Impact of Microplastic Exposure on Human Health: A Systematic Review of Mechanisms, Biomarkers, and Clinical Outcomes
Abstract
Microplastics (≤5 mm) are increasingly recognized as pervasive environmental pollutants with potential implications for human health. Human exposure occurs primarily through ingestion and inhalation, with limited evidence also suggesting dermal contact. Microplastics have been detected in human blood, placental tissue, and gastrointestinal samples, indicating systemic exposure. Proposed biological pathways include oxidative stress, inflammation, endocrine disruption, and alterations in the gut microbiota; however, direct evidence linking these mechanisms to adverse health outcomes in humans remains limited. This systematic review synthesizes human-based evidence to evaluate health outcomes associated with microplastic exposure. The review includes primary human studies, specifically observational studies and clinical trials, as well as human-focused systematic reviews. Animal and in vitro studies were excluded from outcome synthesis because they do not directly reflect human clinical effects. Mechanistic insights derived from non-human experimental studies were included only to provide biological context and were clearly separated from human outcome data to avoid over-interpretation. A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar for articles published between January 2010 and May 2025. Primary human studies constituted the core evidence base for data extraction, qualitative synthesis, and certainty of evidence…
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