The world’s reliance on plastic has many unseen consequences on human health, enabling fragments of micro- and nano-plastics — and the chemicals that they’re composed of — to proliferate throughout organ tissue and even enter the bloodstream. 

In a 2024 study published in the Journal of the Endocrine Society, researchers found that the chemicals in plastics were responsible for causing diseases ranging from prenatal impairments in unborn children to obesity to polycystic ovary syndrome and testicular and breast cancer. The study team estimated that the burden placed on the health system from patients with diseases directly attributable to the chemicals from plastics was approximately $249 billion in 2018.

While that study primarily addressed the endocrine-disrupting disease mechanism of some of the chemicals used to manufacture plastics, micro- and nano-plastics may also have an inflammatory mechanism, said Heather Leslie, PhD, an independent scientist and consultant and leading international expert in micro- and nano-plastics. Since ultrafine particles have the ability to cause inflammation, which can lead to chronic diseases — a well-known toxicological pathway — researchers are starting to determine if the same thing is happening with plastic particles, Leslie said.

Despite their harmful effects, plastics’ durability, their ability to be sterilized, and their relative affordability have long made for safe and scalable care delivery in nearly every clinical setting, from advanced operating theaters to rural health outposts, according to a new report from Systemiq, a systems change company that works with multiple stakeholders toward a more sustainable and inclusive economy, and Eunomia Research & Consulting, with a practice focused on the transition to a circular, decarbonized economy. The report is titled, A Prescription for Change: Rethinking plastics use in healthcare to reduce waste, greenhouse gas emissions and costs. 

“But today, that advantage is a systemic vulnerability,” the report states. “(T)he opportunity is clear. The healthcare sector is not starting from zero; around the world, hospitals are piloting reusable gowns and surgical trays, manufacturers are redesigning packaging for recyclability, and innovators are recovering hard-to-recycle waste streams.” 

How Plastics Affect the Body

“I think there's a plausibility that plastic particles will act like some other particles in causing immune responses. There's some research coming now that shows that does actually happen,” Leslie said. “On one hand we have exposure data, and we're looking now inside the human [body], so that [we have] not just an estimate of what might get inside if you breathe in 6 liters of air per minute in a certain city.”

These tiny fragments peel off of countless consumer products and industrial waste and have become ubiquitous in the air, water, and food. Research has shown that they have breached most biological barriers, with studies detecting them in human blood, deep lung tissue, and the placenta, said Leslie. 

She said that micro- and nanoplastics endanger health in a variety of different ways: A single plastic product — and thus, a micro- or nano-plastic — can be composed of hundreds, if not thousands, of different chemicals, including metals, and that there are “something like 10,000 plastic materials on the market.”

“So the mixtures that we're talking about when we just say the word microplastic are enormous,” Leslie said. “And of course, within the mixture of chemicals and the particles, there can be a whole range of toxicities, neurotoxicity, endocrine disruption, DNA damage. You can probably find the whole spectrum of toxicology in one sort of microplastics or another.”

Hospitals’ Role in Putting Plastics Into the Environment

Hospitals are a significant source of plastic pollution, consuming a wide variety of single-use plastics for hygiene reasons. A statistic from the Healthcare Plastics Recycling Council (HPRC) finds that in the US, up to one fourth of the 14,000 tons of waste generated daily by hospitals is plastic. The HPRC noted that healthcare products often contain plasticizers, chemicals added to plastics to increase their flexibility, durability, and longevity. Commonly used plasticizers in medical products include phthalates, such as DEHP (diethyl-hexyl-phthalate), and other substances like BPA (bisphenol A). While these chemicals improve the functionality of medical devices, they can also pose significant health risks. 

At the 2024 CleanMed summit held by the nonprofit Health Care Without Harm, Emily Sbiroli, MD, an emergency medicine physician from the University of Colorado, began a clinician-led session on plastics in healthcare with data collected from the summit attendees — all practitioners themselves — concerning their feelings on plastic waste. 

Sbiroli uncovered sentiments that made it clear that practitioners are concerned about the use of plastics. The dozens of respondents registered their concern about the use of a wide variety of these materials at their hospitals, especially PVC, gloves, and “anything single-use.” More than 80% of respondents said they were “very concerned” about the use of plastics at their clinic or healthcare organization.

Hilary Ong, MD, a pediatrician and assistant professor of pediatric emergency medicine (EM) at the University of California San Francisco School of Medicine, presented on the same panel. In an article she wrote for Health Care Without Harm, she gave the example that 75% of single-use materials in laceration repair kits, most of which were plastic-based, were unused by the pediatric EM clinicians in the hospital there. Clinicians who tracked their use of the laceration kit materials identified that only 4 out of the 17 items in the kits were necessary. “By using only the essential items, we could potentially reduce our current waste by approximately 70%,” Ong wrote.

How Hospitals Can Help Reduce Plastic Waste 

As the Prescription for Change... report notes, hospitals all over the world are working to enact change in their use of plastics. With 39 hospitals that serve more than 12 million members in eight states and Washington, DC, Kaiser Permanente, headquartered in California, recently worked with the nonprofit Practice Greenhealth to author a white paper on one step they took toward mitigating the plastics problem.

More than 35 of Kaiser Permanente’s hospitals are in California, a state that requires disinfectant wipe containers with residual liquid in them to be collected as hazardous medical waste, with a disposal cost of $5.75 per container. Given the significant number of disinfectant wipes it buys, Kaiser Permanente used its purchasing power and turned to its suppliers to collaborate on packaging redesign that would allow for full use of the product with no residual liquid. 

According to Kaiser Permanente, the redesigned soft packs have resulted in more than $2 million in cost savings for the company, and the reduction in the size of the new packaging has led to a lower volume of overall waste.

According to one supplier, the report said, the redesigned packaging uses 80% less plastic than the original rigid containers. There was also a smaller distribution carbon footprint, with one truckload of the soft packs being equal to six truckloads of the original containers. The report provided various other case studies involving the successful use of tactics, including prefilled syringes reducing waste in emergency departments; switching to reusable infant bottles and patient gowns; and transitioning to rigid containers for anesthesia trays rather than those covered with single-use surgical blue wrap. 

A Canadian campaign called “Glove Smart” educated staff to rely on handwashing and sanitation practices to reduce nonsurgical glove use; the result was a cutback of 53% in 6 months. Hospitals included in the report’s case studies each reduced their plastic waste while also saving money and narrowing the size of their carbon footprint.