Unraveling the potential human health risks from used disposable face mask-derived micro/nanoplastics during the COVID-19 pandemic scenario: A critical review

The hidden threat: Unraveling the impact of microplastics on reproductive health

Microplastics, with intricate physical and chemical characteristics, infiltrate the food chain and extensively impact ecosystems. Despite acknowledging the link between environmental pollution and declining fertility, the specific mechanisms affecting reproductive health remain to be elucidated. This review emphasizes the global correlation between microplastics and subfertility, focusing on entry pathways and impacts on ecosystems. Research suggests that microplastics disrupt the neuroendocrine system, influencing sex hormone synthesis through the hypothalamic-pituitary-gonadal (HPG) axis. In the reproductive system, microplastics interfere with the blood-testis barrier, impairing spermatogenesis in males, and causing placental dysfunction, ovarian atrophy, endometrial hyperplasia, and fibrosis in females. Moreover, microplastics potentially affect offspring's lipid metabolism and reproductive functions. However, complex microplastic compositions and detection method limitations impede research progress. Mitigation strategies for reproductive effects, combined with addressing microplastic pollution through sustainable practices, are imperative. This review underscores the urgency of global initiatives and collaborative research to safeguard reproductive health amid escalating microplastic contamination.

Application of organoid technology in the human health risk assessment of microplastics: A review of progresses and challenges

Microplastic (MP) pollution has become a global environmental issue, and increasing concern has been raised about its impact on human health. Current studies on the toxic effects and mechanisms of MPs have mostly been conducted in animal models or in vitro cell cultures, which have limitations regarding inter-species differences or stimulation of cellular functions. Organoid technology derived from human pluripotent or adult stem cells has broader prospects for predicting the potential health risks of MPs to humans. Herein, we reviewed the current application advancements and opportunities for different organoids, including brain, retinal, intestinal, liver, and lung organoids, to assess the human health risks of MPs. Organoid techniques accurately simulate the complex processes of MPs and reflect phenotypes related to diseases caused by MPs such as liver fibrosis, neurodegeneration, impaired intestinal barrier and cardiac hypertrophy. Future perspectives were also proposed for technological innovation in human risk assessment of MPs using organoids, including extending the lifespan of organoids to assess the chronic toxicity of MPs, and reconstructing multi-organ interactions to explore their potential in studying the microbiome-gut-brainaxis effect of MPs.

Wearing face masks as a potential source for inhalation and oral uptake of inanimate toxins - A scoping review

BACKGROUND

From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins.

METHODS

A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation).

RESULTS

24 studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO2.

DISCUSSION

Of course, masks filter larger dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary.

CONCLUSION

Undoubtedly, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins with health threatening and carcinogenic properties at population level with almost zero distance to the airways.

Micro- and nano-plastics in the atmosphere: A review of occurrence, properties and human health risks

The ubiquitous occurrence of micro/nano plastics (MNPs) poses potential threats to ecosystem and human health that have attracted broad concerns in recent decades. Detection of MNPs in several remote regions has implicated atmospheric transport as an important pathway for global dissemination of MNPs and hence as a global health risk. In this review, the latest research progress on (1) sampling and detection; (2) origin and characteristics; and (3) transport and fate of atmospheric MNPs was summarized. Further, the current status of exposure risks and toxicological effects from inhaled atmospheric MNPs on human health is examined. Due to limitations in sampling and identification methodologies, the study of atmospheric nanoplastics is very limited today. The large spatial variation of atmospheric MNP concentrations reported worldwide makes it difficult to compare the overall indoor and outdoor exposure risks. Several in vitro, in vivo, and epidemiological studies demonstrate adverse effects of immune response, apoptosis and oxidative stress caused by MNP inhalation that may induce cardiovascular diseases and reproductive and developmental abnormalities. Given the emerging importance of atmospheric MNPs, the establishment of standardized sampling-pretreatment-detection protocols and comprehensive toxicological studies are critical to advance environmental and health risk assessments of atmospheric MNPs.

A novel tiRNA-Glu-CTC induces nanoplastics accelerated vascular smooth muscle cell phenotypic switching and vascular injury through mitochondrial damage

Nanoplastics pose several health hazards, especially vascular toxicity. Transfer RNA-derived small RNAs (tsRNAs) are novel noncoding RNAs associated with different pathological processes. However, their biological roles and mechanisms in aberrant vascular smooth muscle cell (VSMC) plasticity and vascular injury are unclear. This study investigated the potent effects of tsRNAs on vascular injury induced by short- and long-term exposure to polystyrene nanoplastics (PS-NPs). Mice were exposed to PS-NPs (100 nm) at different doses (10-100 μg/mL) for 30 or 180 days. High-throughput sequencing was used to analyze tsRNA expression patterns in arterial tissues obtained from an in vivo model. Additionally, quantitative real-time polymerase chain reaction, fluorescent in situ hybridization assays, and dual-luciferase reporter assays were performed to measure the expression and impact of tiRNA-Glu-CTC on VSMCs exposed to PS-NPs. Short-term (≥50 μg/mL, moderate concentration) and long-term (≥10 μg/mL, low concentration) PS-NP exposure induced vascular injury in vivo. Cellular experiments showed that the moderate concentration of PS-NPs induced VSMC phenotypic switching, whereas a high concentration of PS-NPs (100 μg/mL) promoted VSMC apoptosis. PS-NP induced severe mitochondrial damage in VSMCs, including overexpression of reactive oxygen species, accumulation of mutated mtDNA, and dysregulation of genes related to mitochondrial synthesis and division. Compared with the control group, 13 upregulated and 12 downregulated tRNA-derived stress-induced RNAs (tiRNAs) were observed in the long-term PS-NP (50 μg/mL) exposure group. Bioinformatics analysis indicated that differentially expressed tiRNAs targeted genes that were involved in vascular smooth muscle contraction and calcium signaling pathways. Interestingly, tiRNA-Glu-CTC was overexpressed in vivo and in vitro following PS-NP exposure. Functionally, the tiRNA-Glu-CTC inhibitor mitigated VSMC phenotypic switching and mitochondrial damage induced by PS-NP exposure, whereas tiRNA-Glu-CTC mimics had the opposite effect. Mechanistically, tiRNA-Glu-CTC mimics induced VSMC phenotypic switching by downregulating Cacna1f expression. PS-NP exposure promoted VSMC phenotypic switching and vascular injury by targeting the tiRNA-Glu-CTC/Cacna1f axis.

Assessment of inhalation exposure to microplastic particles when disposable masks are repeatedly used

Wearing masks to prevent infectious diseases, especially during the COVID-19 pandemic, is common. However, concerns arise about inhalation exposure to microplastics (MPs) when disposable masks are improperly reused. In this study, we assessed whether disposable masks release inhalable MPs when reused in simulated wearing conditions. All experiments were conducted using a controlled test chamber setup with a constant inspiratory flow. Commercially available medical masks with a three-layer material, composition comprising polypropylene (PP in the outer and middle layers) and polyethylene (PE in the inner layer), were used as the test material. Brand-new masks with and without hand rubbing, as well as reused medical masks, were tested. Physical properties (number, size, and shape) and chemical composition (polymers) were identified using various analytical techniques such as fluorescence staining, fluorescence microscopy, and micro-Fourier Transform Infrared Spectroscopy (μFTIR). Scanning Electron Microscopy (SEM) was used to scrutinize the surface structure of reused masks across different layers, elucidating the mechanism behind the MP generation. The findings revealed that brand-new masks subjected to hand rubbing exhibited a higher cumulative count of MPs, averaging approximately 1.5 times more than those without hand rubbing. Fragments remained the predominant shape across all selected size classes among the released MPs from reused masks, primarily through a physical abrasion mechanism, accounting for >90 % of the total MPs. The numbers of PE particles were higher than PP particles, indicating that the inner layer of the mask contributed more inhalable MPs than the middle and outer layers combined. The released MPs from reused masks reached their peak after 8 h of wearing. This implies that regularly replacing masks serves as a preventive measure and mitigates associated health risks of inhalation exposure to MPs.

The release of polypropylene plastic from disposable face masks in different water conditions and their potential toxicity in human cells

Due to their extensive use during and after the COVID-19 pandemic, many disposable face masks are irresponsibly deposited into the water environment, threatening the health of people living nearby. However, the effects of water conditions on the degradation and potential hazards of these masks are generally unclear. This paper entailed the release and cellular toxicity of micro/nano plastics from disposable face masks once discarded in different waters, including soil water, river water, and tap water, with deionized (DI) water as control. At first, polypropylene (PP) was confirmed to be the major component of disposable face masks with Raman and Fourier transform infrared (FTIR) techniques. To monitor the release rate of PP from masks, a silver nanoparticle (AgNP)-based surface-enhanced Raman scattering (SERS) method was established by employing the unique Raman fingerprint of PP at 2882 cm-1. During 30-d incubation in different waters, the release rates of PP, sizes of PP aggregates, length of fibers, and proportions of plastics smaller than 100 nm were in the order of soil water > river water > tap water > DI water. All the obtained PP exhibited significant toxicity in human lung cancer (A549) cells at concentrations of 70 mg/L for 48 h, and the ones obtained in soil water exhibited the most severe damage. Overall, this paper revealed that environmental waters themselves would worsen the adverse effects of disposable face masks, and the key compounds affecting the degradation of masks remain to be clarified. Such information, along with the established methods, could be beneficial in assessing the health risks of disposable face masks in different waters.

Ingestion and biodegradation of disposable surgical masks by yellow mealworms Tenebrio molitor larvae: Differences in mask layers and effects on the larval gut microbiome

During the COVID-19 pandemic, the usage and production of face masks considerably increased, resulting in large quantities of mask waste accumulating in the natural environment. To investigate whether masks of polypropylene (PP) material could be ingested and degraded by insect worms like PP foam plastic, yellow mealworms were provided with different layers of disposable surgical masks as sole diets for 30 d. Although mask layers, especially the middle layer of melt-blown filter, could be ingested by yellow mealworms, sole mask layer diets had adverse effects on the larval survival and growth. Analyses of Fourier transform infrared spectroscopy, differential scanning calorimeter and thermogravimetric, and gel permeation chromatography demonstrated the changes of functional groups, thermostability and molecular weights in frass compared to original masks, indicating the partial oxidation and degradation of masks. And the depolymerization of the middle layer of masks by yellow mealworms was different from that of other layers. The larval gut bacterial and fungal microbiomes were assessed by Illumina MiSeq, indicating that both of them shifted upon sole layer mask diets. Changes in relative abundances of dominant bacterial and fungal genera demonstrated the strong association between gut microbiome and mask degradation. For instance, unclassified Enterobacteriaceae was closely associated with outer layers degradation. Lactococcus and unclassified Ascomycota were responsible for middle layers degradation, while Lactococcus and Morganella for inner layers degradation. In conclusion, disposable surgical masks of PP material could be ingested and biodegraded by yellow mealworms. The diversities of gut bacterial and fungal microbiomes were associated with the differences in rigid crystalline structures of the layer masks.

Personal protective equipment (PPE) litter in terrestrial urban areas of Iligan City, Philippines

In recent years, many countries have relied on the massive use of personal protective equipment (PPE) following the recommendation of the World Health Organization (WHO) to combat COVID-19, an infectious disease caused by the SARS-CoV-2 virus. These PPEs include facemasks, face shields, disinfectant wipes, and disposable gloves. While PPE serves as protection, it can also be a source of pollution. This study is the first to establish a baseline monitoring and assessment of the spatial distribution of COVID-19-related PPE litter approaching the post-pandemic from the urban areas in Iligan City, Philippines. A total of 1632 COVID-19 PPE litter were gathered in all surveyed locations, predominantly facemasks (90.7%) and disinfectant wipes (8.8%). Among the surveyed areas, the location that recorded the highest count and density of PPE litter is in a residential zone (52.14%; n = 851; 0.0317 item m-2); the lowest was determined in recreational parks (2.57%; n = 42; 0.0016 item m-2). The significant difference in the total count of PPE items in each location could be traced to the varying land uses and ecosystems as well as the human behavior and activities. FTIR results reveal that all types of facemasks sampled are principally made of polypropylene, a material that threatens environmental sustainability and low recyclability. As the country is embracing the new normal and somewhat returning to pre-pandemic activities, this study calls for the prioritization of the government agendas on ecological solid waste management in the country.

Phthalate acid esters contribute to the cytotoxicity of mask leachate: Cell-based assay for toxicity assessment

After the COVID-19 outbreak, masks have become an essential part of people lives. Although several studies have been conducted to determine the release of hazardous substances from masks, how their co-presence poses a potential exposure risk to human health remains unexplored. In this study, we quantitatively compared the leaching of substances from six different common types of masks, including phthalate acid esters (PAEs), metals, and microplastics (MPs), and comprehensively evaluated the potential cytotoxicity of different leachates. MPs smaller than 3 µm were quantified by Py-GC-MS, and reusable masks showed greater releasing potentials up to 1504 µg/g. We also detected the prevalence of PAEs in masks, with the highest release reaching 42 μg/g, with dibutyl phthalate (DBP), diisobutyl phthalate (DiBP) and bis (2-ethylhexyl) phthalate (DEHP) being the predominant types. Moreover, the antimicrobial cloth masks released 173.0 µg of Cu or 4.5 µg of Ag, representing 2.7% and 0.04% of the original masks, respectively. Our cell-based assay results demonstrated for the first time that mask leachate induced nuclear condensation with DNA damage, and simultaneously triggered high levels of glutathione and reactive oxidative stress production, which exacerbated mitochondrial fragmentation, eventually leading to cell death. Combined with substance identification and correlation analysis, PAEs were found to be the contributors to cytotoxicity. Masks containing Cu or Ag led to acidification of lysosomes and alkalinization of cells. These results strongly suggested that the levels of PAEs in the production of regulatory masks should be strictly controlled.

Material flow analysis-based assessment of polypropylene-fiber-containing microplastics released from disposable masks: Characterizing distribution in the environmental media

With the upsurge in the use of disposable masks during the coronavirus disease pandemic, improper disposal of discarded masks and their negative impact on the environment have emerged as major issues. Improperly disposed of masks release various pollutants, particularly microplastic (MP) fibers, which can harm both terrestrial and aquatic ecosystems by interfering with the nutrient cycling, plant growth, and the health and reproductive success of organisms. This study assesses the environmental distribution of polypropylene (PP)-containing MPs, generated from disposable masks, using material flow analysis (MFA). The system flowchart is designed based on the processing efficiency of various compartments in the MFA model. The highest amount of MPs (99.7 %) is found in the landfill and soil compartments. A scenario analysis reveals that waste incineration significantly reduces the amount of MP transferred to landfills. Therefore, considering cogeneration and gradually increasing the incineration treatment rate are crucial to manage the processing load of waste incineration plants and minimize the negative impact of MPs on the environment. The findings provide insights into the potential environmental exposure associated with the improper disposal of waste masks and indicate strategies for sustainable mask disposal and management.

Toxicological impact of microplastics and nanoplastics on humans: understanding the mechanistic aspect of the interaction

Plastic is a pervasive material that has become an indispensable part of our daily lives and is used in various commercial products. However, plastic waste has significantly impacted the environment, accumulating in water and land ecosystems and harming all forms of life. When plastic degrades, it breaks down into smaller particles called microplastics (MPs), which can further breakdown into nanoplastics (NPs). Due to their small size and potential toxicity to humans, NPs are of particular concern. During the COVID-19 pandemic, the production of plastic had reached unprecedented levels, including essential medical kits, food bags, and personal protective equipment (PPE), which generate MPs and NPs when burned. MPs and NPs have been detected in various locations, such as air, food, and soil, but our understanding of their potential adverse health effects is limited. This review aims to provide a comprehensive overview of the sources, interactions, ecotoxicity, routes of exposure, toxicity mechanisms, detection methods, and future directions for the safety evaluation of MPs and NPs. This would improve our understanding of the impact of MPs and NPs on our health and environment and identify ways to address this global crisis.

Fibrous microplastics released from textiles: Occurrence, fate, and remediation strategies

Microplastics (MP), i.e., particles measuring less than 5 mm in size, are considered emerging pollutants. The ubiquity of MP is causing great concern among environmental and public health agencies. Anthropogenic activities are responsible for the extensive dispersal of MP in nature. Adverse effects on living organisms, interactions with other contaminants occurring in the environment, and the lack of effective degradation/removal techniques are significant issues related to MP. Most MP found in nature are fibrous (FMP). FMP originate from textile products, mainly synthetic fibers (e.g., polyester). Synthetic fibers are intensively used to produce countless goods due to beneficial characteristics such as high mechanical resistance and economic feasibility. FMP are ubiquitous on the planet and impart lasting adverse effects on biodiversity. Data on the consequences of long-term exposure to these pollutants are scarce in the literature. In addition, few studies address the main types of synthetic microfibers released from textiles, their occurrence, adverse effects on organisms, and remediation strategies. This review discusses the relevant topics about FMP and alerts the dangers to the planet. Furthermore, future perspectives and technological highlights for the FMP mitigation/degradation are presented.

Current knowledge on the presence, biodegradation, and toxicity of discarded face masks in the environment

During the first year of the COVID-19 pandemic, facemasks became mandatory, with a great preference for disposable ones. However, the benefits of face masks for health safety are counteracted by the environmental burden related to their improper disposal. An unprecedented influx of disposable face masks entering the environment has been reported in the last two years of the pandemic, along with their implications in natural environments in terms of their biodegradability, released contaminants and ecotoxicological effects. This critical review addresses several aspects of the current literature regarding the (bio)degradation and (eco)toxicity of face masks related contaminants, identifying uncertainties and research needs that should be addressed in future studies. While it is indisputable that face mask contamination contributes to the already alarming plastic pollution, we are still far from determining its real environmental and ecotoxicological contribution to the issue. The paucity of studies on biodegradation and ecotoxicity of face masks and related contaminants, and the uncertainties and uncontrolled variables involved during experimental procedures, are compromising eventual comparison with conventional plastic debris. Studies on the abundance and composition of face mask-released contaminants (microplastics/fibres/ chemical compounds) under pre- and post-pandemic conditions should, therefore, be encouraged, along with (bio)degradation and ecotoxicity tests considering environmentally relevant settings. To achieve this, methodological strategies should be developed to overcome technical difficulties to quantify and characterise the smallest MPs and fibres, adsorbents, and leachates to increase the environmental relevancy of the experimental conditions.