of microplastics, lost funds could be reallocated to social and environ-
mental causes, such as health and sustainability.
As exemplified in the previous paragraphs, an overarching evalua-
tion of the impacts and mitigation measures of microplastics could ben-
efit many specific research questions and highlight the true impacts of
this contaminant in the real world, in addition to routine toxicity assess-
ment. Novel forms of addressing the impacts of microplastics at large
scales are needed, since most of these effects are suppositional from dis-
perse literature, with little evidence so far supporting ecosystem wide
levels under current concentrations. Comprehensible and relevant
data could be obtained by involving a multidisciplinary team. For in-
stance, stakeholders could introduce a day-to-day experience to the
challenges faced in the presence of microplastics (e.g. tourism faced
with littered beaches) and provide guidance regarding the application
of mitigation measures (e.g. cost-effective beach cleaning efforts), that
should consider the economic costs and benefits, but also animal,
human, and environmental health. A One Health approach could truly
translate the cascading impacts of microplastics on the environment,
animal, and human health since these systems exist in interdepen-
dency. Therefore, inclusion of professionals with multiple backgrounds,
such as biologists, chemists, engineers, health professionals, and econo-
mists, could benefit the assessment of direct and indirect adverse effects
of microplastics and propose solutions that can help mitigate this
problem.
J.C. Prata, J.P. da Costa, I. Lopes et al.
6. Conclusion
Microplastics are widespread and persistent contaminants accumu-
lating in the environment, leading to inevitable exposure. Despite
claims of toxic effects of microplastics, there is so far no evidence of
widespread adverse effects on animal and human health under current
environmental concentrations. Nonetheless, microplastics could still
cause harm through the chronic and cumulative burden to which or-
ganisms are routinely exposed and through indirect effects. These indi-
rect effects include changes in populations, in habitat properties, and
impacts on essential ecosystem functions. Impacts of microplastics can
threaten ecosystem services that may lead to health hazards, for
instance, in food security, increased dispersal of pathogens, or increased
risk of flooding. As microplastics persist and accumulate in the natural
system, without effective means of their retrieval, these potential direct
and indirect effects should be a cause for concern. To overcome
challenges posed by microplastics, more high-quality research, con-
ducted under environmental relevant conditions, covering different
microplastics characteristics (e.g., polymers, weathering, shapes), a
wide range of organisms, and exposure with co-occurring contami-
nants, is needed to better understand consequences to the natural envi-
ronmental, ideally conducted and interpreted by a multidisciplinary
team leading to the intersection of information from multiple areas
and perspectives.
CRediT authorship contribution statement
Joana C. Prata: Conceptualization, Project administration, Visualiza-
tion, Writing – original draft, Writing – review & editing. João P. da
Costa: Writing – review & editing. Isabel Lopes: Writing – review &
editing. Anthony L. Andrady: Writing – review & editing. Armando C.
Duarte: Conceptualization, Supervision, Project administration,
Funding acquisition, Writing – review & editing. Teresa Rocha-
Santos: Conceptualization, Supervision, Project administration, Funding
acquisition, Writing – review & editing.
Declaration of competing interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influ-
ence the work reported in this paper.
Acknowledgement
This work was funded by Portuguese Science Foundation (FCT)
through scholarship PD/BD/135581/2018 under POCH funds, co-
financed by the European Social Fund and Portuguese National Funds
from MEC. Thanks are due to FCT/MCTES for the financial support to
CESAM (UIDP/50017/2020+UIDB/50017/2020), through national
funds.
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