Letters to the Editor
Presentation Is Incomplete
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The summary of what is currently known regarding microplastics and nanoplastics (MNPs) (1) has gaps at the scientific and societal levels that urgently require critical assessment in the context of continuing medical education. The assumptions that MNPs do not represent a relevant risk owing to their low bioavailability ignores the noxious/harmful effects of plastics for the environment and health. Omitting these crucial aspects results in an incomplete representation, a distortion of the state of scientific knowledge, and it conveys apparent safety—which we consider highly problematic in the context of continuing medical education.
The global health burden from plastic contamination was described in detail in a recently published report from the Lancet Countdown on Health and Plastics. Plastics contribute to breaching the limits of planetary boundaries: the burden is the result of chemical, physical, and systemic chains of effects. The production chain, transport, and breakdown cause substantial greenhouse gas emissions and affect health through chemical exposures, air contamination, and food contamination (2).
Furthermore, more than 16 000 additives, some of them toxic, have been documented in plastic (3). These reach the environment as a result of attrition, migration, and breakdown processes. Studies have yielded evidence for associations with impaired fertility as well as metabolic disorders and cancers. Environmental studies have documented the ubiquitous bioaccumulation as well as the concentration in the food chain. Insights regarding MNPs to date indicate—in spite of the limitations of animal experimental studies—substantial health risk for humans (4).
These facts were known before the CME article was submitted. In view of the inextricable link between human health and the environment, a holistic assessment seems crucial to us.
We recommend educating doctors comprehensively about the potential risks of MNPs and supporting and driving prevention initiatives (“primum non nocere”).
DOI: 10.3238/arztebl.m2025.0244
Dr. med. Dipl. Biol. Susanne Saha, Dr. med. Christina Hecker
AG Dermatologie der Allianz Klimawandel und Gesundheit (KLUG e.V.)
Dr. med. Katharina Schwede
Hautarztpraxis Leipzig
Zivilgesellschaftliches Bündnis Exit Plastik – Wege aus der Plastikkrise
Conflict of interest statement
The authors declare that no conflict of interest exists.
