Plastic induced urinary tract disease and dysfunction: a scoping review

Abstract

Introduction: In 2019 the World Health Organisation published a report which concluded microplastics in drinking water did not present a threat to human health. Since this time a plethora of research has emerged demonstrating the presence of plastic in various organ systems and their deleterious pathophysiological effects.

Methods: A scoping review was undertaken in line with recommendations from the Johanna Briggs Institute. Five databases (PubMed, SCOPUS, CINAHL, Web of Science and EMBASE) were systematically searched in addition to a further grey literature search.

Results: Eighteen articles were identified, six of which investigated and characterised the presence of microplastics and nanoplastics (MNPs) in the human urinary tract. Microplastics were found to be present in kidney, urine and bladder cancer samples. Twelve articles investigated the effect of MNPs on human cell lines associated with the human urinary tract. These articles suggest MNPs have a cytotoxic effect, increase inflammation, decrease cell viability and alter mitogen-activated protein kinases (MAPK) signalling pathways.

Conclusion: Given the reported presence MNPs in human tissues and organs, these plastics may have potential health implications in bladder disease and dysfunction. As a result, institutions such as the World Health Organisation need to urgently re-evaluate their position on the threat of microplastics to public health.

Impact statement: This scoping review highlights the rapidly emerging threat of microplastic contamination within the human urinary tract, challenging the World Health Organisation's assertion that microplastics pose no risk to public health. The documented cytotoxic effects of microplastics, alongside their ability to induce inflammation, reduce cell viability and disrupt signalling pathways, raise significant public health concerns relating to bladder cancer, chronic kidney disease, chronic urinary tract infections and incontinence. As a result, this study emphasises the pressing need for further research and policy development to address the challenges surrounding microplastic contamination.

Keywords: Incontinence; Inflammation; Kidney; Microplastic; Nanoplastic; Urinary tract; Urine.

Fig. 1

PRISMA-ScR Flow Diagram.

Fig. 2. Article characteristics.

Details pertaining to country of origin, number of publications per country and year of publication.

Fig. 3

Number of articles organised by aim of article and sample type.

Fig. 4. Microplastic bioaccumulation.

Summary of consequences of microplastic bioaccumulation pertaining to the urinary tract.

Fig. 5. Size comparison.

Size of plastic organised by sample type and particle shape.

Fig. 6. Global burden of disease.

Potential mechanism by which MNPs contribute to chronic disease burden globally.