Last month my friends and I treated ourselves to a stand-up comedy cabaret evening at Glasgow’s la rotunda on the bank of the river Clyde. A few acts in, one young comic made a crack at one commodity we’ve all noticed proliferate over the past few years across our fast-food chains – the ubiquitous paper straw.

Though amused as we were by the gibes and lampoonery at the straw’s expense, it did give me pause for thought.

I remember being at school when the gut-churning video of marine biologist Dr Nathan Robinson pulling a plastic straw out of an olive ridley sea turtle’s nose went viral. Since that summer of 2015, paper straws seem to have become synonymous with ‘saving the turtles’. Kids (and now comedians it seems) took aim at the turtles, joking about their indifference to their fate and of the inferiority of paper straws compared to the tried and tested plastic straws we’d grown up with.

But I fear that these associations have led us to miss the bigger picture. Our love affair with single use plastics doesn’t come at the sole expense of unfortunate sea turtles, or even just aquatic life in general; plastics threaten us.

 

Humans and plastics: a toxic relationship

 

Now I know we’ve all probably never seen anyone cursing because of a plastic straw up their nose, but hear me out.

Plastics first came into popular use in the 1950s and have since integrated themselves into nearly all facets of our daily lives; packaging, clothing, building material, cosmetics… the list is endless. Our obsession with plastics has seen their production rise to almost 400 metric tons a year, with a 2017 study estimating that 8300 million metric tons of virgin plastics had been produced to date. For context, one metric ton is about the weight of an adult walrus or a 1979 Volkswagen Beetle.

According to one study, about 8 million tonnes of plastics are deliberately dumped into the oceans globally, and at the current rate we can expect to see the amount of plastic waste to reach a whopping 12,000 metric tons by 2050.

Plastics are known to have a wide range of detrimental effects on the environment, from killing wildlife to degrading our soil, but how much do you know about the threat they pose to your health?

Scientists are becoming increasing alarmed by the threats to human health that plastics pose, in particular nano-plastics. Now it’s likely that you’ve heard about microplastics, but nanoplastics have only recently entered our lexicon. Nanoplastics are broken fragments of microplastics, their size between 1 and 1000 nanometres in length. It’s hard to imagine something that small isn’t it? But it is their minuteness that makes them so threatening.

Nanoplastics are everywhere, and I mean everywhere. Soil, air, food, tap water; all have been found to contain nanoplastics. You can’t even go for a pint now without risking ingesting the stuff. It’s now believed that the average person eats around 70,000 microplastics each year.

Disturbingly, plastics contain a number of chemicals that are toxic to humans, such as fire retardants and UV blockers, added to everyday plastics to enhance their performance. A test by Professor Takeda Hideshige of Tokyo university of agriculture and technology tested the effect of secondary nanoplastic consumption by fish who had  been fed small Mysid shrimp that had consumed nanoplastics. The results where shocking: these fish had higher concentrations of harmful chemicals from plastics than the fish who had eaten nanoplastics directly. One dreads to think what affect this will have on aquatic food chains. And who’s at the top of that food chain? Yep, that’s us. Will we see a time when fish become inedible? Given the evidence, this is not such a fanciful claim.

More research is needed to ascertain what exact risks nanoplastics, airborne or otherwise, have on humans. However, the current outlook is grim.

 

“the harmful effects [of nanoplastics] can linger for decades, or over generations. That’s the scary aspect” – Prof. Takeda Hideshige

Source: NHK Documentary: Road to 2030

Even before being thrown away plastics are a threat to our health. According to recent studies there is an increasing amount of evidence that highly toxic PFAS, so called ‘forever chemicals’, used in plastic containers for everything from water bottles to vegetable packaging is leaking on to our food. These chemicals are linked to cancer, birth defects, liver disease, thyroid disease, plummeting sperm counts, kidney disease, decreased immunity and a range of other serious health problems.

As nanoplastics are so light that they can travel by air over vast distances, even being found falling with snow in the Arctic. Studies now show that we’re all breathing in much more nanoplastics than we are ingesting. Every time we walk on a busy street, or even just sit down in the living room in front of the telly we are breathing the stuff in.

Fibres up to 250 μm have been found in human lungs. Such accumulation can lead to respiratory problems and autoimmune diseases, and chronic exposure can even lead to cancer onset as observed in textile workers.

So small are these bits of plastics that they can enter our bloodstream through our lungs, running all around our body, ever accumulating as we live in our plastic world. One is reminded of Kate Bush’s haunting 1980 hit Breathing, though few could imagine then that it could be plastics rather than nuclear fallout that could leave us crying out for something to breathe.

W.H.O. you gonna call?

You’d be forgiven for feeling pretty fearful at this point. Clearly plastics pose a great health risk to all of us, on a scale that no one country can solve on their own. So, who do we turn to in at times of global health crises? Well, que the WHO – otherwise known as the World Health Organization.

Currently, discussions around plastics pollution have been the remit of the United Nations Environment Programme (UNEP), their efforts cumulating last year in a commitment by 175 countries to forge an international legally binding agreement on plastic pollution by the end of 2024.

This statement from the UNEP however fails to mention public health. Even if all plastic production were to end tomorrow we still have an uncountable number of plastics in the ocean breaking down and attacking our ecosystems and health. The genie is out of the plastic bottle now, and with that bottle taking around 450 years to decompose, well, that sprite’s going nowhere.

Given the global nature of plastic waste, this is a threat to the health of all 8 billion of us. Which brings this well into the remit of the World Health Organisation.

The WHO was established on 7 April 1948, what is now World Health Day. It’s objective as outlined in article one of its constitution is

“…the attainment by all peoples of the highest possible level of health”

Since then, the organisation has been at the forefront of tackling global health issues, most notably taking the lead in the eradication of smallpox and near-eradication of polio amongst other achievements.

For the past 3 years the WHO has been focused on it’s ‘triple billion targets’. By 2023, the WHO proposed to achieve:

• 1 billion more people benefitting from universal health coverage
• 1 billion more people better protected from health emergencies
• 1 billion more people enjoying better health and well-being.

With plastics remaining unaddressed however, that final billion in particular looks very difficult to sustain. Now that 2023 is here though, this is the year that the WHO is set to decide it’s fourteenth general programme of work for the next four years, and so now is an opportune moment for the organisation to plan in earnest it’s response to the plethora of plastics-related health issues to come.

With the inevitability of a plastics induced global health crisis, how should the WHO react?

A number of functions listed in article two of the WHO’s constitution shed light on how the organisation should help:

(a) to act as the directing and co-ordinating authority on international health work;

(k) to propose conventions, agreements and regulations, and make recommendations with respect to international health matters and to perform such duties as may be assigned thereby to the Organization and are consistent with its objective;

What complicates this question is the gap in knowledge of how exactly plastic-related health problems will manifest. However, this is precisely where the WHO can help.

 

“We still don’t have the faintest idea of the true health repercussions” – Nagafuchi Osamu, reseacher at Fukuoka Institute of Technology

Source: NHK Documentary: Road to 2030

Under function (n) of article two of the WHO’s constitution, the WHO is obligated to “promote and conduct research in the field of health”. When it comes to plastics then, the WHO certainly has its work cut out; given how high the levels of plastic waste are, the knowledge gap on its effect on human health must be closed before the situation gets out of hand. The WHO must be held to its constitution and fund more research to shine a light on this. This is the first step they can and must take.

The constitution also obligates the WHO to “assist in developing an informed public opinion among all peoples”, and that includes comedians and school kids. Our addiction to plastics is far from over, but perhaps a more informed public would think twice before running paper straws into the ground in malcontent if the personal threat of plastic was more widely known.

Working with others across the globe will also be essential to mitigate the crisis, and plans must be made now to prepare for the future. One of the WHO’s major current collaborative initiatives is One Health, established with the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization (FAO) in 2008 as a framework to jointly tackle world health issues. Now referred to as The Quadripartite Organizations with the inclusion of the UNEP, they work together to promote a united approach to world health that acknowledges the intersection between environmental, animal, and human health. Given that plastics threaten all life on earth, One Health provides an ideal collaborative framework to fight the effects of plastic pollution.

The One Health Joint Plan of Action (‎2022‒2026)‎ outlines their current strategy, focusing on zoonotic diseases, antimicrobial resistance, and food safety, all of which I’m sure you’ll agree are very important areas that need addressing.

However, the 86 page document mentions plastics but once, acknowledging microplastics in the human food chain in a throwaway sentence. Plastics are both an environmental problem and a health problem for humans and animals alike, they do not discriminate in their terror. Thus, they fall well within the remit of One Health and are surely worth more than a mere nod. In fact, tackling plastics is a food safety concern and thus should fall well within the document’s scope.

The One Health initiative then provides a framework at least for a multilevel approach to tackling the scourge of plastics, one I hope will be utilised.

The WHO does have its limitations, however. As is more often than not the case in international politics and cooperation, progress and agreements are slow. It’s unclear if its triple billion targets have been successful, indeed by its very nature progress will be difficult to assess.

We saw with covid as well how systemic problems such as the global economic inequalities that led to the vaccine apartheid make the WHO’s job even harder, not to mention Trump’s politicising of the WHO that sowed the seeds of distrust in the organisation.

But with time of the essence, if the WHO is to beat its critics and continue to execute its objective to ensure the health of humanity then the time to act is now. In this crucial year with the launch of the WHO’s next four-year plan, I look forward to meeting those at the organisation and get a feel of the air as the final parts of the plan are decided upon. The silence from the organisation on the threat of plastics to human health is deafening, the absence of a plan unnerving; questions need answering and I look forward raising them in Geneva.

I hold my breath in anticipation, but also in fear of what I may inhale.