Science of the Total Environment 904 (2023) 166745

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Science of the Total Environment

journal homepage: www.elsevier.com/locate/scitotenv

Review

Airborne microplastics: A narrative review of potential effects on the

human respiratory system
Udomratana Vattanasit a, *, Jira Kongpran a, Atsuko Ikeda b, c
a
Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
b
Faculty of Health Sciences, Hokkaido University, Sapporo 0600812, Japan
c
Center for Environmental and Health Sciences, Hokkaido University, Sapporo 0600812, Japan

H I G H L I G H T S G R A P H I C A L A B S T R A C T

• Occurrence and effects of microplastics

on the respiratory system are
summarized.
• Fibers are common microplastics in the
air and the human respiratory system.
• Smaller size, irregular shape, and posi­
tive charge showed higher toxic effects.
• Human biomonitoring and toxicological
assessment of microfiber are needed.

A R T I C L E I N F O A B S T R A C T

Editor: Philip K. Hopke There has been growing evidence showing the widespread of airborne microplastics (AMPs) in many regions of
the world, raising concerns about their impact on human health. This review aimed to consolidate recent
Keywords: literature on AMPs regarding their physical and chemical characteristics, deposition in the human respiratory
Microplastics tract, translocation, occurrence from human studies, and toxic effects determined in vitro and in vivo. The physical
Air pollution
characteristics influence interactions with cell membranes, cellular internalization, accumulation, and cytotox­
Inhalation
icity resulting from cell membrane damage and oxidative stress. In addition, prolonged exposure to AMP-
Oxidative stress
Inflammation associated toxic chemicals might lead to significant health effects. Most toxicological assessments of AMPs in
vitro and in vivo have demonstrated that oxidative stress and inflammation are major mechanisms of action for
their toxic effects. Elevated reactive oxygen species production could lead to mitochondrial dysfunction, in­
flammatory responses, and subsequent apoptosis in experimental models. To date, there has been some evidence
suggesting exposure in humans. However, the data are still insufficient, and adverse human health effects need to
be investigated. Future research on the existence, exposure, and health effects of AMPs is required for developing
preventive and mitigation measures to protect human health.

* Corresponding author.
E-mail address: udomratana.va@mail.wu.ac.th (U. Vattanasit).

https://doi.org/10.1016/j.scitotenv.2023.166745
Received 21 May 2023; Received in revised form 30 July 2023; Accepted 30 August 2023
Available online 4 September 2023
0048-9697/© 2023 Elsevier B.V. All rights reserved.
U. Vattanasit et al.
1. Introduction
There has been growing concern regarding microplastics (MPs) in
recent decades due to their potential risks to ecosystems and human
health. MPs were initially documented in 2004 by a group of ecologists
who investigated the occurrence of microscopic fragments and fibers in
marine habitats (Thompson et al., 2004). To date, many researchers
have published data on the occurrence of MPs in various environmental
media: water (Suttiviriya and Kongpran, 2022; Vivekanand et al., 2021;
Yu et al., 2022), soil (Yang et al., 2021a), sediment (Peng et al., 2018;
Van Cauwenberghe et al., 2015; Venkatramanan et al., 2022), air (Allen
et al., 2020; Munyaneza et al., 2022; Wright et al., 2020), and biota (de
Sá et al., 2018; Maneechan and Prommi, 2022). MPs have also been
detected in remote areas, such as a polar region (Peeken et al., 2018) and
high mountains (Allen et al., 2019; Godoy et al., 2022), suggesting a
long-range transport of these pollutants. Among all environmental
compartments, MP contamination in water has received the most
attention (Akdogan and Guven, 2019). Accordingly, the toxic effects of
MPs on aquatic organisms, especially fish and small crustaceans, have
been extensively investigated (de Sá et al., 2018).
The toxic effects of MPs in humans have been investigated in several
in vitro models using various cell types representing different tissues and
organ systems, such as the gastrointestinal tract (Zhang et al., 2022c),
kidney (Wang et al., 2021b), respiratory tract (Dong et al., 2020;
Goodman et al., 2021; Yang et al., 2021b), and blood cells (Çobanoğlu
et al., 2021; Salimi et al., 2022; Weber et al., 2022). In addition, studies
on simulated organ systems, such as the digestive system (Liao and
Yang, 2020) and respiratory system (Lim et al., 2021; Winkler et al.,
2022), were also conducted. Some studies were carried out in vivo, for
instance, in mice (Aghaei et al., 2022; Rawle et al., 2022; Shengchen
et al., 2021; Wu et al., 2023). Only a few human studies are available
showing the presence of MPs in human organ systems, such as the
gastrointestinal tract (Schwabl et al., 2019; Zhang et al., 2021), pla­
centas (Ragusa et al., 2022; Ragusa et al., 2021; Zhu et al., 2023), blood
(Leslie et al., 2022), and respiratory tract (Amato-Lourenço et al., 2021;
Huang et al., 2022). Among these studies, ingesting contaminated food
or drinks is considered the primary route of exposure to MPs. Research
on MPs in the air is limited, and evidence of exposure via inhalation and
the toxic effects of airborne MPs (AMPs) in humans is still less well-
defined. This review aimed to consolidate up-to-date information on
sources and atmospheric dispersion, physical and chemical character­
istics, deposition and clearance in the human respiratory tract, trans­
location, human exposure, and toxic effects of MPs on the respiratory
system investigated in vitro and in vivo. Current knowledge gaps and the
need for future studies are presented.
2. Sources and characteristics of AMPs
MPs were defined as “synthetic solid particles or polymeric matrices,
with regular or irregular shape and with size ranging from 1 μm to 5 mm,
of either primary or secondary manufacturing origin, which is insoluble
in water” (Frias and Nash, 2019). Plastic particles of <1 μm are known as
nanoplastics (NPs). Unfortunately, the characterization and quantifica­
tion of NPs in the environment are still difficult due to several meth­
odological obstacles (Schwaferts et al., 2019). Primary MPs are
intentionally manufactured at sizes <5 mm for various specific appli­
cations, especially in personal-care products and cosmetics (Madhumi­
tha et al., 2022; Napper et al., 2015; Praveena et al., 2018). Secondary
MPs are plastics broken down into small particles of <5 mm by abiotic
and biotic transformation upon entering the environment or in biolog­
ical systems. Mechanical weathering and chemical degradations, such as
photo-oxidation by ultraviolet radiation, make plastics brittle and
degraded into micro-sized particles (Cózar et al., 2014). Other envi­
ronmental degradation mechanisms include thermo-oxidative degrada­
tion (i.e., slow oxidative breakdown at moderate temperatures and
hydrolysis) (Andrady, 2011).
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Science of the Total Environment 904 (2023) 166745
The first report on the occurrence of AMPs was published by Dris
et al. (2015) and has ignited research on this issue up to the present. The
primary sources of AMPs in indoor and outdoor environments include
synthetic clothes, tire treads, household furniture, and disposal sites for
waste materials (Facciolà et al., 2021). Synthetic textiles are considered
the primary source of AMPs (Chen et al., 2020), especially indoors (Dris
et al., 2017). Interestingly, it has been suggested that cigarette filter are
a potential source of small microfibers released into the environment
(Baeza-Martinez et al., 2022). As a result, smokers may inhale MPs that
reach the lower airway. Some studies have indicated that smokers were
exposed to a higher number (Baeza-Martínez et al., 2022) and more
types of MPs (Huang et al., 2022) compared to non-smokers.
Human activities and meteorological conditions affect the distribu­
tion and deposition of AMPs (Chen et al., 2020). Vertical gradient, wind
speed, and wind direction have been shown to influence the dispersion
of AMPs in both indoor and outdoor environments (Allen et al., 2020;
Facciolà et al., 2021). MPs in the environment are composed of various
plastic types with different physical properties that influence their at­
mospheric transport and distribution. AMPs with small and low den­
sities can be suspended in the air and transported by wind (Allen et al.,
2019). It has been reported that the amount of MPs released is correlated
with population densities (Allen et al., 2020). A study in Central London
(Wright et al., 2020) showed that AMPs were 20 times greater than those
detected in the French Pyrenees, a remote mountain catchment (Allen
et al., 2019). In addition, a study conducted at two urban and sub-urban
sites in Paris demonstrated that the atmospheric fallout of fibers is
higher in urban sites (Dris et al., 2016). AMPs were found in indoor and
outdoor air (Gasperi et al., 2018); however, outdoor environments have
fewer AMPs than indoor environments (Dris et al., 2017).
Plastic is a biochemically inert material; however, exposure to MPs
can cause various toxic effects. The physical and chemical characteris­
tics, considered critical determinants of the adverse effects of AMPs, are
presented as follows and summarized in Table 1.
2.1. Physical characteristics
The physical properties are primarily shape, charge, and size. MPs
have three main shapes: spherical (beads), irregular (fragments), and
fibrous (fibers) (Wright et al., 2013). In addiiton, the shapes can be
further categorized into various groups, namely fragments (with a
length-to-width ratio ≤ 3), microfibers (length-to-width ratio > 3),
films, foam, and beads (Kooi and Koelmans, 2019). Scanning electron
microscope (SEM) has been widely used to investigate the morphologies
of MPs. Examples of SEM photographs showing a variety of shapes of
MPs are available in many articles (Liu et al., 2022a; Shao et al., 2022;
Shi et al., 2022). The shapes of AMPs include fragments, foam, films,
granules, fibers, and microbeads (Enyoh et al., 2019). Fibers and frag­
ments are the most commonly reported shapes (Cai et al., 2017; Chen
et al., 2020; Dris et al., 2016; Wang et al., 2021a; Zhang et al., 2020b).
Moreover, the surface charge quantified by the particles’ ζ-potential
is an important parameter for determining the adhesion of MPs to cells,
potentially affecting their bioavailability and subsequent toxic effects
(Silva et al., 2014). The predominant size of AMPs reported in previous
research ranged from 20 to 500 μm, whereas the smallest size ranged
from 5 to 100 μm (Wang et al., 2021a). The detection limits of Fourier
transform infrared (FTIR) spectroscopy (10–20 μm) and stereo micro­
scope (50 μm) were suggested as technical constraints for identifying
MPs (Wang et al., 2021a). Technologies and standardized methods for
detecting and identifying MPs are currently a challenge for the research.
Agreement on standardized methods among the scientific community is
lacking; therefore, data obtained from different studies are not readily
comparable (Koelmans et al., 2019).
2.2. Chemical characteristics
The chemical properties of MPs are related to their chemical
U. Vattanasit et al. Science of the Total Environment 904 (2023) 166745

Table 1 Table 2
Summary of MP characteristics. Chemical components of plastic additives.
MP Categories Description/examples References Type of Applications Chemical constituents References
characteristics plastic
additives
Physical Shapes
Pellet/bead Rounded plastic Functional additives
Granules Cylinder or a small
Heat Prevent thermal Primary stabilizer: Mixed Kattas et al.
sphere
stabilizers degradation metal salt blends, (2000)
Fiber Fibrous plastic Kooi and Koelmans
Organotin compounds,
(length-to-width (2019)
and Lead compounds
ratio > 3)
Secondary stabilizer:
Irregular or Fragmentation of
Alkyl
fragment larger plastic (length-
Organophosphites,
to-width ratio ≤ 3)
Epoxy compounds, and
Film Thin plane of flimsy Free et al. (2014)
Beta diketones
plastic
UV Prevent damage Benzotriazole, Rani et al.
Foam Sponge-like plastic
stabilizers from UV-radiation Benzophenone (2017),
typically white and
Tarafdar et al.
pliable sphere
(2022)
Charge Quantified by Silva et al. (2014)
Antioxidants Delay the overall Arylamines phenolics, Hahladakis
particles’ ζ-potential
oxidative Organophosphites et al. (2018)
(parameter for the
degradation
interaction with cells)
Flame- Protect plastics in Chlorinated paraffins, Campanale
Size MPs: 1 μm to 5 mm Frias and Nash
retardants the event of a fire PBDEs, TCEP, Antimony et al. (2020),
(2019)
oxide, Aluminum oxide, Hahladakis
AMPs: 20–500 μm Wang et al.
Zinc borate et al. (2018)
(2021a)
Plasticizers Make plastics softer PAEs, DEHA, DOA, Godwin
Chemical Plastic additives AMPs: Plasticizers Kitahara and
or more flexible ATBC, TCEP (2011),
and flame retardants Nakata (2020)
Sablani and
Environmental
Rahman
contaminants
(2007)
Organic PHE, PAHs, OC, PCBs, Hu et al. (2022),
Slip agents Reduce the surface Fatty acid amides, Fatty Bhunia et al.
pollutants BPA NSAIDs, Antunes et al.
coefficient of acid esters, Metallic (2013),
antibiotics (2013), Mato et al.
friction, provide stearates, Waxes Sablani and
(2001), Ogata
lubrication and Rahman
et al. (2009), Wang
antistatic properties (2007)
et al. (2020)
Biocides Make the plastic Arsenic compounds, Hahladakis
Elizalde-Velázquez
resistant to Organic tin compounds, et al. (2018)
et al. (2020), Li
biodegradation Triclosan
et al. (2018)
Colorants Provide a variety of Soluble dyes (bright Campanale
Toxins Microcystins Pestana et al.
colors transparent color): Azo et al. (2020),
(2021)
compounds Hahladakis
Heavy metals MPs: Cu, Pb, Cd, Zn, Munier and
Organic pigments: Cobalt et al. (2018)
Ni, AMPs: Al, Na, Ca, Bendell (2018),
(II) diacetate,
Mg, Si Holmes et al.
Phthalocyanine
(2012), Dehghani
pigments,
et al. (2017)
Anthraquinone
AMPs: airborne microplastics; PHE: phenanthrene; PAHs: polycyclic aromatic chromophores
hydrocarbons; OC: organochlorine; PCBs: polychlorinated biphenyls; BPA: Inorganic pigments:
bisphenol A; NSAIDs: nonsteroidal anti-inflammatory drugs. Cadmium/Chromium/
Lead compounds, Cobalt
acetate, TiO2
components (i.e., intrinsic polymeric raw materials, plastic additives, Reinforcing Enhance impact Clays, Silica, Glass, Andrady and
and environmental contaminants). MPs are composed of polymers made fillers strength or tensile Chalk, Talc, Asbestos, Rajapakse
strength Alumina, Rutile, Carbon (2019)
from repeating monomer units. >20 types of polymers are found in
black, Carbon
AMPs. The most common types include polyethylene terephthalate nanotubes
(PET), polyethylene (PE), polypropylene (PP), and polystyrene (PS)
(Wang et al., 2021a). In addition to the polymer, MPs could release their PBDEs: polybrominated diphenyl ethers; TCEP: tris(2-chloroethyl)phosphate;
PAEs: phthalic esters; DEHA: di(2-ethylhexyl) adipate; DOA: di-octyladipate;
components, such as endogenous plastic additives, adsorbed environ­
ATBC: acetyltributyl citrate; TCEP: tris(2 chloroethyl) phosphate.
mental pollutants (Koelmans et al., 2016), and pathogenic organisms
(Prata et al., 2020).
plastic additives, such as phthalate esters (PAEs) (Cao et al., 2022; Yan
2.2.1. Plastic additives et al., 2021), can be released from MPs into water. On the other hand,
Depending on plastic types and applications, plastic additives are the atmospheric fate of the additives in AMPs is absent. The intrinsic
chemicals intentionally added during production to improve plastic properties of different polymers and metrological conditions may be key
properties. Most additives are not chemically bound to the polymer determinants. Plastic additives, such as dyes and plasticizers have been
chain; therefore, they can migrate from plastics during their use, suggested to cause mutagenicity and carcinogenicity (Gasperi et al.,
disposal, and recycling (Hahladakis et al., 2018). A list of chemicals used 2018). The toxicity mechanisms of the 50 most common plastic addi­
as common plastic additives can be categorized as presented in Table 2. tives were determined using ToxCast™ to investigate the hazardous
Plastic additives (i.e., plasticizers and flame retardants) in road dust effects of MPs (Jeong and Choi, 2020). The results showed that neuro­
MPs have been reported, and additive profiles have been suggested as toxicity, inflammation, lipid metabolism, and cancer are potential
suitable tracers for determining their potential sources (Kitahara and mechanisms. However, the health consequences of the AMP-associated
Nakata, 2020). The type of plastic and environmental factors could additives released are mostly unknown.
affect the release of additives. Experimental studies have shown that

3
U. Vattanasit et al.
2.2.2. Organic pollutants
MPs serve as carriers of environmental pollutants. Organic pollutants
could adhere onto the MPs’ surface by adsorption due to their hydro­
phobic surface (Wright and Kelly, 2017). A study on the sorption be­
haviors of phenanthrene (PHE) and PHE derivatives on PE, PP, and PS
reported that sorption on MPs was positively correlated with hydro­
phobicity (Hu et al., 2022). The large surface area and electrostatic
charge of MPs have been shown to facilitate adsorption (Verla et al.,
2019). The increased surface area/volume ratio of MPs and their hy­
drophobicity enhance their affinity to various hydrophobic and persis­
tent compounds that can be presented to the human body. Adsorption of
some hydrophobic organic compounds, such as polycyclic aromatic
hydrocarbons (PAHs), organochlorine pesticides, polychlorinated bi­
phenyls (PCBs), and bisphenol A (BPA), onto MPs has been reported
(Antunes et al., 2013; Mato et al., 2001; Ogata et al., 2009; Wang et al.,
2020). Plastic additives and chemical contaminants adsorbed from the
environment, such as PCBs, can accumulate in fish livers due to the long-
term ingestion of MPs (Herrera et al., 2022).
Recently, the ability of hydrophilic compounds, such as pharma­
ceuticals, to be adsorbed onto plastic surfaces has been shown (Atugoda
et al., 2021). Furthermore, experimental studies on the potential for
adsorption on MPs of some environmental contaminants, such as
microcystins (Pestana et al., 2021), nonsteroidal anti-inflammatory
drugs (Elizalde-Velázquez et al., 2020), and antibiotics (Li et al.,
2018), have been documented. MPs act as vectors for pathogenic or­
ganisms (Kirstein et al., 2016) and toxins (Pestana et al., 2021).
Nevertheless, the biological characteristics of AMPs have not been re­
ported. The adsorption of hydrophobic compounds onto AMPs has yet to
be documented compared to MPs in other environmental media.
2.2.3. Heavy metals
A study of coastal ecosystems in Canada showed that plastic debris
provided a sorption site for Cu and Pb, whereas the desorption of Cd and
Zn from plastic was observed (Munier and Bendell, 2018). Moreover,
metals such as Cd, Ni, Zn, and Pb were found in plastic debris collected
from beaches and sediment flats in Southwest England (Holmes et al.,
2012). Interestingly, the adsorption of trace metals in aged beached
pellets was more significant than in virgin pellets. This finding follows a
study that reported that biofilm formed by microorganisms in an
aqueous environment could assist as a sorbent for metals (van Hull­
ebusch et al., 2003). For AMPs, a study in Iran found trace amounts of Al,
Na, Ca, Mg, and Si in MPs collected from urban street dust (Dehghani
et al., 2017). Additives of plastic polymers or adsorbed debris on MPs’
surfaces were suggested as possible sources of the metals. Most of the
studies mainly focused on the adsorption and release of the MPs com­
ponents in aquatic and terrestrial environments that link to ecological
effects on organisms. Research on the occurrence, source, fate, and toxic
effects of adsorbed contaminants on AMPs must be included. A proba­
bilistic lifetime exposure model was established to estimate MP exposure
in children and adults via the ingestion of food and inhalation
(Mohamed Nor et al., 2021). Intake rates (particles/capita/day) and
accumulation in the body tissue of 1–10 μm particles in adults until age
70 were reported. Moreover, four chemicals – benzo[a]pyrene (B[a]P),
di(2-ethylhexyl) phthalate (DEHP), PCBs, and Pb – were used as a rep­
resentation for assessing actual chemical exposure via MPs. The results
revealed that the chemical contribution of MPs to total chemical intake
is small to negligible.
3. Deposition and clearance of inhaled AMPs in the human
respiratory tract
AMPs may pose a potential risk to human health via inhalation or
dust ingestion. As an airborne particulate matter (PM), inhalation is
considered the primary route of exposure to MPs in the air. It has been
estimated that human exposure to AMPs through inhalation was (0–3.0)
× 107 items per person per year. In addition, the intake via inhalation of
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Science of the Total Environment 904 (2023) 166745
AMPs, especially in indoor air, is much higher than that via dietary
exposure (Zhang et al., 2020a). PM may be inhalable or respirable,
depending mainly on size. The aerodynamic diameter (AED) of airborne
PM depends on particle density and physical diameter (Swift, 1980).
This is an essential determinant of their deposition.
3.1. Deposition
Inhalable PM can be deposited in the upper airways after entering
the nostrils or mouth. In contrast, the respirable PM (AED < 2.5 μm) can
reach and deposit in the deep lung (Gasperi et al., 2018).
The potential of AMPs to cause adverse health effects depends
mainly on their deposition and clearance in the respiratory system
(Prata, 2018). There are primarily three mechanisms of PM deposition in
the respiratory tract: inertial impaction, gravitational sedimentation,
and Brownian diffusion (Muchão and Filho, 2010). PM with an aero­
dynamic diameter of 5–30 μm deposits on the wall of the upper respi­
ratory tract by impaction, whereas PM of 1–5 μm deposits on the small
airways by sedimentation and diffusion (Prata, 2018). The deposition of
particles of <1 μm occurs through Brownian motion (Prata, 2018). In
contrast, ultrafine PM (< 0.1 μm) or NPs, due to their thermodynamic
property, are efficiently deposited by diffusion in the entire respiratory
tract, from the upper respiratory tract to the alveoli (Geiser and Krey­
ling, 2010). A very thin tissue barrier of the lung allows NPs to trans­
locate through the pulmonary interstitium, penetrate the bloodstream,
penetrate cells, and accumulate in extra-pulmonary organs (Lehner
et al., 2019).
For plastic fibers, a study showed that airborne dust from a nylon
flocking plant was respirable and could penetrate rats’ lower respiratory
tracts after intratracheal instillation (Porter et al., 1999). The deposition
of fibers in the respiratory tract (i.e., terminal bronchioles, alveolar
ducts, and alveoli) has been found in humans occupationally exposed to
fibers (Beckett, 2000; Greim et al., 2001). It has been documented that
the efficiency of fiber deposition increases with a decrease in diameter
(Donaldson et al., 1993). In addition, diameter is a crucial determinant
of fiber breathability, whereas length influences its persistence and
toxicity (Amato-Lourenço et al., 2020).
3.2. Clearance
3.2.1. Physical processes
The physical processes include mucociliary movement and macro­
phage phagocytosis. Macrophages with PM inside gradually move to­
ward the mucociliary escalator and are generally expelled within a day
(Geiser, 2002). Macrophages act as carriers to transport engulfed MPs to
tissues and organs through the lymphatic system (Eyles et al., 2001;
Urban et al., 2000). MPs (< 10 μm) are likely to be removed by muco­
ciliary clearance (Yang et al., 2022). Accordingly, susceptible in­
dividuals with compromised clearance mechanisms may suffer from
localized biological responses, including inflammation, due to the
accumulation of MPs in the lungs (Gasperi et al., 2018). It was
mentioned that most of the fibers could be cleared from the respiratory
tract. However, the clearance mechanism involves an inflammatory
response that can lead to respiratory lesions (Prata, 2018). On the other
hand, a report showed that fibers of 15–20 μm cannot be successfully
removed from macrophages to the lungs (Wright and Kelly, 2017). Their
fiber length-to-diameter ratio could determine the uptake of fibers by
alveolar macrophages. In terms of length, long and thin fibers are
incompletely phagocytosed, are more persistent, and tend to induce
biological effects than short fibers (Donaldson et al., 1993). In addition,
a study on the interaction of nanofibres TiO2 (200 to 1000 nm) with
macrophages revealed that the fibers were engulfed incompletely
(Allegri et al., 2016).
3.2.2. Biochemical processes
Biochemical clearance processes include the digestion, dissolution,
U. Vattanasit et al.
and leaching of chemical components, either soluble in lipids or intra­
cellular and extracellular fluids. The processes occur to different extents
depending on local conditions, such as pH. Unlike physical processes,
biochemical clearance processes can occur in any lung region. Soluble
components can undergo absorption, diffusion, or binding to proteins
and can eventually be exported to blood and lymphatic circulation. The
chemicals leached from the PM and exported to the circulations may
then be metabolized and excreted out of the body. A molecular dynamics
simulation investigated the fate and toxicity of airborne NPs in the
human respiratory system (Li et al., 2022a). The results showed that the
adsorption layer of lung surfactant molecules on NPs increased the
particle size, reduced and equalized the surface hydrophobicity, and
caused negative surface charges.
Interestingly, lung surfactants’ dissolution of polypropylene NPs (PP-
NPs) and polyvinylchloride NPs caused increased bioavailability of the
polymers and their toxic additives. However, there is still no evidence of
plastic fibers’ additive leaching from the plastic polymer matrix upon
entering the human body. For the interaction of MPs and lung surfac­
tants, a group of researchers investigated the effects of polystyrene MPs
(PS-MPs) on alterations in the interfacial properties of lung surfactants
and the generation of reactive oxygen species (ROS) (Shi et al., 2022a).
They reported that the phase behavior, surface tension, and membrane
structure of lung surfactants changed in the presence of MPs. In addition,
MPs caused hydrogen peroxide production and subsequently increased
hydroxyl radicals in simulated lung surfactants.
3.3. Retention
The retention of inhaled particles in the lungs is a crucial determi­
nant of potential health risks. The retention of PM starts with wetting
and then displacement from the air to the aqueous phase of lung sur­
factants (Geiser and Kreyling, 2010). The amount of PM retained is the
difference between the amount deposited and cleared at a given time.
The retention time depends on the deposition site and the interaction
with the lung surface. A study on long-term particle retention in human
lungs showed that about 40 % of the alveolar interstitium deposits of
insoluble particles are sequestered in the interstitium, and the remaining
fraction is cleared to the ciliated airways with a half-time of about 300
days (Gregoratto et al., 2010). On the other hand, it has been estimated
that the human excretory system could eliminate up to 90 % of ingested
MPs (Smith et al., 2018).
4. Translocation of AMPs
Although most MPs found in the human respiratory tract were fiber
and fragment, a general statement that humans are exposed to only
fibrous MPs cannot be made. We could also be exposed to other shapes
of smaller MPs and NPs that could not be detected in AMPs due to
analytical limitations in characterizing and quantifying them.
4.1. Evidence from animal studies
An animal study showed that fluorescent PS microspheres (1.1 μm)
could be found in the spleens of mice 10 days after nasal instillation of
the microsphere suspended in phosphate-buffered saline (Eyles et al.,
2001). This study suggests the translocation of MPs from the respiratory
system through the lymphatic system and the bloodstream to other tis­
sues. More recently, a study investigated the translocation of PS-NPs (20
nm) across the placental barrier and fetal tissue deposition in pregnant
rats after intratracheal instillation (Fournier et al., 2020). The results
revealed that NPs were detected in the maternal lung, heart, and spleen
and observed in the placenta and fetal tissues. On the other hand, there
is evidence showing that spherical PS-MPs (0.8 μm) (Liu et al., 2022b)
and irregular PE-MPs (10–50 μm) (Lee et al., 2022) orally administered
in mice are distributed and accumulate in various tissues, including the
lungs.
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Science of the Total Environment 904 (2023) 166745
4.2. Evidence from human studies
A group of researchers conducted an experimental study to evaluate
particle translocation in healthy human volunteers exposed to gold NPs
by acute inhalation (Miller et al., 2017). Gold was detected in the blood
and urine of the volunteers following 15 min to 24 h exposure and even
after 3 months. In addition, the levels of the NPs detected were higher
for those with a 5 nm diameter than for those with a 30 nm diameter.
This study provided evidence of the possibility of NP translocation from
the respiratory system into blood circulation in healthy humans. The
available information demonstrated that MPs could be detected in the
human blood of healthy volunteers, showing the possible distribution of
MPs throughout the body and the underlying health effects. The sys­
temic toxicity of MPs could be expected, as they have been shown to be
present in the various tissues mentioned above. Inhalation is one of the
possible routes of exposure to blood MPs; however, further investigation
is needed to draw this conclusion.
4.3. Factors influencing the translocation of MPs
A fragile barrier to human lung tissue could allow NPs to penetrate
blood circulation and distribute throughout the body (Lehner et al.,
2019). For MPs, it has been suggested that only MPs smaller than 20 μm
should be able to penetrate organs; in particular, those with a size of
about 10 μm should be able to access all organs, cross cell membranes, or
even cross the blood–brain barrier through the circulatory system
(Campanale et al., 2020). The permeability of biological barriers and
membranes, the flow status of body fluids (Wang et al., 2018), and MPs
size have been shown to influence MPs distribution in the human body
(Wright and Kelly, 2017).
Until now, evidence of translocating AMPs to other human tissues
has been unclear. It has been proposed that MPs accumulated in the
lungs can migrate to lymph nodes or transport them to other tissues and
organs (Song et al., 2009). Recently, the distribution of microparticles in
human-enclosed body fluids was carried out in 104 patients receiving
different medical treatments (Guan et al., 2023). Whole blood, cere­
brospinal fluid, and two primary pathological body fluids (effusions and
cyst fluids) were collected and analyzed for microparticles, including
MPs, using a Raman microspectroscope. This study showed that density
could affect the human body’s transfer rate and the distribution of mi­
croparticles. Nine types of MPs, with sizes ranging from 19.66 to 103.27
μm, were observed in the whole blood, pelvic cyst fluid, and effusions. It
should be noted that the MPs found were fragmented or irregularly
shaped, whereas fiber-shaped, which are the most abundant types of
AMPs, were not found in the human fluid samples. Soft texture and
excellent surface tension have been suggested as related properties that
cause fiber-shaped MPs to be less capable of penetrating blood or ter­
minal tissue (Guan et al., 2023; Meng et al., 2020).
The overall findings on sources, abundance in the environment,
physical and chemical characteristics, and disposition of MPs in the
human respiratory system reviewed in this article are summarized in
Fig. 1.
5. Evidence of AMPs in the respiratory tract from human studies
5.1. AMPs in lung tissues
Mineral fibers, for example, asbestos and fibrous MPs detected in
human lungs in occupational settings, were reported a long time ago
(Prata, 2018). The first report on the existence of plastic fibers in human
lungs was documented by Pauly et al. (1998). They demonstrated a
finding of cellulosic and plastic fibers with dimensions of up to 250 μm
in 87 % of 114 lung specimens from patients undergoing lung resection
to remove a tumor, suggesting that the fibers are respirable and accu­
mulate in human lung tissue (Pauly et al., 1998). In 2021, a study in
Brazil revealed the presence of MPs in 65 % of human parenchymal
U. Vattanasit et al.
Fig. 1. Summary of the main findings on sources, abundance in the environment, physical and chemical characteristics, and disposition of MPs in the human
respiratory system.
PET: polyethylene terephthalate; PE: polyethylene; PP: polypropylene; PS: polystyrene; AMPs: airborne microplastics; MPs: microplastics; NPs: nanoplastics; ROS:
reactive oxygen species.
tissue from the distal and proximal regions obtained at autopsies
(Amato-Lourenço et al., 2021), implying that MPs are widespread in the
air. PE and PP were reported as the most frequently determined poly­
mers in that study. The size of all polymeric particles was smaller than
5.5 μm, and the fibers ranged from 8.12 to 16.8 μm (Amato-Lourenço
et al., 2021). It should be noted that small MPs with a lower density,
such as PE, are more likely to reach deep airways (Carvalho et al., 2011).
After that, a study collected lung tissue samples from living patients
following surgical resection for cancer or lung volume reduction surgery
to determine MPs. Using μFTIR spectroscopy (size limitation of 3 μm),
MPs were detected in 11 out of 13 lung tissue samples obtained from 11
patients. Further characterization of the MPs found 12 polymer types.
The most abundant polymers were PP (23 %), PET (18 %), and resin (15
%). Additionally, the highest MP content was detected in the lower re­
gion (3.12 ± 1.30 MP/g), followed by the upper region (0.80 ± 0.96
MP/g) and the middle/lingular region (0.41 ± 0.37 MP/g) (Jenner
et al., 2022). Additionally, the presence of microfibers was investigated
in patients with ground glass nodules (GGNs) (Chen et al., 2022). The
results showed that 36.92 % of the total microfibers detected were MPs.
Microfibers were detected at a higher rate in the GGNs compared to the
normal 307 lung tissues. The correlation between the presence of MPs in
human lung tissues and GGN formation suggests future research on the
link between AMP exposure and lung injury. In addition, the results
revealed that the abundance of microfibers increased with the age of the
patients. This observation indicated the accumulation of microfibers in
lung tissues, possibly over the human lifetime. Accumulated MPs could
serve as a source of leaching hazardous chemicals, such as additives,
impurities, and unreacted monomers, and persistent oxidative stress and
6
Science of the Total Environment 904 (2023) 166745
inflammation could result in long-term effects.
5.2. AMPs in respiratory secretions
Apart from lung tissues, studies on MPs in the respiratory tract using
other biological samples have been reported. Huang et al. (2022)
determined MPs of 20–500 μm in the sputum of patients suffering from
different respiratory diseases. They found that MPs were ubiquitous in
all sputum, and that the median size was 75.43 μm. Interestingly, they
also found that smokers inhaled more types of MPs compared with non-
smokers. A correlation between MP exposure and personal smoking
habits was documented. In addition, Baeza-Martínez et al. (2022)
collected bronchoalveolar lavage fluid (BALF) from patients undergoing
bronchoscopy to investigate MPs in the lower human airways. They
reported that microfibers were the most abundant form. The average
size of the microfibers was 1.73 ± 0.15 mm, and the longest dimension
(9.96 mm) was isolated from a patient with pulmonary parenchymal
pathology. They also found statistically significant differences in the
concentrations of MPs in the BALF according to smoking habits.
Recently, Qiu et al. (2023) reported evidence on the presence of MPs in
BALF of 18 participants with respiratory diseases who underwent
fiberoptic bronchoscopy. The diseases included lung cancer (88.9 %)
and others (11.1 %) (i.e., bronchial mucositis and interstitial fibrosis).
They found 13 types of polymers in 18 BALF samples. The most abun­
dant polymer type was PE (86.1 %), followed by PET (7.5 %) and PP
(1.9 %); the size of MPs observed ranged from 20 to 80 μm. This study
excluded smokers to mainly focus on MPs in the lower airway from a
nonsmoking pathway.
U. Vattanasit et al. Science of the Total Environment 904 (2023) 166745

The studies mentioned above were conducted on patients. A study on
exposure to MPs in the upper respiratory tract conducted in healthy
volunteers has also been reported (Jiang et al., 2022). Sputum and nasal
lavage fluid were collected from office staffs from a local unit in China
and couriers operating within a radius of 3 km from the office. Partici­
pants with respiratory diseases were excluded. The results obtained from
polarized light microscopy showed that MPs in the sputum and nasal
lavage of couriers and office staff were mainly fibrous. The predominant
polymer types included polycarbonate (PC), PVC, polyamide (PA), and
PE. Cigarette smoking has been considered a source of AMPs and has
been pointed out in recent publications on human exposure to AMPs
(Baeza-Martínez et al., 2022; Huang et al., 2022). Recently, a study was
conducted to investigate the relationship between smoking and inhala­
tion of MPs in BALF of smokers and nonsmokers patients undergoing
bronchoscopy (Lu et al., 2023). The results revealed that concentrations
of total MPs, polyurethane (PU), and silicone were higher in smokers
than in non-smokers. Moreover, a system that simulates active smoking
via cigarette filters showed higher levels of the total MPs, PU, and sili­
cone in the smoke than the control. The occurrence and types of MPs
found in the smoke from the simulated system were consistent with
those found in the BALF of the patients. Available human studies on MPs
in the respiratory tract are presented in Table 3.
The available data presented in Table 3 demonstrate that MPs
detected in the human respiratory tract were in accordance with the MPs
most frequently found in the air in terms of shape, size, and polymer
types. The predominant MPs found in the human respiratory tract were
fibrous, with the same size range of AMPs reported in previous studies (i.
e., 20–500 μm) (Wang et al., 2021a). Existences of some longer fibers
were also observed (Baeza-Martínez et al., 2022; Jenner et al., 2022).
The most common polymer types found in AMPs, such as PET, PE, PP,
and PS (Wang et al., 2021a), were detected. Synthetic textiles have been
suggested as the primary source of AMPs (Blackburn and Green, 2022).
In addition, cigarette smoking has been suggested as a source of inhaled
AMPs. Therefore, we are now possibly exposed to this pollutant daily. In
addition to human studies, the occurrence of AMPs in the respiratory
tracts of domestic (Li et al., 2023) and wild animals (Tokunaga et al.,
2023) has also been documented recently. This evidence also suggests
exposure to the AMPs of other living organisms in the environment.
At the early stage of the research timeline shown in Table 3, lung
tissues from patients suffering from respiratory diseases were used to
determine the occurrence of MPs in the human respiratory system (Chen
et al., 2022; Jenner et al., 2022; Pauly et al., 1998). The sample
collection in these studies was primarily aimed at medical diagnosis. The
diseases of the subjects might affect the deposition, accumulation, and
clearance of MPs in the lungs. Thus, the results might not reflect the
occurrence in healthy people. The results on the occurrence of MPs in
the small tissue samples collected did not represent the whole lungs
since the inhaled MPs might not distribute throughout all the lung re­
gions. Therefore, the data obtained provided evidence of deposition in
the lung parenchyma, but they could not be used to estimate the internal
dose in the exposure assessment. However, the relationship between MP
exposure and diseases could not be established due to the lack of evi­
dence on the environmental exposure of MPs in these patients.
The use of biological samples obtained from respiratory secre­
tions—sputum, nasal lavage fluid, and BALF—has been introduced in
recent studies (Baeza-Martínez et al., 2022; Huang et al., 2022; Jiang
et al., 2022; Lu et al., 2023; Qiu et al., 2023). BALF might be a better
representative sample for the lower respiratory tract compared to lung

Table 3
Human studies on MPs in respiratory tract.
Subjects n Smoking Type of sample Site of MPs’ characteristics References
status of the deposition
Polymer typesa Shape Size (μM)
subjects

Patients with lung 114 human N/A Malignant and The lungs N/A Cellulosic and Up to 250 Pauly et al.
tumor lung adjacent non- plastic fibers (1998)
specimens neoplastic lung
tissues
N/A (Autopsies) 20 adult Non-smoker Parenchymal tissue Distal and PE and PP Polymeric <5.5 Amato-
individuals proximal lung particles, fibers 8.12–16.8 Lourenço
regions et al. (2021)
Patients with lung 11 patients N/A Peripheral lung Upper, middle PP, PET, resin Fiber, fragment, Length Jenner et al.
tumor tissues (lingular) or film 12–2475 (2022)
lower lobe Width 4–88
Patients with ground 50 lung cancer Smoker 20 Lung specimens The lungs Cotton, PES, Microfiber, non- Length 1.45 Chen et al.
glass nodules patients % with GGNs rayon, acrylic, fibrous resin and ± 0.98 (2022)
(GGNs) PET, phenoxy chipboard Width 35.74
resin ± 21.09
Patients with 22 patients Smoker Sputum Upper airways PU, PES, N/A 20–500 Huang et al.
respiratory diseases 72.7 % chlorinated PE (2022)
Patients undergoing a 44 patients Active BALF Lower airways Rayon, PES, Microfiber Up to Baeza-
bronchoscopy smoker 52.3 cellulose 9.96 mm Martínez
% (1.73 ± et al. (2022)
Former 0.15 mm)
smoker 34.1
%
Indoor (office staffs) 8 office staffs N/A Sputum, nasal Upper airways PVC, PA, PC, PE Fiber N/A Jiang et al.
and outdoor 8 couriers lavage fluid (2022)
workers (couriers)
Patients undergoing a 18 patients Never- BALF Lower airways PE, PET, PP Fiber, irregular 20–80 μm Qiu et al.
fiberoptic (Lung cancer smokerb (median 34.0 (2023)
bronchoscopy 88.9 %) μm)
Smokers and 32 subjects Smokers BALF Lower airways Smoker: PU, PE, Irregular 20–100 μm Lu et al.
nonsmokers 53.1 % silicone (2023)
patients undergoing Non-smoker Non-smoker PET,
a bronchoscopy 46.9 % PE, POM

N/A: not available; PE: polyethylene; PP: polypropylene; PET: polyethylene terephthalate; GGNs: ground glass nodules; PES: polyester; PU: Polyurethane; BALF:
bronchoalveolar lavage fluid; PVC: polyvinylchloride; PA: polyamide; PC: polycarbonate; POM: polyoxymethylene.
a
The most frequently determined types.
b
Adults who have never smoked or have smoked <100 cigarettes in their lifetimes (Centers for Disease Control and Prevention, 2023).

7
U. Vattanasit et al.
tissues. However, it might not be applicable to subjects without respi­
ratory symptoms. Compared to BALF, sputum and nasal lavage fluid are
less invasive and more appropriate for use in healthy volunteers. How­
ever, they are appropriate samples for representing deposition in the
upper airways not the lower airways. To date, studies on the occurrence
of MPs are extremely limited, and most have been conducted on small
groups of subjects. Future research is needed, and the relationship be­
tween the occurrence of MPs in the respiratory tract and data on AMPs
from air monitoring is essential for exposure assessment.
6. Experimental studies on the toxic effects of MPs in vitro and in
vivo
The toxic effects of MPs have been extensively investigated in
various human cell types in vitro and organ systems in vivo. Among these
studies, toxic effects in the gastrointestinal tract have received the most
attention since ingestion of MPs via food and drink was considered the
main route of exposure to MPs. Until now, few studies have investigated
the toxic effects of MPs on the respiratory system. Published articles
related to MPs were searched on PubMed on April 19, 2023. The key­
words used to find the literature were “microplastics” and “human.”
There were 2256 results found, and 24.5 % of these articles were review
and systematic review articles. For research articles, there were 262
articles on toxicological studies on MPs/NPs in vitro (168), in vivo (84),
or both (10) models representing human or mammalian systems. Among
the experimental models, only 22 in vitro and 11 in vivo studies were
conducted to investigate the effects of MPs/NPs on the respiratory sys­
tem. Toxicological studies on the adverse effects of MPs evaluated in
vitro and in vivo, representing the human respiratory system, are sum­
marized in Tables 4 and 5, respectively.
6.1. In vitro studies
Human lung epithelial cells are in vitro models that have generally
been used to investigate the toxic effects of MPs on the respiratory
system. The cell lines include the adenocarcinoma epithelial cell line
(A549), human bronchial epithelial cells (BEAS-2B), human pulmonary
alveolar epithelial cells (HPAEpiC), and primary human nasal epithelial
cells (HNEpCs). The A549 cell line is originally from adenocarcinoma
human alveolar basal epithelial cells. As shown in Table 4, it was often
used as a representative model of the human alveolar epithelium in most
studies because it is stable, has rapid growth, has easy cultivation, and
has structure similar to normal human lung epithelial cells. In addition,
human airway organoids (three-dimensional [3D] in vitro model) (van
Dijk et al., 2021; Winkler et al., 2022) and molecular dynamics simu­
lations (Li et al., 2022a) have also been applied.
Spherical PS polymer was the most common MP used in most studies.
However, AMPs in the natural environment are of different shapes and
sizes due to the degradation of natural plastic into small fragments.
Fibrous MPs are the most prevalent in the air and human respiratory
tract; however, they are not widely used in the toxicological assessment
of AMPs. As shown in Table 4, only two studies conducted the experi­
ment using fibrous MPs (van Dijk et al., 2021; Winkler et al., 2022), the
most common shape found in the air. Accordingly, the results obtained
from studies using spherical PS-MPs might not represent the mecha­
nisms of action or the effects caused by inhaled AMPs in real situations.
Further studies on the effects of fibrous MPs are required. Fibrous MPs
produced as reference materials are a good choice to support repro­
ducible experiments. Alternatively, environmental fibrous MPs collected
from indoor air or intentionally made from sources of concern, such as
fabrics, are interesting.
PS is one of the most abundant components of AMPs (i.e., PET, PE,
PP, and PS) (Wang et al., 2021a). In addition, PS particles are
commercially available in various size ranges and fluorescent-labeled
types, which helps track living cells (Varela et al., 2012). Accordingly,
PS has been the polymer of choice for most toxicological studies on the
8
Science of the Total Environment 904 (2023) 166745
toxic effects of MPs. Other polymer types employed in the studies pre­
sented in Tables 4 and 5 include PE (Gautam et al., 2022; Li et al., 2022a;
Winkler et al., 2022), PP (Danso et al., 2022; Li et al., 2022a; Wu et al.,
2023), PET (Li et al., 2022a; Zhang et al., 2022a), PVC (Danso et al.,
2022; Li et al., 2022a), polyester (PES) (van Dijk et al., 2021), poly­
methylmethacrylate (PMMA) (da Silva Brito et al., 2023), and phenol-
formaldehyde (PF) resins (Zhu et al., 2020). Interestingly, one study
used irregular MPs as a polymer mixture derived from waste plastics
(Bengalli et al., 2022). This study is an example of a toxicological
assessment representing exposure to various polymer types in real-life
situations. The disadvantages of using environmental MPs include, for
example, the interferences of unidentified complex chemical compo­
nents, reproducibility of toxicological experiments, and readily
comparative results with other studies. Some studies have also investi­
gated the effects by applying special conditions, including co-exposure
with plasticizers (Shi et al., 2021), surface charges and stretch from
simulated breathing (Roshanzadeh et al., 2020), surface modifications
(Shi et al., 2022b), simulated photo–aging, and environmental free
radicals (Zhu et al., 2020). Moreover, viral infection facilitated by
exposure to NPs was also examined (Wang et al., 2023).
It has been reported that PS-MPs of 1 and 10 μm diameter caused
dual effects of inhibition of cell proliferation and significant changes in
the cell morphology of A549 cells observed as loss of cell-to-cell adhe­
sion (Goodman et al., 2021). The authors suggested that MPs could
block the cells at G1/S boundary during the cell cycle and subsequently
lead to the reduction of cell proliferation. In addition, inflammatory
proteins induced by the mechanical signals of MPs might cause a loss of
cell-to-cell contact. This finding at the cellular level possibly links to
alveolar epithelial damage observed at the organism level in vivo (Fan
et al., 2022; Li et al., 2022b). A study on the effects of PS-NPs in BEAS-2B
and HPAEpiC cells reported oxidative stress and inflammatory responses
that could lead to cell death and epithelial barrier destruction (Yang
et al., 2021b). After prolonged exposure, subsequent tissue damage and
lung disease are possible health outcomes. PS-MPs also showed cyto­
toxic and inflammatory effects by inducing ROS formation in BEAS-2B
cells (Dong et al., 2020). Apart from pristine or prepared MPs that are
commercially available, a mixture of MPs (<50 μm) prepared from a
plastic waste of various origins was tested for cytotoxic, inflammatory,
and genotoxic responses in A549 cells (Bengalli et al., 2022). Similar
results to commercial or lab-produced MPs were observed. The waste-
derived MPs induced inflammation and genotoxicity at high concen­
trations (100 μg/mL) and prolonged exposure time (48 h) due to the
surface interactions of the cells and MPs and the uptake of the smaller
particles. It should be noted that only a few MPs (1–2 μm) were observed
inside the cells, suggesting that their chemical components might mainly
be responsible for the effects. Additionally, this study was carried out
using relatively larger particles compared to other studies, and the size
of MPs was not inhalable. Thus, MPs might not be suitable representa­
tives for investigating the effects of AMPs.
A group of researchers investigated the epithelial-to-mesenchymal
transition (EMT) induced by PS-NPs of different sizes and surface
charges in A549 cells (Halimu et al., 2022). EMT is a complex cellular
process in which epithelial cells depolarize, lose their cell–cell contacts,
and gain an elongated, fibroblast-like morphology. This is the key step in
lung fibrosis. Halimu et al. (2022) reported that PS-NPs could induce
EMT in the respiratory epithelium system via the activation of NOX4-
mediated mitochondrial dysfunction and endoplasmic reticulum (ER)
stress. These processes are related to particle size and surface charge. PS-
NP induced the most severe effects with a smaller size (20 nm) and
positive surface charge (amino functionalized PS-NPs). Additionally,
mitochondrial dysfunction indicated by membrane potential changes,
and impaired cellular energy metabolism was observed in PS-NP-treated
cells. This finding provides evidence that NPs can disturb mitochondrial
functions. Another study investigated mitochondrial damage and
metabolic pathways in two types of cells: normal human lung (BEAS-2B)
cells and hepatic (L02) cells induced by PS-NPs (80 nm) (Lin et al.,
U. Vattanasit et al. Science of the Total Environment 904 (2023) 166745

Table 4
Toxic effects of NPs and MPs in respiratory models in vitro.
Cell types Polymer types/special Shape Size Toxic effects/major findings References
conditions

A549 PS Sphere 70, 200, 500 nm • All NPs could enter the cells by phagocytosis Zhang et al.
• The smallest size (70 nm) could also be (2022b)
internalized by clathrin- and caveolae-mediated
endocytosis.
A549 PS N/A 25 and 70 nm • Cell cycle S phase arrest Xu et al. (2019)
• Up-regulation of pro-inflammatory gene TNF-
α-associated apoptosis pathway
A549 PS N/A 20 and 50 nm (PS20 and • Mitochondrial dysfunction and endoplasmic Halimu et al.
PS50) reticulum (ER) stress: related to particle size (2022)
Amino functionalized PS 20 and charge (PS20+ > PS20 > PS50)
nm (positively charged; • PS-NPs induced epithelial-to-mesenchymal
PS20+) transition (EMT) with the activation of NOX4
A549 PS Sphere 1 and 10 μm • Reduction in cell proliferation Goodman et al.
• Changes in cell morphology (2021)
A549 PS N/A PS 50, 200, 1000 nm • The uptake depends on polymer sizes but not da Silva Brito
Amine-modified polymer types et al. (2023)
PS (PS-NH2) 55 nm • Increased intracellular thiol content suggested a
PMMA N/A 70, 400, 1100 nm role of oxidative stress
• PS-NH2 showed the most dramatic effects
A549 PS Sphere 1 and 5 μm • Photoaging altered the morphology and El Hayek et al.
Pristine vs UV irradiated PS increased polar groups on the surface (2023)
• Photoaging enhanced toxicity of PS-MPs: S and
G2 cell cycle accumulation, changes in cell
morphology, reduced monolayer barrier
integrity
A549 PS Sphere 117.23 ± 1.96 nm • Absorption of PAEs (DEHP > DBP) onto NPs Shi et al. (2021)
Co-exposure with PAEs reduced bioavailability and toxicity
(DBP and DEHP) • NPs dominated toxicity at high concentration
• Oxidative stress and inflammatory reactions are
underlying mechanisms
A549 Amine-modified (+) vs Sphere 50 nm • Higher cytotoxicity and activation of apoptotic Roshanzadeh
carboxylate-modified (− ) signaling pathways in cells treated with et al. (2020)
PS-NPs positively charged PS-NPs
With cyclic stretches
representing breathing
exposures
A549 Amino functionalized PS Sphere 80 nm and 2 μm • Cytotoxicity and genotoxicity (PS-NPs > PS- Shi et al. (2022b)
(PS-NH2) MPs)
and carboxy functionalized • Cell viability inhibitory ability, and induction of
PS micronuclei (functionalized PS-NPs >
(PS-COOH) unmodified PS-NPs)
Influenza A virus PS Sphere 85.98 ± 0.62 nm • IAV could be enriched on PS and entered cells Wang et al.
(IAV)-infected through endocytosis. (2023)
A549 cells • PS promote IAV infection.
A549 PE Sphere 30.5 ± 10.5 and 6.2 ± 2.0 μm • Small reduction of cell viability at high Gautam et al.
concentration (1000 μg/mL) (2022)
• Induction of nitric oxide (NO)
A549 PP Irregular 0.66 ± 0.27 μm • Inflammation via p38-mediated NF-κB signaling Woo et al.
fragments and pathway resulting from mitochondrial damage (2023)
sphere
A549 PET Sphere 122–221 nm and 142–296 nm • Decrease of mitochondrial membrane potential Zhang et al.
(fluorescent PET) consistent with the increase of ROS (2022a)
A549 PF resin as commercial N/A Average diameter of 4 PF • Increase of the cellular ROS Zhu et al. (2020)
powder Photoaged vs non- powder 12.13, 14.61, 14.20, • Reduction in cell viability
irradiated PF-MPs 13.52 and 12.61 μm
A549 Polymer mixture (mainly PE Irregular <50 μm • Cytoxicity at high concentration (100 μg/mL) Bengalli et al.
and PP) derived from waste fragments • Pro-inflammatory response (2022)
plastics • Genotoxicity (increase of micronucleus and
nuclear buds)
BEAS-2B PS Sphere 80 nm • Overproduction of mitochondrial ROS Lin et al. (2022)
• Alterations in the mitochondrial membrane
potential
• Suppression of mitochondrial respiration
BEAS-2B PS Sphere 1.72 ± 0.26 μm (1.67–2.17 • Cytotoxic and inflammatory effects by inducing Dong et al.
μm) ROS formation (2020)
BEAS-2B PS positively charged (NH2- N/A N/A • NH2-PS-MPs showed cytotoxicity and increased Jeon et al.
PS-MPs) ROS generation (2023)
• Deformity of the nucleus with autophagy
induction.
BEAS-2B and PS Sphere 40 nm • Reduction in cell viability Yang et al.
HPAEpiC • Redox imbalance (2021b)
(alveolar • Induction of inflammatory responses
epithelial cells) • Cell death and epithelial barrier destruction
(continued on next page)

9
U. Vattanasit et al.
Table 4 (continued )
Cell types Polymer types/special Shape Size
conditions
HNEpCs (nasal PS Sphere 50 and 500 nm
epithelial cells)
Human airway PE Fiber Length 700 ± 400 μm
organoids Width 10 ± 5 μm
Human lung PE, Nylon Fiber PE: 15 × 52 μm
organoids Nylon: 12 × 31 μm
Molecular dynamics PS, PVC, PE, PP, PET Sphere 5 and 10 nm
simulation
N/A: not available; PS: polystyrene; NPs: nanoplastics; TNFα: tumor necrosis factor-alpha; EMT: mesenchymal transition; PMMA: polymethylmethacrylate; PAEs:
phthalate esters; DBPs: di-n-butyl phthalate; DEHP: di(2-ethylhexyl)phthalate; IAV: influenza A virus; PE: polyethylene; PP: polypropylene; PET: polyethylene tere­
phthalate; ROS: reactive oxygen species; PF: phenol-formaldehyde resins; PVC: polyvinylchloride; LS: lung surfactant.
2022). Overproduction of mitochondrial ROS, mitochondrial membrane
potential alterations, and mitochondrial respiration suppression indi­
cated mitochondrial damage in the cells caused by NP exposure.
Regarding metabolic function, BEAS-2B cells were less susceptible to
NPs than L02 cells, suggesting a difference between the two cell types. In
addition, PP-NPs also cause mitochondrial dysfunction, indicated by
mitochondrial depolarization and decreased adenosine triphosphate
(ATP) levels in A549 cells (Woo et al., 2023). Consequently, stimulation
led to cytotoxicity, ROS production, increased inflammatory cytokines,
and cell death in A549 cells treated with PP-NPs.
Gautam et al. (2022) measured cell viability, intracellular ROS, nitric
oxide (NO), and cytokines in six different cell lines treated with poly­
ethylene MPs (PE-MPs). They found that PE-MPs did not cause the same
effects in all cell types, suggesting no generalized effects for all tissues or
organs for a specific type of MPs. Interestingly, a group of researchers
assessed the effect of PS-MPs on respiratory pathogen infection using
influenza A virus (IAV)-infected A549 cells (Wang et al., 2023). The PS-
MPs had negative charges with a diameter of 85.98 ± 0.62 nm in water.
Following exposure, analysis by bioluminescence imaging revealed an
attachment of IAV to PS-MPs, facilitating the internalization of PS-MPs
into the cells via endocytosis. Additionally, PS-MPs significantly sup­
pressed the production of interferon type I and its downstream IFITM3
through a cascade mechanism, eventually promoting IAV infection.
Moreover, human airway organoids were used as a 3D in vitro model
representing a normal lung to examine the toxic effects of microplastic
fibers (Winkler et al., 2022). Lung injury was observed from a significant
reduction in SCGB1A1 gene expression. Furthermore, the presence of
the fibers during the repair phase of a damaged lung epithelium suggests
inclusion in the repaired tissue, which might lead to long-term health
consequences.
As shown in Table 4, the induction of ROS (Annangi et al., 2023;
Gautam et al., 2022; Jeon et al., 2023; Zhang et al., 2022a; Zhu et al.,
2020) and inflammatory responses are major endpoints determined in
most of the studies in vitro (Bengalli et al., 2022; da Silva Brito et al.,
2023; Dong et al., 2020; Shi et al., 2021; Winkler et al., 2022; Woo et al.,
2023; Xu et al., 2019; Yang et al., 2021b). Changes in cell proliferation
and morphology (El Hayek et al., 2023; Goodman et al., 2021), induc­
tion of micronuclei/genotoxicity (Bengalli et al., 2022; Shi et al.,
2022b), mitochondrial damage (Halimu et al., 2022; Lin et al., 2022;
Woo et al., 2023), cytotoxicity (Shi et al., 2022b), and apoptosis
(Roshanzadeh et al., 2020; Xu et al., 2019) were also reported. Evidence
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Science of the Total Environment 904 (2023) 166745
Toxic effects/major findings References
• Induction of intracellular ROS Annangi et al.
• Loss of mitochondrial membrane potential (2023)
• Modulation of the autophagy pathway
• Inclusion of non-biodegradable fibers in the Winkler et al.
repaired tissue (2022)
• Reduction of SCGB1A1 gene expression
normally associated to airway inflammatory
diseases
• PE and nylon microfiber inhibited growth of the van Dijk et al.
lung organoids. (2021)
• Nylon caused more profound effects
• The inhibition was mediated by components
leaking from nylon
• Lung surfactant (LS) molecule increased the Li et al. (2022a)
particle size, reduced surface hydrophobicity,
and provided negative surface charges.
• Dissolution of PP and PVC by LS enhanced their
bioavailability.
• NPs disturbed the LS structure and fluidity, and
caused collapse of the LS film.
from in vivo studies presented in Table 5 supports the in vitro studies that
oxidative stress and inflammation are the primary outcomes of AMP
exposure, which should be a concern. Chronic inflammation and an
increased risk of neoplasia are potential health consequences of AMPs.
6.2. In vivo studies
To date, research on the effects of MP on the respiratory system in
vivo is limited. A group of researchers conducted a sub-acute inhalation
toxicity study for PS-MPs and PS-NPs in Sprague–Dawley rats using a
whole-body inhalation system (Lim et al., 2021). After 14 days of
exposure to PS-MPs and PS-NPs via inhalation, dose-dependent changes
in physiological, serum biochemical, hematological, and respiratory
functions were not observed in the rats. However, alterations at the
molecular level expressed by up-regulation of inflammatory gene
expression, that is, transforming growth factor beta (TGF-β) and tumor
necrosis factor-alpha (TNF-α), were noticed. In addition, a study in mice
treated with ultraviolet fluorescing polymer microspheres (1–5 μm)
showed that MPs induced inflammatory responses characterized by in­
flammatory cell infiltration, bronchoalveolar macrophage aggregation,
increased TNF-α level in BALF, and increased plasma immunoglobulin G
(IgG1) production (Lu et al., 2021). MPs also increased mucus produc­
tion and inflammatory cells, especially macrophage aggregation, in mice
with asthma. The molecular mechanism of MP-induced toxic effects was
further investigated in the asthma model using bioinformatics analysis.
The results showed that stimulation of TNF and IgG and subsequent
activation of transmembrane B-cell antigens resulted in the modulation
of cellular stress and programmed cell death. Woo et al. (2023) evalu­
ated lung injury in mice exposed to PP-NPs. They found infiltration of
inflammatory cells into the perivascular/parenchymal space, alveolar
epithelial hyperplasia, and foamy macrophage aggregates. The overall
results suggest that PP-NPs cause mitochondrial damage, which could
lead to lung inflammation via the p38 phosphorylation-mediated nu­
clear factor-kappaB (NF-κB) pathway.
Recently, a study examined pulmonary toxicity responses to three
types of MPs–PS, PP, and PVC–in three strains of mice (Danso et al.,
2022). Lung inflammatory responses were characterized by inflamma­
tory cell changes in mice instilled with PS-MPs and PP-MPs. In contrast,
no effect was found in mice treated with PVC-MPs. This evidence sug­
gests that exposure to different types of polymers could lead to different
outcomes. Accordingly, polymer type should be considered a factor of
U. Vattanasit et al. Science of the Total Environment 904 (2023) 166745

Table 5
Toxic effects of NPs and MPs in respiratory models in vivo.
Animal model Polymer type Shape Size Exposure method Toxic effects/major findings References

Sprague PS Sphere 100 nm Inhalation (3 days) • Deposition of PS-MPs (100 nm and 1 μm) within lung Fan et al.
Dawley rats 500 nm, tissues (2022)
1 μm
2.5 μm
100 nm Intratracheal instillation • Alveolar destruction
(every two days for 14 • Up-regulation of pro-inflammatory cytokines (IL-6,
days) TNF-α and IL-1β)
• Altered expression of long non-coding RNA and cir­
cular RNA
Sprague- PS Sphere 0.1 μm Modified OECD TG412 • Increased expression of inflammatory proteins (TGF-β Lim et al.
Dawley rats inhalation exposure and TNF-α) in the lung tissue (2021)
14 days
Pregnant PS Sphere 20 nm Intratracheal instillation • Reduced fetal and placental weights Fournier
Sprague- on gestational day (GD) • PS-NPs observed in the maternal lung, heart, and et al. (2020)
Dawley rats 19 spleen
• Maternal lung-to-fetal tissue nanoparticle trans­
location (liver, lungs, heart, kidney, and brain)
C57BL/6 mice PS Sphere 5 μm Intratracheal • Activation of pulmonary fibrosis via the Wnt/ Li et al.
administration 3 times per β-catenin signaling pathway. (2022b)
week for 3 weeks • Induction of oxidative stress and alveolar epithelial
damage
• Treatment with melatonin reduced oxidative stress
and mitigated pulmonary fibrosis.
C57BL/6 mice PS N/A 1–5 μm Intranasal instillation • Inflammatory responses Cao et al.
10–20 once a day for 3 weeks • Apoptosis (2023)
μm • Collagen deposition
• Up-regulation of TLR2 mRNA expression
C57BL/6 mice Cationic (amine-PS- Sphere 100 nm Intratracheal • Infiltration of inflammatory cells in lung tissues Wu et al.
NPs; APS-NPs) administration 3 times/ • Early inflammatory responses in lung tissue by (2023)
week for 1 week activating the NLRP3/capase-1/IL-1β signaling
pathway.
• Treatment with N-acetyl cysteine (NAC) could
prevent lung toxicity caused by APS-NPs
C57BL/6, PS, PP, and PVC N/A N/A Intratracheal • PS- and PP-instilled mice: inflammatory cell Danso et al.
BALB/c, and administration 14 days infiltration, increase of inflammatory cytokines (IL-1β (2022)
ICR mice and IL-6) and proteins in NLRP3 inflammasome
components
• PVC-instilled mice: no effect
ICR mice PP Irregular 0.66 ± Intratracheal instillation 5 • Increase of ROS, inflammatory cytokines, and Woo et al.
fragment and 0.27 μm times/week for 4 weeks chemokines (2023)
sphere • Lung injuries, including the infiltration of
inflammatory cells, alveolar epithelial hyperplasia,
and foamy macrophage aggregates.
Normal and Thermoset amino Sphere 1–5 μm Nasal drip every 3 days for • Normal mice: inflammatory cell infiltration, increased Lu et al.
asthmatic formaldehyde 24 days macrophage aggregation and TNF-α level in (2021)
mice polymer bronchoalveolar, increased plasma IgG1
• Asthmatic mice: increased mucus production and
inflammatory cell infiltration, cellular stress and
programmed cell death
Pregnant PE Sphere 10–45 Intratracheal instillation • Dams: PE-MPs were detected in lung, liver, and Han et al.
female mice μm intestine. (2021)
• Neonates (postnatal day 7): PE-MPs were detected only
in kidneys of the high administration group.

N/A: not available; PS: polystyrene; MPs: microplastics; TNFα: tumor necrosis factor-alpha; IL: interleukin; OECD: Organisation for Economic Co-operation and
Development; TGF- β: transforming growth factor β; NPs: nanoplastics; TLR2: toll-like receptor 2; APS-NPs: amine polystyrene nanoplastics; NLRP3: nucleotide-binding
domain, leucine-rich–containing family, pyrin domain–containing-3; NAC: N-acetyl cysteine; PP: polypropylene; PVC: polyvinylchloride; ROS: reactive oxygen spe­
cies; IgG1: PE: polyethylene.

concern in toxicological assessment. The chemical characteristics of MPs
may vary in different polymer types. The results from toxicity testing
using only a single type of polymer, such as PS, which has been widely
used as a surrogate for MPs in most studies, might be over- or under­
estimated. In addition, the effects of PS-MPs on the development of lung
injury have been investigated via the intranasal instillation of particles
in mice (Cao et al., 2023). The results showed that exposure to PS-MPs
activated Toll-like receptors (TLRs) in mouse lungs. NF-κB participated
in the induction of inflammation, oxidative stress, and apoptosis in
mouse lungs and consequently stimulated the process of fibrosis. It
should be noted that two different size ranges of PS-MPs were employed
in the experiments (i.e., 1–5 μm and 10–20 μm), and the smaller MPs
caused apparent damage. Another study on the effects of PS-MP
inhalation in mice reported that PS-MPs induced pulmonary fibrosis (Li
et al., 2022b). Additionally, the suppression of superoxide dismutase
(SOD) and glutathione peroxidase (GSH-Px) indicated that inhalation of
PS-MPs triggered oxidative stress in mice.
Possible mechanisms of AMP-induced toxic effects include the acti­
vation of pathways in response to the particle by itself and its associated
constituents. The chemical constituents (i.e., unreacted monomers and
plastic additives), which vary in different polymer types, should be
considered essential determinants of MP-induced toxicity. However,
data on chemical release from the particles in biological systems have
yet to be well established, especially in the cells representing the res­
piratory system. The effects of MPs, determined by their physical and
chemical characteristics, are described below.

11
U. Vattanasit et al.
6.3. Toxic effects of MPs related to their physical characteristics: shape,
size, and surface charges
Physical properties have been proposed as parameters that should be
considered in toxicological studies on MPs (Ramsperger et al., 2022). As
shown in Tables 4 and 5, monodisperse spherical PS-MPs have been
widely used to investigate particle uptake and toxicity. MPs of the same
size and shape should exhibit comparable outcomes. Nevertheless, a
group of researchers documented that MPs with the same polymer type
(PS) and size (3 μm) obtained from two commercial sources could lead to
significant differences in particle–cell interactions and cytotoxicity
(Ramsperger et al., 2022). MPs with a lower ζ-potential and higher
monomer content showed more particle–cell interactions and conse­
quently decreased cell metabolism and proliferation.
A study in zebrafish exposed to comparable sizes of different shapes
of MPs showed shape-dependent accumulation of MPs in the gut, with
the order of fibers > fragments > beads. Moreover, MP fibers cause more
severe intestinal toxicity than those in fragment and bead forms (Qiao
et al., 2019). However, the shape-dependent effects in different exper­
iments may vary depending on the size and concentration of the MPs
tested (Schwarzer et al., 2022). Weber et al. (2022) reported the in­
duction of cytokine secretion by NPs in primary human monocytes and
monocyte-derived dendritic cells. Cytokine secretion varies according to
NPs of different shapes and polymer types. Irregular polystyrene NPs
showed higher pro-inflammatory responses compared to spherical NPs.
Chemical leaching from these NPs was considered a less concern. For
MPs, Choi et al. (2021) investigated the differences in the toxic effects of
two different shapes of PE: microbeads (primary MPs) and irregularly
ground PE (secondary MPs) (Choi et al., 2021). They found that
microbeads did not exhibit severe cytotoxicity at any tested concentra­
tions, whereas inflammatory responses and hemolysis were observed
only at high exposure levels. On the other hand, irregular MPs adversely
affect the cells.
It has been suggested that the toxicity of MPs increases with a
decrease in size (Banerjee and Shelver, 2021). The sizes of MPs influence
their internalization into cells, which causes toxicological effects. Small
MPs (<1 μm) can be taken up through the lung epithelium and enter
systemic circulation by passing through endothelial cells (Yang et al.,
2022). Liu et al. (2021) investigated the internalization and release of
PS-NPs and PS-MPs (50 nm, 500 nm, and 5 μm) in both model cell
membranes and rat basophilic leukemia (RBL-2H3) cells. They reported
that smaller particles more readily enter or leave cells by different
mechanisms. In the case of NPs, a study using PE-NPs reported that the
particle could enter lipid membranes and cause alteration in cell mem­
brane integrity, demonstrated by lower density, fluidity changes, and
membrane thickening of the dipalmitoyl phosphatidylcholine (DPPC)
bilayer (Wang et al., 2022). The attachment of the particles tends to
cause pores and damage to the DPPC bilayer. For MPs, it has been
demonstrated that microbeads ranging from 1 to 10 μm attached to lipid
membranes could lead to mechanical stretching and subsequent cellular
dysfunction (Fleury and Baulin, 2021).
Furthermore, different sizes of PS-MPs and PS-NPs were tested in
normal human intestinal cell lines to investigate their adverse effects on
cell membranes. The results showed that PS-NPs have more potential to
enter cells than PS-MPs but caused significantly lower damage to the cell
membrane (Zhang et al., 2022c). Another group of researchers investi­
gated the phagocyte function of leukocytes, monocytes, and macro­
phages induced by PS-MPs (1 μm) and PS-NPs (20, 100, 200, and 500
nm) (Prietl et al., 2014). The cytotoxicity of the smallest particles (20
nm) was caused by a higher number of ingested particles with
concomitant plasma membrane damage. At non-cytotoxic concentra­
tions, PS-NPs could enter the cell more easily but with less cell damage
than PS-MPs. However, a high number of NPs may also cause damage to
the cell membrane. Studies on the uptake of NPs and MPs have also been
carried out in respiratory cell lines. A study on the effects of PS-NPs (25
and 70 nm diameter) in A549 cells showed that smaller NPs (25 nm)
12
Science of the Total Environment 904 (2023) 166745
were internalized more rapidly and efficiently than bigger NPs (70 nm)
(Xu et al., 2019). In addition, cell viability, apoptosis, and the cell cycle
were also affected by NPs.
Surface properties, such as charge and roughness, have been sug­
gested as possible determinants for MPs to interact with cellular mem­
branes (Brachner et al., 2020; Chen et al., 2022). Nonetheless, they were
out of concern in most previous studies on the toxicity of MPs. The ef­
fects of the surface charges of PS-NP internalization and toxicity to
alveolar cells were examined (Roshanzadeh et al., 2020). Cyclic
stretches were applied to human alveolar cells to simulate dynamic
mechanical conditions during breathing. The results showed that posi­
tively charged PS-NPs accumulated higher than negatively charged PS-
NPs. Another study on human gastric epithelium (GES-1) and colonic
mucosa (FHC) cell lines also showed that surface charges influence
cytotoxicity (Li et al., 2021). The authors indicated that electrostatic
attraction between negatively charged MPs and cationic pollutants
could reduce the cytotoxicity of MPs. Regarding the effect of surface
charge in lung cells, a study in BEAS-2B treated with three differently
charged PS-MPs revealed that only positively charged PS-MPs (NH2-PS-
MPs) exhibited cytotoxicity and elevated ROS generation (Jeon et al.,
2023). This finding was in accordance with the results from animal
experiments in the same study, showing that only NH2-PS-MPs caused
increased expression and secretion of pro-inflammatory cytokine (IL-β)
after repeated exposure to MPs by intratracheal instillation. Other
autophagy and ER stress-associated protein analyses showed that NH2-
PS-MPs induced autophagic death in BEAS-2B cells.
In addition, the surface roughness of PS micro-fragments has been
shown to enhance physical damage in human cells. Cell membrane
damage and hemolysis were observed in fibroblasts and red blood cells
directly in contact with PS micro-fragments (Choi et al., 2020).
Furthermore, a study on microfibers in the lung tissues of patients with
GGNs showed the surface roughness of the microfibers (Chen et al.,
2022). The authors confirmed that this kind of morphology differs from
atmospheric microfibers, which may be related to aging due to envi­
ronmental conditions. The sampling and laboratory processes would not
be the cause. To date, the increase in roughness after microfibers or MPs
enter tissues has not been reported. This roughness phenomenon of
microfibers in human tissues may suggest leaching of the microfibers’
chemical constituents, which is interesting for further investigation.
6.4. Toxic effects of MPs related to their chemical characteristics: plastic
additives and environmental contaminants
Plastic has low chemical reactivity; however, leaching its chemical
constituents, including plastic additives and environmental contami­
nants, may lead to adverse health effects. In addition, the hydropho­
bicity of MPs enables the sorption of toxic organic contaminants in the
environment that can be released upon entering the human body. Shi
et al. (2021) investigated the combined effects of polystyrene NPs and
various PAEs, the most used plasticizers (i.e., Di-n-butyl phthalate (DBP)
and DEHP), on A549 cells. The co-exposure caused alterations in cell
viability, oxidative stress, and inflammatory reaction influenced by the
exposure levels of NPs and the sorption capacity of each PAE. In addi­
tion, at low exposure levels of NPs, sorption of the PAEs onto NPs could
reduce the bioavailability and joint toxicity caused by the co-exposure of
NPs and PAEs. Instead, NPs exhibited dominant effects at higher expo­
sure levels of co-exposure.
Surface modifications also influence internalization and subsequent
toxic effects. A study on the cytotoxicity of PF resin MPs (PF-MPs) in
A549 cells stated that PF-MPs irradiated with simulated sunlight showed
higher cellular ROS and lower cell viability than virgin MPs (Zhu et al.,
2020). In addition, a study treated A549 cells with polystyrene particles
(i.e., PS-MPs [2 μm] and PS-NPs [80 nm]) to evaluate cytotoxicity and
genotoxicity (Shi et al., 2022b). The effects of surface modification were
also investigated using pristine particles and carboxy and amino-
functionalized particles. Regarding the cytotoxicity and genotoxicity
U. Vattanasit et al.
of A549 cells, it was shown that PS-NPs caused more severe effects than
PS-MPs. Moreover, surface-functionalized PS-NPs showed higher up­
take, more vital cell viability inhibitory ability, and more micronucleus
formation. Interestingly, a study of murine macrophage J774A.1 cells
revealed that an eco-corona of biomolecules formed under environ­
mental conditions could enhance the cellular internalization of PS beads
with a diameter of 3 μm (Ramsperger et al., 2020). In other words, the
eco-corona facilitated particles that generally did not interact with
membrane receptors to become internalized.
7. Conclusion and recommendations
Available published data demonstrated the occurrence and human
uptake of AMPs. However, evidence of exposure via inhalation and the
toxic effects of AMPs in humans remain unclear. Indoor AMPs were
detected at higher concentrations than those of outdoor AMPs. Fiber was
the most common shape, and synthetic textiles were suggested as the
primary sources. The predominant size and shape of AMPs found in air
samples were in accordance with those found in the human respiratory
tract. Physical characteristics, including size, shape, and surface prop­
erties (i.e., charges and roughness), have been shown to influence their
interaction with cell membranes, cellular internalization, accumulation,
and cytotoxicity resulting from cell membrane damage and oxidative
stress. Chemical intake from MPs was considered negligible, but the
accumulation of MPs in tissues allows prolonged exposure to associated
toxic chemicals, which might also lead to long-term health effects.
The physical clearance process by macrophage phagocytosis was
inefficient in removing fibrous MPs from the lungs, and the subsequent
inflammation could lead to respiratory lesions. Long and thin fibers are
incompletely phagocytosed, are more persistent, and tend to induce
biological effects than short fibers. Oxidative stress and inflammation
are mechanisms of action primarily identified in the toxicological
assessment of AMPs in vitro and in vivo. Elevated ROS production causes
inflammatory responses and mitochondrial dysfunction, which could
lead to programmed cell death or possibly to the initiation of carcino­
genesis. Knowledge gaps and recommendations for future research on
the health effects of AMPs are listed as follows:
• People spend most of their time indoors; thus, prolonged exposure to
indoor AMPs can cause adverse health effects, especially in suscep­
tible groups (i.e., young children and older adults). Still, only limited
data on indoor AMPs are available. Future research on the existence,
exposure, and health effects of indoor AMPs, particularly micro­
fibers, is required to elucidate possible health outcomes and rein­
force the need for mitigation measures.
• The physical and chemical characteristics of AMPs are key de­
terminants of possible health outcomes from exposure to AMPs. At
present, data from different studies are not readily comparable.
There are several methodological obstacles to the detection, char­
acterization, and quantification of MPs. Sensitive and high­
–throughput technologies and standardized methods for determining
MPs are required for the scientific community.
• In the last decade, environmental MPs, recognized as emerging
pollutants, have been extensively studied in vivo and in vitro. MPs
were detected in various human specimens. To date, studies on the
occurrences and health effects of MPs in humans, especially in the
respiratory system, are still inadequate.
• Information on AMPs’ biological fate in the human body is absent
and should be explored. Some polymers’ chemical constituents,
especially those made of microfibers that are frequently detected as
AMPs and in the respiratory tract and adsorbed environmental
contaminants, should be examined for their leaching upon
deposition.
• Chemical constituents possibly leach from deposited AMPs in the
respiratory tract and may result in health effects from the plastic
components (i.e., unreacted monomers and plastic additives).
13
Science of the Total Environment 904 (2023) 166745
Specific plastic components in airborne microfibers are interesting
for use as biomarkers of exposure to AMPs.
• Evidence of the translocation of airborne MPs and NPs needs to be
clarified and should be further investigated. Fiber-shaped MPs are
not likely to pass across the lung tissue barrier and penetrate the
blood and other terminal tissues. Nonetheless, it should be noted that
other shapes of smaller sizes of MPs or NPs that could not be detected
due to analytical limitations should not be overlooked.
• A limited number of experiments have been conducted to determine
the adverse effects of MPs using respiratory cell lines in vitro and
exposure routes via inhalation in vivo. In addition, most MPs used
were commercially available, mostly spherical, monodisperse in size,
and made of only some types of polymers, such as PS, PE, and PP,
that did not represent real-world situations; the effects might be
underestimated. Environmental samples of secondary MPs and
source-specific primary MPs, such as indoor microfibers, are inter­
esting for testing the toxicological assessment of AMPs. Importantly,
the physical and chemical characterizations of these MPs are
essential.
Funding
This review did not receive any specific grant from funding agencies
in the public, commercial, or not-for-profit sectors.
CRediT authorship contribution statement
Udomratana Vattanasit: Conceptualization, Investigation, Data
curation, Writing – original draft, Visualization. Jira Kongpran: Visu­
alization, Writing – review & editing. Atsuko Ikeda: Writing – review &
editing.
Declaration of competing interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Data availability
Data will be made available on request.
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