Chartres Nicholas, Cooper Courtney B, Bland Garret, Pelch Katherine E, Gandhi Sheiphali A, BakenRa Abena, Woodruff Tracey J
Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94143, United States.
School of Pharmacy, Faculty of Medicine & Health, The University of Sydney, Sydney 2006, Australia.
Environ Sci Technol. 2024 Dec 31;58(52):22843-22864. doi: 10.1021/acs.est.3c09524. Epub 2024 Dec 18.
Microplastics are ubiquitous environmental contaminants for which there are documented human exposures, but there is a paucity of research evaluating their impacts on human health. We conducted a rapid systematic review using the "Navigation Guide" systematic review method. We searched four databases in July 2022 and April 2024 with no restriction on the date. We included studies using predefined eligibility criteria that quantitatively examined the association of microplastic exposure with any health outcomes. We amended the eligibility criteria after screening studies and prioritized digestive, reproductive, and respiratory outcomes for further evaluation. We included three human observational studies examining reproductive ( = 2) and respiratory ( = 1) outcomes and 28 animal studies examining reproductive ( = 11), respiratory ( = 7), and digestive ( = 10) outcomes. For reproductive outcomes (sperm quality) and digestive outcomes (immunosuppresion) we rated overall body evidence as "high" quality and concluded microplastic exposure is "suspected" to adversely impact them. For reproductive outcomes (female follicles and reproductive hormones), digestive outcomes (gross or microanatomic colon/small intestine effects, alters cell proliferation and cell death, and chronic inflammation), and respiratory outcomes (pulmonary function, lung injury, chronic inflammation, and oxidative stress) we rated the overall body of evidence as "moderate" quality and concluded microplastic exposure is "suspected" to adversely impact them. We concluded that exposure to microplastics is "unclassifiable" for birth outcomes and gestational age in humans on the basis of the "low" and "very low" quality of the evidence. We concluded that microplastics are "suspected" to harm human reproductive, digestive, and respiratory health, with a suggested link to colon and lung cancer. Future research on microplastics should investigate additional health outcomes impacted by microplastic exposure and identify strategies to reduce exposure.
微塑料是普遍存在的环境污染物，已有文献记载人类会接触到它们，但评估其对人类健康影响的研究却很匮乏。我们使用“导航指南”系统评价方法进行了快速系统评价。我们于2022年7月和2024年4月检索了四个数据库，对日期无限制。我们纳入了使用预定义纳入标准的研究，这些研究定量考察了微塑料暴露与任何健康结局之间的关联。在筛选研究后，我们修订了纳入标准，并将消化、生殖和呼吸结局作为进一步评估的重点。我们纳入了三项人类观察性研究，分别考察了生殖结局（2项）和呼吸结局（1项），以及28项动物研究，分别考察了生殖结局（11项）、呼吸结局（7项）和消化结局（10项）。对于生殖结局（精子质量）和消化结局（免疫抑制），我们将总体证据质量评为“高”，并得出结论，微塑料暴露“疑似”会对它们产生不利影响。对于生殖结局（女性卵泡和生殖激素）、消化结局（结肠/小肠大体或微观解剖学效应、改变细胞增殖和细胞死亡以及慢性炎症）和呼吸结局（肺功能、肺损伤、慢性炎症和氧化应激），我们将总体证据质量评为“中等”，并得出结论，微塑料暴露“疑似”会对它们产生不利影响。基于证据质量“低”和“非常低”，我们得出结论，微塑料暴露对人类出生结局和孕周的影响“无法分类”。我们得出结论，微塑料“疑似”会损害人类生殖、消化和呼吸健康，并有迹象表明与结肠癌和肺癌有关。未来关于微塑料的研究应调查微塑料暴露影响的其他健康结局，并确定减少暴露的策略。
