Plastics are a “grave, growing and under-recognised danger” to people and the planet, causing “disease and death” from infancy to old age, a landmark review has found.

The Lancet Plastics Countdown, published as diplomats from around the world arrived in Geneva on Monday for the overtime round of talks on a global plastics treaty, estimates the cost of just three plastic chemicals at $1.5 trillion across 38 countries, representing one-third of the world’s population.

“It is clear we are in a plastics crisis,” the review found. “Plastics are not as inexpensive as they appear and are responsible for massive hidden economic costs borne by governments and societies. These impacts fall disproportionately upon low-income and at-risk populations.”

Plastics pollute human health through an array of pathways, including direct exposure to waste fills or chemical plants, environmental contamination, absorption through food packaging, microplastics, air and soil pollution, and burning of feedstock fossil fuels. 

The health consequences are equally varied, from birth defects and microplastic poisoning in the womb. to asthma, various cancers, heart attacks, hormone disruption, and developmental problems. 

Plastics affect human health across their production cycle from extracting the fossil fuels that make up 98% of plastics, to use, and eventual disposal, the report found. 

One chemical alone, BPA, was associated with 5.4 million cases of ischaemic heart disease and 346,000 cases of stroke in 2015, killing 237,000 and 194,000 people, respectively. BPA is one of 16,000 chemicals present in plastics.

PM2.5 emissions from plastic production were responsible for an estimated 158,000 premature deaths globally and health-related economic losses of more than $200 billion, the report found.

Yet limited global data means these vast sums are equally vast underestimates. The $1.5 trillion price tag is for just 38 nations. Surging plastic production is multiplying future risks from waste, and there are still vast knowledge gaps in the health effects of plastic chemicals, so researchers warn that this number could grow exponentially.

“What is also abundantly clear, and that’s coming from the science as well, is that without intervention, the problem will not go away. It will escalate,” said Martin Wagner, co-author of the Lancet report. “Global plastic production is bound to triple by 2060, escalating not only the environmental pollution aspect, but also the associated health consequences.”

What’s in our plastic? 

In the majority of cases, scientists simply don’t know what the chemicals in plastic are, or what they might do to health. 

Complete safety information is missing for more than two-thirds of the chemicals used in plastics, according to the Lancet. Where data exists, it’s often incomplete, with three-quarters of plastic chemicals never properly assessed for human health impacts.

When authorities restrict or ban chemicals, manufacturers often replace them with structurally similar substitutes that carry the “same or other unknown hazards,” according to the Plastics Health Map, an open-source database mapping research on plastic chemical exposures.

The pace of scientific evaluation adds another layer of delay. Studies on the health impacts of substitute chemicals typically commence years after their introduction to the market, creating a perpetual knowledge gap.

As plastic chemicals proliferate faster than research can evaluate them, both regulatory systems and scientific understanding struggle to keep pace with determining their health effects.

“Despite their large production volumes and widespread human exposure,” the report states, hazard information remains missing for thousands of chemicals in everyday use.

Of the plastic chemicals that have been studied, the picture is alarming. Approximately 4,200 substances have been found to be highly hazardous due to their toxic effects, persistence, and bioaccumulation.

Almost 1,500 are carcinogenic, mutagenic, or toxic to reproduction, and more than 1,700 are toxic to specific organs like the liver.

Scientists say we have enough evidence to act.

“Some people will tell you, do you have enough scientific evidence proving that the plastics are affecting human health?” said Dr. Maria Neira from the World Health Organization. 

“People, do you have enough evidence demonstrating that having microplastics in our placenta is a good thing for human health? Start by the end, are you happy with having microplastics everywhere in our body?”

Living in sacrifice zones

For Jo Banner, co-founder of the Descendants Project, these statistics represent daily reality. Her town of St James’ Parish in Louisiana’s industrial corridor – known as Cancer Alley – bears the brunt of petrochemical production.

The elevated risks of physical health issues, including cancer, heart disease, respiratory illness, strokes, and reproductive health problems, earned her town and surrounding region a grim moniker: “sacrifice zone”.

“Sacrifice zones” originally described communities around nuclear weapon testing sites, but has expanded to encompass areas where residents are exposed to disproportionately high levels of industrial pollution. 

Banner’s community is among more than 1,000 toxic hot spots across the United States where an estimated 250,000 people face elevated cancer risks from industrial air pollution. 

“Science is one thing, but science doesn’t work when we have a population that is sacrificed for the economy,” Banner told at a Geneva press conference Monday. “My ancestors were brought to the United States to work the plantations and were sacrificed. We, as descendants of those enslaved Africans, are also facing that same type of sacrifice.”

The UN Special Rapporteur on Human Rights and the Environment identified millions of people at risk worldwide from similar industrial pollution to Cancer Alley, causing nine million premature deaths annually – twice as many as COVID-19 caused in its first 18 months. The Rapporteur blamed businesses for being willing to cut corners – and lose lives – to protect or expand their bottom line.

“Our areas are described as cancer alley, but it could also be called asthma alley, anxiety alley, heart attack alley,” Banner said. “The petrochemical companies and plastic makers only works when our communities are sacrificed.”

Thousands of miles away in Kenya, John Chweya experiences a different part of the same crisis. As president of the Kenya National Waste Pickers Welfare Association, he represents workers who live and work in landfills where plastic waste burns continuously.

An estimated 20 million people worldwide work as waste pickers, collecting about 60% of all plastic recycled globally. Those living directly in landfills face constant exposure to toxic fumes from burning chemicals, many of which remain unidentified.

“It’s always like 24/7 breathing in plastic. Even when it rains, you will see smoke,” Chweya said, adding that community members frequently developed health conditions they were unable to identify or seek treatment for.

“About 22 years ago, I was compelled to live in a landfill in Kenya called Kisumu, a very small city. And during that time, I encountered people that I would call family,” Chweya said. “Today, as I sit here, most of these people I call family are no longer alive.”

Cap or no cap 

The UN Plastics Treaty will be hammered out – hopefully – over the following two weeks. The goal of the talks is to establish a legally binding mechanism to protect people and the planet from the ever-growing tsunami of plastic waste suffocating oceans, forests, mountains, air, animals, microorganisms and cities.

More than 100 UN member states have supported setting legally binding targets to cap plastic production as talks begin Tuesday. Many more have voiced support for phasing out harmful plastic production and chemicals of concern from plastic production. 

The Lancet report identifies this surge in production as the “first and most fundamental” driver of the plastics crisis. This is also the defining fight of the upcoming negotiations as major petrochemical powers like Saudi Arabia, the United States, Russia and China push back on production limits while they seek to expand petrochemical manufacturing. 

Global output has grown more than 250-fold from less than two million tonnes in 1950 to 475 million tonnes in 2022. This surge is driven partly by fossil fuel companies pivoting toward plastics as demand for energy declines. The Saudi Arabian Oil Company plans to channel about one-third of its oil production to plastics and petrochemicals by 2030. 

Plastic production releases more than two gigatons of CO2 and other greenhouse gases every year. If the plastics industry were a country, it would be the fifth-largest annual greenhouse gas emitter in the world, behind Russia at 2.7 gigatons, and roughly double the next four nations of Brazil, Japan, Iran and Indonesia. 

While plastics have revolutionised fields from medicine to aerospace, 35-40% of production takes the form of single-use packaging, bottles, bags, and other disposable items, principally related to the food industry. 

Plastic-producing nations argue that the focus should be on recycling technologies and circular economies for plastics. But unlike other materials such as glass, paper, aluminium, or steel, the technology still does not exist to efficiently recycle chemically complex plastics.

“Despite decades of effort, less than 10% of plastics are recycled, and thus 90% are either burned, landfilled, or accumulate in the environment,” the report states. “It is now clear that the world cannot recycle its way out of the plastic pollution crisis.”

Life or death

The treaty requires consensus among all participating nations, but given the hard opposition from major petrochemical-producing countries, progress may require moving forward without holdouts. Donald Trump’s US and Saudi Arabia are unlikely to agree to production caps, while China, the world’s largest plastic producer, is likely to follow suit. 

“If the consensus required going for the minimum, the lowest denominator, that’s not a good consensus,” said Neira. “So be very ambitious, because it’s about the health of the people here.”

For Banner and Chweya, the question remains whether health arguments, which have failed over decades to drive decisive action at climate, biodiversity, and other UN environmental negotiations, will finally move the needle.

“I represent the ones collecting from the streets, the ones collecting from households and those living and working at landfills,” Chweya said. “I would say, for us, it’s a matter of life and death.”

Image Credits: Muhamad Numan, Chad Davis, Koshy Koshy.