A rapid review and meta-regression analyses of the toxicological impacts of microplastic exposure in human cells.

Humans are exposed to microplastics (MPs) daily via ingestion and inhalation. It is not known whether this results in adverse health effects and, if so, at what levels of exposure. Without epidemiological studies, human cell in vitro MP toxicological studies provide an alternative approach to this question. This review systematically synthesised all evidence and estimated thresholds of dose-response relationships. MEDLINE and Web of Science were searched from inception to March 2021 and study quality was rated using a novel risk of bias assessment tool. Seventeen studies were included in the rapid review and eight in the meta-regression. Four biological endpoints displayed MP-associated effects: cytotoxicity, immune response, oxidative stress, barrier attributes, and one did not (genotoxicity). Irregular shape was found to be the only MP characteristic predicting cell death, along with the duration of exposure and MP concentration (µg/mL). Cells showed varying cytotoxic sensitivity to MPs, with Caco-2 cells (human adenocarcinoma cell line) being the most susceptible. Minimum, environmentally-relevant, concentrations of 10 µg/mL (5-200 µm), had an adverse effect on cell viability, and 20 µg/mL (0.4 µm) on cytokine release. This work is the first to quantify thresholds of MPs effects on human cells in the context of risk assessment.

A Rapid Review of Prescribing Education Interventions.

INTRODUCTION: Many studies conducted on the causes and nature of prescribing errors have highlighted the inadequacy of teaching and training of prescribers. Subsequently, a rapid review was undertaken to update on the nature and effectiveness of educational interventions aimed at improving the prescribing skills and competencies. METHODS: Twenty-two studies taking place between 2009 and 2019 were identified across nine databases. RESULTS AND DISCUSSION: This review reinforced the importance of the WHO Guide to Good Prescribing to prescribing curriculum design as well as the effectiveness of small group teaching. However, it also highlighted the lack of innovation in prescribing education and lack of longitudinal follow-up regarding the effectiveness of prescribing education interventions.

Microplastic Contamination of Seafood Intended for Human Consumption: A Systematic Review and Meta-Analysis.

BACKGROUND: Microplastics (MPs) have contaminated all compartments of the marine environment including biota such as seafood; ingestion from such sources is one of the two major uptake routes identified for human exposure. OBJECTIVES: The objectives were to conduct a systematic review and meta-analysis of the levels of MP contamination in seafood and to subsequently estimate the annual human uptake. METHODS: MEDLINE, EMBASE, and Web of Science were searched from launch (1947, 1974, and 1900, respectively) up to October 2020 for all studies reporting MP content in seafood species. Mean, standard deviations, and ranges of MPs found were collated. Studies were appraised systematically using a bespoke risk of bias (RoB) assessment tool. RESULTS: Fifty studies were included in the systematic review and 19 in the meta-analysis. Evidence was available on four phyla: mollusks, crustaceans, fish, and echinodermata. The majority of studies identified MP contamination in seafood and reported MP content <1 MP/g, with 26% of studies rated as having a high RoB, mainly due to analysis or reporting weaknesses. Mollusks collected off the coasts of Asia were the most heavily contaminated, coinciding with reported trends of MP contamination in the sea. According to the statistical summary, MP content was 0-10.5 MPs/g in mollusks, 0.1-8.6 MPs/g in crustaceans, 0-2.9 MPs/g in fish, and 1 MP/g in echinodermata. Maximum annual human MP uptake was estimated to be close to 55,000 MP particles. Statistical, sample, and methodological heterogeneity was high. DISCUSSION: This is the first systematic review, to our knowledge, to assess and quantify MP contamination of seafood and human uptake from its consumption, suggesting that action must be considered in order to reduce human exposure via such consumption. Further high-quality research using standardized methods is needed to cement the scientific evidence on MP contamination and human exposures. https://doi.org/10.1289/EHP7171.

Microplastic contamination of drinking water: A systematic review.

BACKGROUND: Microplastics (MPs) are omnipresent in the environment, including the human food chain; a likely important contributor to human exposure is drinking water. OBJECTIVE: To undertake a systematic review of MP contamination of drinking water and estimate quantitative exposures. METHODS: The protocol for the systematic review employed has been published in PROSPERO (PROSPERO 2019, Registration number: CRD42019145290). MEDLINE, EMBASE and Web of Science were searched from launch to the 3rd of June 2020, selecting studies that used procedural blank samples and a validated method for particle composition analysis. Studies were reviewed within a narrative analysis. A bespoke risk of bias (RoB) assessment tool was used. RESULTS: 12 studies were included in the review: six of tap water (TW) and six of bottled water (BW). Meta-analysis was not appropriate due to high statistical heterogeneity (I2>95%). Seven studies were rated low RoB and all confirmed MP contamination of drinking water. The most common polymers identified in samples were polyethylene terephthalate (PET) and polypropylene (PP), Methodological variability was observed throughout the experimental protocols. For example, the minimum size of particles extracted and analysed, which varied from 1 to 100 µm, was seen to be critical in the data reported. The maximum reported MP contamination was 628 MPs/L for TW and 4889 MPs/L for BW, detected in European samples. Based on typical consumption data, this may be extrapolated to a maximum yearly human adult uptake of 458,000 MPs for TW and 3,569,000 MPs for BW. CONCLUSIONS: This is the first systematic review that appraises the quality of existing evidence on MP contamination of drinking water and estimates human exposures. The precautionary principle should be adopted to address concerns on possible human health effects from consumption of MPs. Future research should aim to standardise experimental protocols to aid comparison and elevate quality.

A preliminary analysis of microplastics in edible versus non-edible tissues from seafood samples.

Plastics have been widely reported to be present in the environment yet there are still many questions regarding the extent of this and the impacts these may have on both the environment and human health. The purpose of this investigation is to determine levels of micro and mesoplastic (MP), in the 1-5000 µm range, in commercially important species of finfish and shellfish. Additionally, to determine and compare the relative MP levels in edible versus non-edible tissues, and consider the wider implications in terms of human health concerns with a preliminary risk identification approach. For several fish species, samples taken from typically non-edible (gills, digestive system) and edible (muscle) flesh, and were analysed separately. Scallops, where all tissues are edible, were analysed whole. Significant differences were observed in the number of particles isolated from the finfish gills and digestive tissues relative to the control samples, but not in the edible flesh. For scallops, the abundance of particles in the Scottish samples did not vary significantly from the control, while the Patagonian scallops displayed significantly higher numbers of MPs. Characterisation of MPs by FTIR microscopy found that 16-60% (depending on species) were polyethylene terephthalate (PET) and polyethylene (PE) in origin. The risk identification results validate MPs as an emerging risk in the food chain and establish seafood as a vector for the exposure and uptake of MPs through the ingestion route for humans. Levels of MPs in seafood, and a direct link to the human food chain, suggests that their quantification be included as one food safety measure.