Plastic waste is a global problem and emerging research shows adverse effects on marine life and human health from the ingestion and absorption of toxic microplastic waste products. 

As physiotherapists, we are well positioned to reduce plastic consumption in the clinic and to advise our patients to consider the effects of plastics/microplastics, helping to improve their health outcomes. 

Plastics were first manufactured in 1869 by John Wesley Hyatt, using cotton and camphor. 

This innovation marked the beginning of a new era in materials science. 

By the 1950s, global plastic production had soared to two million tonnes and plastics were marketed to housewives as symbols of convenience, luxury and ‘throwaway living’. 

Plastic debris was first observed in the oceans during the 1960s. 

In the 1970s, plastic production and usage increased significantly, raising concerns about environmental impacts. 

Today, over 414 million tonnes are produced annually in an industry worth approximately US$712 billion (Statista research department 2025). 

This is expected to increase by four per cent per year and production could double by 2040. 

While plastics are essential for many aspects of modern life—such as computers, IT equipment, home appliances, medical products and sports gear—an extraordinary amount is produced for unnecessary consumption and single-use items. 

This overproduction and misuse contribute to the growing problem of plastic pollution. 

Every year, 19–23 million tonnes of plastic waste is carelessly dumped into our lakes, rivers and seas (United Nations Environment Programme 2021). 

That’s the equivalent of more than 2000 garbage trucks full of plastic every day—a number that could triple by 2040 if current trends continue. 

What are microplastics? 

Microplastics are tiny plastic particles that have become a growing environmental concern due to their widespread presence and potential health risks. 

They are categorised by size: macroplastics (plastic particles larger than five millimetres), microplastics (between one micrometre and five millimetres) and nanoplastics (smaller than one micrometre). 

There are also different types. 

Primary microplastics are plastic particles intentionally manufactured for use in industrial processes, commercial products and personal care items (such as plastic nurdles), while secondary microplastics are the result of the breakdown of larger plastic debris into smaller pieces due to sunlight exposure, salt water, temperature changes and the passage of time. 

Why are microplastics a problem? 

Microplastics and nanoplastics are commonly found on beaches, in oceans and in waterways. 

They are often mistaken for food and ingested by sea turtles, other marine life, seabirds and even humans. 

This can lead to serious health problems for both wildlife and people, making microplastics a potentially dangerous environmental pollutant. 

Microplastics are consumed at all levels in the ecosystem’s food chain. 

Foundational organisms phytoplankton and zooplankton ingest nanoplastics, disrupting nutrient cycling and energy transfer. 

In fish larvae and small fish, nanoplastics and microplastics interfere with growth, development and survival. 

Larger marine life such as turtles, seabirds and fish consume nanoplastics/microplastics-contaminated prey, leading to bioaccumulation. 

These plastics then move up the food chain, culminating in exposure to predators, including humans. 

Microplastics and human health 

Microplastics have been detected throughout the human body, including in blood, the lungs, the liver and the brain. 

They have also been found in urine, breastmilk, semen and newborns’ first stool. 

Widespread effects 

The effects of microplastics can be seen across multiple systems of the body. 

In the musculoskeletal system, they increase oxidative stress on joints, which may worsen arthritis and may delay post-injury recovery. 

Within the immune system, microplastic exposure triggers human immune cells to secrete cytokines like TGF-β1 (transforming growth factor beta-1) and TNF (tumour necrosis factor), which are key initiators of inflammation. 

It may also exacerbate autoimmune diseases. In the lungs, inhaled microplastics have been linked to conditions like chronic obstructive pulmonary disease and asthma and the synergistic effects with heavy metals like cadmium intensify the damage. 

Microplastic synergy with cadmium may also affect renal function and bone health, contributing to osteoporosis. 

The gastrointestinal tract represents a primary entry point for microplastics, making it particularly vulnerable to microplastic-induced inflammation. 

Research indicates that microplastics may cause changes in the intestinal microbiome, resulting in an imbalance between beneficial and harmful bacteria. 

This can lead to various gastrointestinal symptoms including abdominal pain, bloating and changes in bowel habits. 

Microplastics may affect the reproductive system. 

Evidence suggests potential damage to testicular tissue, sperm count and sperm motility. 

They may also impair fertility and disrupt hormonal regulation. 

Microplastics can carry endocrine-disrupting chemicals such as BPA and phthalates, impacting metabolism and hormone balance. In terms of neurological effects, emerging research indicates that microplastics may induce neuroinflammation, with potential brain and cognitive consequences such as dementia. 

They affect the cardiovascular system—heart disease patients with microplastics in their carotid arteries were twice as likely to experience a heart attack or stroke and more likely to die over the next three years. 

Chronic inflammation and chemical exposure to microplastics also raises concerns about long-term cancer risk in various organs. 

At-risk populations 

Some members of the population are likely to be at greater risk from microplastics than others. 

Children have increased vulnerability due to their developing organs and behaviours (eg, mouthing objects). 

In pregnant women there is the potential for placental transfer of microplastics. 

In elderly and immunocompromised people, reduced detoxification capacity makes the effects more severe, while workers in certain environments—eg, the textile, plastic and construction industries—are more likely to be exposed. 

What can we do about microplastics? 

There are things everybody can do to reduce microplastics. 

Dispose responsibly by always putting plastics and litter in the bin. 

Pick up litter. Even a few pieces a day help. 

Our oceans and beaches are increasingly littered with plastic and microplastic debris. 

While some in the community actively remove this waste, many pass by, unaware of the broader health risks associated with microplastics. 

Assess your ‘plastic footprint’ and take up the challenge of Plastic Free July. 

Avoid single-use plastic—say no to plastic straws, cutlery, bags and food packaging. 

Buy less plastic and textiles, especially items with excessive packaging and synthetic fibres. 

Switch to alternatives— choose bamboo, metal, cardboard or other natural materials. 

Reuse what you can—give plastic items a longer life. 

Support proper waste systems by recycling bottles and cans. 

What can physiotherapists do? 

There are a number of strategies that physiotherapists can employ in the clinic to combat microplastics. 

One is to reduce plastic waste. 

Encourage patients to bring their own towels, replace disposables with reusable alternatives and set up clearly labelled recycling bins. 

Choose sustainable products. 

Single-use plastics can be eliminated in the clinic and in staffrooms. 

Avoid purchasing or using plastic water bottles, especially when they have been heated or left in the sun. 

Source biodegradable or recyclable products and consumables where possible, such as resistance bands, plastic equipment, tape/kinesiology tape, disposable gloves, hand therapy splints and women’s health products. 

Avoid using plastic microwave lids or plastic chopping boards, properly dispose of acupuncture needle plastic guide tubes/retaining tabs and reuse plastic bottles for massage cream, sorbolene and ultrasound gel. 

Minimise purchasing of synthetic clothing and consider using a washing machine microplastic filter. 

Source eco-friendly, biodegradable, non-toxic disinfectants and cleaning agents. 

To improve clinic infrastructure, consider using high-efficiency particulate air filters and reverse osmosis water filters. 

Plastic kitchenware can be replaced with glass, bamboo or stainless steel products. 

Finally, physiotherapists can engage and educate patients. 

Offer digital resources instead of paper or plastic. 

Advise patients on ways to avoid single-use plastic and on reusable/recyclable alternatives. 

Teach them about sources of potential toxicity from microplastic/nanoplastic ingestion, inhalation and contact. 

The bigger picture 

To move from local action to action on a global scale, we need to demand systemic change. 

While supporting better plastic recycling programs, we should also question their longterm sustainability. 

Government and councils must reduce plastic production and waste leakage. 

Businesses and factories need to be held accountable for pollution. 

For example, the ‘Big Plastic’ companies such as Coca-Cola, Dow Chemical and ExxonMobil must drastically reduce plastic production, invest in sustainable alternatives, take responsibility for their role in plastic pollution and reuse/recycle their products. 

Physiotherapists can also advocate for strong global agreements like the 2024 United Nations Global Plastics Treaty. 

We are uniquely positioned to lead and advocate for change, protecting the environment and improving human physical and mental health.

>> Trent Brumby MACP is an APA Titled Sports and Exercise Physiotherapist based on the Sunshine Coast and director of Microplastic Awareness Systems. Trent is actively involved with Alexandra Headland Surf Life Saving Club, the Beach Matters Group and Co-Exist Sunshine Coast, helping with beach clean-up and education initiatives.
 

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