Physiological Impact of Micro plastic Exposure on Human Health: A Comprehensive Review with Indian Contextual Insights
- Rohit Saroha , MD (Physiology) Assistant Professor, Department of Physiology Santosh Deemed to be University , Ghaziabad ,Uttar Pradesh, India
- Soni Singh , MD (Physiology) Assistant Professor, Department of Physiology Santosh Deemed to be University , Ghaziabad Uttar Pradesh, India
- Muneeb kosvi , MD (Physiology) Assistant Professor, Department of Physiology Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
- Chetna Chhabra , MD Physiology Santosh Deemed to be University , Ghaziabad , Uttar Pradesh, India
Article Information:
Abstract:
Background: Microplastics (MPs), synthetic polymer particles smaller than 5 mm, have emerged as pervasive environmental contaminants with increasing evidence of human bioaccumulation. Recent studies have detected MPs in the blood, lungs, placental tissue, and arterial plaques, raising urgent concerns regarding their physiological effects. Experimental models implicate MPs in a cascade of adverse outcomes, including systemic inflammation, oxidative stress, endocrine disruption, and cellular damage, all of which are associated with major non-communicable diseases. India, as one of the world’s largest plastic consumers, faces the dual burden of high environmental plastic loads and socio-economic vulnerabilities that amplify exposure. Drinking water contamination, dietary intake of seafood and salt, and airborne MPs in indoor settings are now recognized as key exposure routes. This review critically synthesizes over a decade of global and Indian research, highlighting the mechanisms of toxicity, routes of exposure, and detection methods, while identifying significant gaps in long-term health monitoring and regulatory oversight. Mechanistic insights revealed that MPs may translocate across biological barriers, interfere with redox pathways, and act as carriers for endocrine-disrupting chemicals. Indian data on bottled water, table salt, and seafood indicate alarmingly high MP loads, often exceeding the global averages. Despite this, India lacks enforceable safety limits and surveillance systems to assess MP-related health risks. This review underscores the urgent need for nationwide biomonitoring, risk-based regulations, and interdisciplinary research. Policy frameworks must move beyond the bans on macroplastics to address the invisible but potent threats posed by microplastics. India’s unique context provides an essential lens through which global mitigation strategies can evolve.
Keywords:
Article :
INTRODUCTION :
Initially considered as a problem limited to ocean waste, microplastics (MPs) have emerged as a significant public health issue. Microplastics (MPs), defined as synthetic polymer particles smaller than 5 mm, originate from various sources such as the degradation of larger plastic objects, microbeads found in personal care items, and fibers from synthetic textiles. [1] Their small size allows them to spread extensively through air, water, and soil, and recent findings have sparked concern owing to their increasing detection in the human body. [2–4]
Worldwide, the rapid increase in plastic production, surpassing 400 million metric tons each year, has outstripped progress in developing efficient waste management and recycling systems. [5] In India, this gap is even more evident. Annually, approximately 3.5 million metric tons of plastic waste is produced, yet only a small portion is successfully recycled. This environmental challenge is further intensified by socioeconomic disparities that lead to varying levels of exposure. [5] In both urban informal settlements and rural areas, practices such as open dumping, burning of plastic waste, and the use of non-certified bottled water are prevalent. These actions enable MPs to infiltrate drinking water supplies, food chains, and indoor air, thereby presenting a potential health risk that is often overlooked.
Although the toxicological characteristics of MPs in humans are not yet fully understood, both in vitro and in vivo studies have indicated that long-term exposure could interfere with immune regulation, redox balance, endocrine signaling, and cellular homeostasis. [6, 7] The discovery of MPs in human feces, placental tissue, lung biopsies, and even cardiovascular plaques highlights the urgency of this discussion. [3, 4]
Although new evidence is emerging, India has not yet established strong national guidelines or surveillance systems to track MP exposure and its health impacts. The existing regulatory systems predominantly target visible plastic debris and impose bans on single-use items. Although these measures are essential, they fall short of tackling the less obvious but equally hazardous issue of microplastics. Moreover, research in India has largely focused on environmental pollution, with limited investigation into its health effects at the clinical or population level. [5]
This review aims to close this gap by thoroughly analyzing current research on the physiological effects of MP exposure and situating it within the specific demographic, environmental, and infrastructural context of India. Our goal is to lay the groundwork for scientific research and policy making based on evidence.
3. Routes of Human Exposure
3.1 Ingestion
It is widely acknowledged that ingestion is the main way humans are exposed to microplastics (MPs). These particles have been found in various consumables such as drinking water and table salts. [8, 9] The research conducted by Cox et al. suggested that humans might consume between 39,000 and 52,000 MP particles each year solely from food sources. [10] Seafood, especially bivalves and fish, plays a significant role in the process of bioaccumulation in aquatic ecosystems. [11] Moreover, over time, plastic packaging and storage materials can release MPs, resulting in the additional consumption of everyday foods and beverages. [12]
3.2 Inhalation
Inhalation has become a major route of exposure to microplastics (MPs). These airborne MPs are commonly found in both indoor and outdoor settings and stem from sources such as synthetic fabrics, vehicle tire abrasion, urban dust, and the breakdown of plastic materials. [13] Airborne MPs are often found at higher concentrations in indoor settings, especially in homes or workplaces with inadequate ventilation. [14] Breathing in particles is particularly worrisome because they can settle in the lower parts of the respiratory system, potentially causing oxidative stress, inflammation, and tissue damage. [4]
3.3 Dermal Contact
Although dermal exposure is often seen as a less significant pathway, it still holds importance, particularly through the use of personal care items with microbeads and contact with polluted water. [3] Recent research indicates that nanoplastics and the additives they release might infiltrate damaged skin barriers or enter through sweat glands. [3] This is especially pertinent to jobs that involve handling plastic or working in informal recycling sectors. Figure 3 depicts the primary human exposure routes to microplastics, including ingestion, inhalation, dermal contact, and transplacental transfer.
4. Clinical Evidence of Microplastic Presence in Humans
4.1 Microplastics in Blood and Circulation
Leslie et al. first verified the presence of microplastics (MPs) in human blood, discovering plastic particles in 77% of healthy adult donors using pyrolysis-GC/MS. [4] Polyethylene terephthalate (PET), polyethylene (PE), and polystyrene (PS) are the polymers most commonly found in packaging materials. This research revealed that MPs have the ability to move through epithelial barriers and enter systemic circulation, which raises concerns about potential vascular inflammation and endothelial dysfunction. [4]
4.2 Detection in Human Placental Tissue
Ragusa et al. were the first to demonstrate the presence of MPs in human placental tissues using Raman microspectroscopy. [3] Particles were detected on both the maternal and fetal sides, indicating the possibility of transplacental transfer. The identified polymers included colored substances found in cosmetics and packaging. While fetal outcomes were not directly evaluated, potential theoretical risks involve the disruption of nutrient transport and immune system activation during crucial developmental periods. [3]
4.3 Microplastics in Lung Tissue
In a study by Amato-Lourenço et al., microplastics were found in 13 of 20 human lung tissue samples obtained during surgical procedures, with PET, PP, and PS fibers and fragments being the most common types identified. [15] These results reflect the patterns of environmental exposure, especially in heavily polluted urban areas. Inhaled microplastics can remain in the lung tissue, possibly causing localized inflammation, granulomatous reactions, and impairments in alveolar function. [16]
4.4 Gastrointestinal Elimination and Fecal Detection
Schwabl et al. conducted a multicentric study that utilized μFTIR spectroscopy to detect MPs in stool samples from participants in eight countries, including India. [17] Every sample contained MPs, with a median count of 20 particles per 10 g of feces. The most commonly identified polymers were PP and PS. The findings revealed not only extensive ingestion but also partial absorption in the gastrointestinal tract and movement through the system. [17, 18]
Zehua et al. conducted further research on the fecal matter of individuals with inflammatory bowel disease, discovering elevated levels of MP compared to those in healthy individuals. This suggests a possible link between MP exposure and gastrointestinal disorders. [19]
While data on fecal MPs in India are still limited, a recent pilot study conducted in Mumbai confirmed Schwabl’s results by identifying MPs in every sample tested, highlighting the urgent need for nationwide monitoring. [20] Table 2 summarizes the current findings on microplastic detection in various human tissues.
METHODOLOGY:
A comprehensive literature search was systematically conducted across three prominent scientific databases, PubMed, Scopus, and Web of Science, covering the period from January 2010 to May 2025. The search strategy employed Boolean operators and incorporated the following keywords: “microplastics,” “human health,” “India,” “exposure,” “toxicity,” “physiological effects,” and “biomonitoring.”
The inclusion criteria were as follows: (1) peer-reviewed original research articles and systematic reviews; (2) studies reporting human or animal exposure and physiological or toxicological mechanisms; and (3) articles containing epidemiological or biomonitoring data relevant to Indian or comparable low- and middle-income country (LMIC) settings.
The exclusion criteria were as follows: (1) editorials, opinion pieces, and grey literature lacking primary data; (2) studies exclusively addressing aquatic ecology or macroplastic degradation; and (3) articles for which full-text access was unavailable.
Three independent reviewers, Dr. Rohit Saroha, Dr. Muneeb Kosvi, and Dr. Soni Singh, conducted the initial screening, full-text eligibility assessment, and thematic coding to ensure inter-reviewer reliability and minimize selection bias. AI tools such as ChatGPT-4.5 and Consensus AI were employed for certain aspects of thematic analysis or language enhancement. The outputs generated by these tools were manually reviewed, verified against the original text, and revised for accuracy and clarity before being incorporated into the manuscript. Discrepancies in study inclusion and thematic categorization were addressed and resolved through consensus discussions.
This methodology aims to balance global evidence synthesis with contextual relevance in Indian populations. Following a comprehensive full-text screening, a total of 84 articles were selected for inclusion. The study selection process adhered to the PRISMA guidelines, and a PRISMA flow diagram detailing the inclusion process is presented in Figure 1.
Figure 1: Flow diagram illustrating the study identification, screening, eligibility, and inclusion process based on PRISMA 2020 guidelines
The eligibility framework was guided using a modified PECO approach. The operational definitions for the population, exposure, comparator, and outcomes are detailed in Table 1. Figure 2 provides a schematic overview of the PECO framework used to structure data extraction in this review.
Table 1: Modified PECO Framework
|
Component |
Details |
|
Population (P) |
Humans and laboratory animals exposed to microplastics; Indian populations where available |
|
Exposure (E) |
Ingestion, inhalation, dermal exposure to microplastics from water, food, air, and consumer products |
|
Comparator (C) |
Unexposed controls or populations with low MP exposure |
|
Outcomes (O) |
Physiological effects including oxidative stress, inflammation, endocrine disruption, and organ-level damage |
Figure 2: PECO Framework Diagram
CONCLUSION :
Initially regarded as an environmental inconvenience, microplastic (MP) pollution has become a significant public health concern with increasing evidence of human exposure to water, air, and food. Although toxicological and mechanistic evidence from in vitro and animal studies strongly suggests that MPs are involved in inflammation, oxidative stress, endocrine disruption, and organ damage, establishing direct clinical connections in humans remains limited and intricate. [71]
Nonetheless, the precautionary principle should steer international and domestic initiatives. India's distinct demographic, infrastructural, and environmental characteristics make its population particularly susceptible to risks associated with MPs. Existing mitigation efforts, which primarily focus on banning visible plastics, do not effectively address the subtle dangers of micro- and nanoplastics. [72]
The moment has arrived at a significant change in this approach. It is crucial to incorporate MP surveillance into monitoring systems for food, water, and air, as part of public health planning. To truly understand the physiological impact of microplastic exposure, interdisciplinary research involving fields such as environmental science, clinical toxicology, molecular biology, and behavioral health is necessary. [73]
To address this new environmental health factor in the 21st century, we must rely on integrated regulatory systems, community-level education, and scientific research.
11. Supplementary Insights and Policy Addendum
11.1 Biomarker Frameworks for Human Exposure Assessment
A significant drawback in the field of MP toxicology is the lack of validated human biomarkers for both exposure and effects. Experimental investigations have consistently demonstrated increased levels of oxidative stress markers, including reactive oxygen species (ROS) and malondialdehyde (MDA), as well as a reduction in antioxidant enzymes, such as glutathione and catalase, following MP exposure in animal models and cell lines. [74] Pro-inflammatory cytokines, such as IL-6, TNF-α, and CRP, are significantly upregulated in both serum and bronchoalveolar lavage samples. [75] Endocrine disruption is evidenced by altered concentrations of T3, T4, estradiol, and luteinizing hormone, particularly in females exposed to leached plastic additives. [76] Genotoxic endpoints, such as 8-hydroxy-2'-deoxyguanosine (8-OHdG) and micronucleus formation in lymphocytes, serve as early indicators of DNA-level damage. [77] These markers, when correlated with quantifiable MP loads in feces, blood, or placenta [4], could serve as the basis for a prospective clinical screening toolkit. Table 6 outlines the key domain-specific research gaps in India and suggests institutionally actionable priorities to guide future investigations and policy efforts.
Table 6: Research Gaps and Priorities for India on Microplastic Exposure
|
Domain |
Current Gaps |
Proposed Solutions |
Lead Institutions |
|
Biomonitoring |
Lack of data from Indian populations |
Initiate tissue/stool-based MP studies |
ICMR, AIIMS, JIPMER |
|
Detection Technology |
High-cost, lab-only methods |
Develop low-cost field kits |
CSIR-NCL, IITs |
|
Food Chain Exposure |
No data on MPs in milk, rice, spices |
Conduct MP residue testing in staples |
FSSAI, NIN Hyderabad |
|
Health Linkages |
No causal link between MP exposure and NCDs |
Design case-control or cohort studies |
ICMR-NCDIR, PGIMER |
|
Public Behavior |
No data on rural plastic use patterns |
Conduct surveys in tribal and rural areas |
NIRDPR, Ministry of Rural Development |
11.2 Divergent Global Policy Responses and Regulatory Gaps
Globally, regulatory approaches to microplastics (MPs) remain inconsistent. In 2020, the European Chemicals Agency (ECHA) proposed comprehensive restrictions on the intentional addition of microplastics, specifically targeting cosmetics, detergents, and agricultural formulations. [78] Concurrently, the World Health Organization has recognized the presence of MPs in drinking water, but has abstained from establishing safety thresholds due to a lack of sufficient toxicological data. [55] The ongoing negotiations for the United Nations-led Global Plastics Treaty seek to incorporate provisions specific to microplastics, focusing on aspects such as labeling, traceability, and permissible limits. [79] France has taken a pioneering step in national legislation by prohibiting synthetic microfibers in textiles by 2025, thereby establishing a precedent for polymer-specific risk management. [80] In contrast, the majority of low- and middle-income countries, including India, do not possess enforceable standards for MPs in food, water, or consumer goods.
11.3 Methodological Harmonization and Detection Protocols
A significant area of focus is the standardization of methods for detecting microplastics (MPs). The SAPEA consortium has advocated the implementation of unified protocols for the sampling, extraction, and polymer identification of particles across both environmental and biological matrices. [69] The International Organization for Standardization (ISO) has formalized these methodologies through ISO 22766:2020, which concentrates on the degradation and field detection of microplastics (MPs) in marine environments. [81] Moreover, the European Commission’s Joint Research Centre (JRC) is at the forefront of conducting inter-laboratory comparisons to enhance the detection accuracy and establish validated reference materials. [82] These initiatives are essential for reducing analytical discrepancies that impede data comparability and risk assessment.
11.4 Emerging Technological Innovations for Surveillance
Recent advancements have effectively bridged the gap between environmental monitoring and real-time microplastic (MP) detection. Hyperspectral imaging platforms, when integrated with artificial intelligence (AI), have shown significant potential for accurately distinguishing microplastic polymers from natural particles in remote sensing applications. [83] In the field of biomedical research, the EU-funded RIBOSOME project is advancing the development of wearable exposure sensors designed to capture inhaled microplastics (MPs). This initiative seeks to quantify urban exposure burdens using portable biosensing units. [84] These technologies have the potential to transform public health surveillance by facilitating individualized exposure profiling, especially in regions with high population density or occupational vulnerability.
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