Plastics in the Perioperative Period: Deleterious Health Effects on Patients and Providers

Plastic enables anesthesiology through packaging, syringes, tubing, catheters, endotracheal tubes, and ventilator circuits. Created inexpensively from fossil fuels, plastic is easily sterilized and allows healthcare providers to reliably deliver life-saving therapies. However, a growing body of evidence demonstrates that small, often invisible plastic particles are accumulating in human bodies, with potentially serious health consequences. The perioperative period introduces plastics through two primary exposure routes, intravenous and inhalational, that bypass patients' natural toxin defense mechanisms. Moreover, this occurs during surgery, when there are often intense physiologic stressors. Anesthesia providers also face chronic inhalational plastic exposure in the operating room via masks and ambient plastic particles. Although evidence of direct adverse effects from microplastics on human health is limited, associations with disease are emerging while animal studies have shown harm. There are also indirect implications for human health and well-being of breaching the novel entities (which include plastics) planetary boundary. It therefore falls upon all of us to advocate for both more information and safer alternatives-for the health of both patients and providers.