Aug 2026· Journal of Medical & Health Sciences Review· Vol 3, pp. 204-218· 0 citations
TL;DR
Current evidence suggests that, under environmentally realistic conditions, microplastics should not generally be regarded as vectors of pharmaceutical contaminants but rather as carriers, sinks, sources, and independent stressors, and future risk assessments should prioritize environmentally aged microplastics.
Abstract
Pharmaceutical compounds and microplastics are ubiquitous aquatic pollutants that frequently co-exist in aquatic environments; however, their combined effects on fish cannot be accurately predicted from studies investigating each pollutant individually. Pharmaceutical compounds can disrupt conserved molecular targets even at low concentrations, whereas microplastics are particulate materials that also act as surfaces capable of sorbing, transporting, and releasing chemical contaminants. This review synthesizes current knowledge on the co-exposure of fish to pharmaceuticals and microplastics, with a particular focus on toxicokinetics, organ toxicity, and associated ecological risks. Findings from direct co-exposure studies indicate that interactions range from synergistic and additive to antagonistic, depending on factors such as particle size, polymer composition, plastic aging, biofilm formation, water chemistry, exposure sequence, pharmaceutical properties, and tissue-specific uptake. The intestine and the gut–liver axis have emerged as particularly vulnerable targets, while the plastisphere may harbor increased abundances of antibiotic resistance genes and exert stronger selective pressure under antibiotic co-exposure. However, most available studies have employed pristine spherical polystyrene microplastics, short exposure durations, and concentrations exceeding environmentally relevant levels. Furthermore, only a limited number of studies have incorporated mixture toxicity models or investigated sub-organismal mechanisms to predict population-level effects. Current evidence suggests that, under environmentally realistic conditions, microplastics should not generally be regarded as vectors of pharmaceutical contaminants but rather as carriers, sinks, sources, and independent stressors. Future risk assessments should prioritize environmentally aged microplastics, realistic pharmaceutical mixtures, time-dependent internal exposure, species-specific sensitivity, and adverse outcome pathways to improve ecological risk predictions.
Pharmaceutical residues are now routinely detected in wastewater-impacted aquatic environments because medicinal compounds and their metabolites enter sewerage, industrial effluents, agricultural drainage and receiving waters through multiple, often continuous pathways. Their environmental significance cannot be inferred from occurrence alone: risk depends on potency, exposure duration, mixtures, transformation products, species sensitivity and the capacity of treatment systems to reduce biologically active mass. This critical narrative review integrates evidence on sources, ecological effects and bioremediation, with emphasis on wastewater-impacted freshwaters and on technologies that rely substantially on microbial, fungal, algal or plant-associated processes. Literature was selected through live searches of multidisciplinary and environmental or biomedical scholarly sources, supplemented by citation searching and DOI verification. The strongest causal ecological evidence comes from whole-ecosystem work with endocrine-active pharmaceuticals, while laboratory and field studies also support concern for behavioural disruption, chronic sublethal effects and antibiotic-driven selection for antimicrobial resistance. Nevertheless, extrapolation remains difficult because monitoring is dominated by parent compounds and targeted analytes, whereas mixtures and transformation products are incompletely characterised. Conventional activated sludge provides variable and compound-specific attenuation; apparent parent removal may reflect sorption or transformation rather than mineralisation. Membrane bioreactors, adapted bacterial consortia, white-rot fungi, microalgae and constructed wetlands can improve removal under favourable conditions, but evidence is uneven across scales and frequently relies on high test concentrations or parent disappearance. The synthesis indicates that no single biological technology provides universal control. Risk reduction is more defensibly pursued through source control, robust biological treatment and targeted polishing, supported by mass balances, transformation-product screening, effect-based endpoints and antimicrobial-resistance assessment. Future research should prioritise trace-level, full-scale comparisons and standardised demonstrations that connect chemical removal to reduced biological hazard.
Yogita Basene, Shreeti Shrivastawa· Asian Journal of Environment...· 0 citations
Microplastics (MPs) are increasingly recognized not only as persistent particulate pollutants but also as active sources and vectors of phthalate esters (PAEs) in aquatic environments. Because PAEs are physically incorporated rather than chemically bonded within polymer matrices, they can be progressively released through leaching, photooxidation, mechanical abrasion, and biological interactions. This review synthesizes current understanding of MP-mediated PAE release, their interactions with co-contaminants, and the implications for ecological exposure. Environmental aging enhances polymer fragmentation and surface oxidation, accelerating additive desorption and altering sorption behavior. Field evidence from major river systems shows that high-molecular-weight PAEs, particularly DEHP and DBP, frequently dominate contamination profiles and contribute most significantly to ecological risk, with cumulative risk quotients (∑RQ) reaching up to 59.22 in heavily impacted watersheds. Ingestion of MPs by aquatic organisms further promotes in situ chemical transfer under gastrointestinal conditions, increasing internal exposure beyond dissolved-phase concentrations alone. Moreover, MPs act as multi-contaminant platforms, facilitating the co-transport of PAEs with metals and hydrophobic organic pollutants, thereby intensifying mixture toxicity and trophic transfer. Collectively, these processes demonstrate that MP-associated PAE release represents a dynamic and sustained pathway of chemical pollution requiring integrated risk assessment and source-control strategies.
Retno Wulandari, Nurul Fahimah, Hanny Merinawati et al.· Journal of Contaminant Hydro...· 0 citations
Plastic pollution has emerged as a pervasive global environmental and public health challenge, affecting terrestrial and aquatic ecosystems across all spatial scales. Macro-, micro-, and nanoplastics enter food webs through ingestion, inhalation, and trophic transfer, posing distinct yet interconnected toxicological and physiological risks to wildlife and livestock, while potential implications for human health are still being actively investigated. Macro plastics primarily cause physical injuries, gastrointestinal obstruction, starvation, and mortality in marine and terrestrial animals, while microplastics act as vectors for chemical additives and pathogens, inducing oxidative stress, inflammation, and microbiome disruption. Nanoplastics, due to their small size and high surface reactivity, exhibit enhanced bioavailability, enabling cellular uptake and translocation across biological barriers in experimental systems, with studies indicating potential genotoxic and endocrine-disrupting effects. However, evidence regarding long-term human health outcomes remains limited and is still emerging. This review synthesizes current evidence on exposure pathways, biological impacts, and ecosystem-level consequences of plastic pollution, highlighting critical knowledge gaps related to chronic toxicity, mixture effects, and long-term health outcomes. This review uniquely integrates waste management system failures, toxicological mechanisms, and circular economy interventions to provide a systems-level synthesis of plastic pollution pathways from production to health outcomes. We further examine mitigation strategies through a circular economy lens, emphasizing source reduction, product redesign, extended producer responsibility, improved waste management, and policy coherence across scales. Integrating technological innovation with governance, behavioral change, and stakeholder collaboration is essential to curb plastic leakage and prevent secondary micro- and nano plastic formation. Overall, addressing plastic pollution requires systemic, science-based interventions that link environmental protection with human health objectives. Such integrated approaches directly support the achievement of Sustainable Development Goals 3 (Good Health and Well-Being), 12 (Responsible Consumption and Production), 14 (Life Below Water), and 15 (Life on Land), reinforcing the urgency for coordinated global action.
Abhijeet Das, Satchidananda Mishra, Krishna Pada Bauri et al.· Discover Sustainability· 1 citation
Background/Objectives: Microplastics (MPs) and nanoplastics (NPs) have emerged as ubiquitous environmental contaminants resulting from the extensive production, use, and degradation of plastic materials. Human exposure occurs primarily through contaminated food and drinking water, with inhalation representing an additional important route. Growing concern has focused on the ability of these particles, particularly NPs, to cross biological barriers, enter the systemic circulation, and reach human tissues. The aim of this review was to summarize current evidence on dietary exposure to MPs and NPs, their gastrointestinal bioavailability and toxicokinetics, and their potential systemic health effects, with particular emphasis on organ-specific responses, underlying biological mechanisms, and the strength and limitations of the available evidence. Methods: A comprehensive narrative review of the scientific literature published between 2000 and 2026 was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Original research articles and review papers addressing dietary exposure, occurrence in food and drinking water, migration from food-contact materials, gastrointestinal absorption, translocation, biodistribution, bioaccumulation, elimination, molecular mechanisms, and potential organ-specific or systemic health effects were included. Publications without full-text availability, conference proceedings, editorials, commentaries, duplicate publications, and studies without relevance to human exposure or health were excluded. Results: Food, drinking water, beverages, and food-contact materials represent important sources of human exposure to MPs and NPs. Following ingestion, most larger particles are eliminated through the gastrointestinal tract, whereas smaller MPs and particularly NPs may cross biological barriers and potentially reach the systemic circulation and distant tissues. Experimental studies consistently identify interconnected biological responses involving oxidative stress, inflammation, mitochondrial dysfunction, barrier impairment, immune dysregulation, genotoxicity, apoptosis, and endocrine disruption. These mechanisms have been associated with alterations in the gastrointestinal, respiratory, cardiovascular, nervous, urinary, reproductive, endocrine, and skeletal systems and with biological processes relevant to carcinogenesis. However, most mechanistic evidence derives from in vitro and animal models, whereas human evidence remains limited and predominantly observational. Consequently, the extent to which these experimental findings translate into clinically significant effects in humans remains uncertain. Conclusions: Current evidence supports the biological plausibility of systemic effects associated with MNP exposure but is insufficient to establish causal relationships between chronic dietary exposure and specific human diseases. The detection of MNPs in human tissues and reported associations with pathological conditions should therefore be interpreted cautiously. Standardized analytical methods, improved characterization of realistic human exposure, and well-designed longitudinal epidemiological studies integrating quantitative exposure assessment with validated clinical outcomes are required to clarify dose–response relationships, long-term health effects, and the clinical significance of MNP exposure.
Łukasz Kogut, Czesław Puchalski, J. Jastrzębska et al.· Molecules· 0 citations
The combined toxicity of microplastics (MPs) and co-occurring organic pollutants is a critical concern in environmental pollution risk assessment. Triphenyl phosphate (TPHP), a widely used flame retardant, frequently coexists with microplastics in aquatic environments. However, research on the impact of MPs on the toxicity of TPHP remains limited. This study integrated physiological, biochemical, and transcriptomic approaches to investigate the individual and combined effects of polystyrene (PS) MPs and TPHP on common carp (Cyprinus carpio) gills and the underlying mechanisms following 3 and 7 days of exposure. The results showed that PS and TPHP compromised the integrity of the gill epithelium, disrupted osmotic regulation, suppressed aerobic energy metabolism, and induced oxidative stress, inflammatory cascades, barrier protein depletion, and apoptosis. Crucially, formal interaction analysis using the interaction effect index (dI) revealed distinct combined toxicity patterns. Furthermore, transcriptomic profiling showed that combined exposure elicited the most extensive transcriptional suppression (1790 differentially expressed genes), uniquely enriching extracellular matrix (ECM) degradation and lipid metabolic disorders. Notably, although PS reduced TPHP accumulation in gills, co-exposure triggered the most severe molecular disturbances, indicating combined effects arise from intracellular pathway crosstalk rather than enhanced uptake. Our findings demonstrate that PS exacerbates TPHP-induced gill toxicity through disruption of metabolism, barrier integrity, and apoptosis, underscoring the need to consider combined effects in aquatic risk assessment.
Microplastics are increasingly recognized as prevalent contaminants in freshwater ecosystems, where they interact with a wide range of co-occurring pollutants, including heavy metals, pesticides, pharmaceuticals, and persistent organic pollutants. Evidence indicates that microplastics can act as vectors, enhancing pollutant mobility and facilitating trophic transfer, while also modulating toxicity through synergistic or antagonistic effects. Ecotoxicological studies reveal adverse impacts on aquatic organisms, ranging from physiological stress and impaired reproduction to altered community dynamics, with implications for ecosystem functioning and human health. Despite growing knowledge, significant gaps remain in understanding long-term environmental behavior, standardized methodologies, and risk assessment frameworks. This review synthesizes current findings on microplastic–pollutant interactions in freshwater systems, highlights emerging ecotoxicological risks, and identifies critical research needs to inform effective management and policy interventions.
Raissa Okwuosa, Thendo Mutshekwa, J. Lebepe· Microplastics· 0 citations
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