The Risk from Widespread Micro- and Nano-Plastic Contamination on a Global Scale and the Threat to Children's Health

Plastic is a synthetic material not found in nature.1 Since plastic does not exist naturally, it is not biodegradable and has progressively accumulated in the environment.2,3 Due to both wear and tear from use and the action of natural forces that degrade it in the environment, plastic objects break down into very small fragments, forming elements of various size, including microplastics (MPs), ranging from 0.1 to 5000 μm, and nanoplastics (NPs), approximately 1-100 nm (0.001-0.1 μm).2,4 These particles are dispersed widely in the seas, atmosphere, and soil. MPs and NPs often appear as waste, forming islands in the oceans, contaminating deep waters and glaciers, polluting beaches, and accumulating in landfills.2 In recent years, several studies have focused on investigating the actual concentrations of MPs and NPs in the human body,5,6 the possible mechanisms of cellular damage, and their effects on public health. Due to the inevitable contact of living organisms with materials in the external environment, MPs and NPs are also absorbed by the human body7 through respiration, ingestion, skin exposure, and transplacental transfer.8,9 Presence of plastics has been detected in the lungs,10 urine,11 feces,12 sperm and testicles,13 placenta,14 breast milk,15 and blood.16 Several international organizations, including the United States Environmental Protection Agency,17 the European Union,18 the Nordic Council of Ministers for the Environment and Climate,19 and the European Food Safety Authority,20 have expressed deep concern about increasing plastic pollution. However, there is currently no international agreement regulating the control of MPs and NPs dispersion in the environment. In November 2024, an agreement among delegations from 175 nations gathered in Busan, South Korea, failed, as has happened in the past, to establish a legally binding international treaty on plastic pollution, including marine environments.21 The treaty was intended, in particular, to set a global cap on plastic production. Recently, particular attention has been given to age groups or individuals who appear to be more vulnerable and at higher risk of organ and system damage caused by plastic fragments. Significant concern has arisen from recent reports showing that children are more exposed to MPs and NPs than adults.22 However, robust studies investigating the causes and origins of MPs and NPs exposure from infancy through adolescence remain largely lacking.22 This commentary, prepared by the working group on social pediatrics of the European Pediatric Association, the Union of National European Pediatric Societies, and Associations (EPA-UNEPSA), focuses on MPs and NPs environmental contamination and their risks for children's health. The aim is to raise the awareness of pediatricians about the importance of recognizing the conditions reported in the literature now being associated with this phenomenon and the need to support national and international prevention programs.