Micro-and Nano-Plastic Exposure as an Emerging Risk for Atherosclerotic Cardiovascular Disease

This review examines micro- and nanoplastic (MNP) exposure as an emerging risk factor for atherosclerotic cardiovascular disease, focusing on how individual-level exposures shaped by behaviours, micro-environments, and lifestyle factors contribute to cumulative internal dose and cardiovascular risk.

Micro- and nanoplastic (MNP) exposure occurs through multiple, continuous pathways, including inhalation of airborne particles, ingestion via food and drinking water, and contact with consumer products. Dietary intake varies substantially, with high concentrations reported in fruits, vegetables, and seafood. Indoor environments represent a dominant exposure setting due to elevated microplastic levels in household dust, synthetic textiles, and personal care products, while urban roadside environments further contribute to inhalation exposure. Marked global disparities are evident, with populations in low- and middle-income countries disproportionately affected due to concentrated plastic production, occupational exposures, and transboundary waste flows. Emerging biomonitoring and clinical evidence confirms the presence of MNPs in human blood, vascular tissues, and atherosclerotic plaques, indicating systemic exposure with potential cardiovascular implications. MNP exposure is a plausible contributor to CVD via inflammation, oxidative stress, and endothelial dysfunction. Despite limited causal evidence, findings highlight the need for improved exposure assessment, prevention strategies, and policy action.