Plain English with Derek Thompson - Microplastics Are Everywhere. How Dangerous Are They?

Episode Date: May 31, 2024

Plastic is a life-saving technology. Plastic medical equipment like disposable syringes and IV bags reduce deaths in hospitals. Plastic packaging keeps food fresh longer. Plastic parts in cars make cars lighter, which could make them less deadly in accidents. My bike helmet is plastic. My smoke detector is plastic. Safety gates for babies: plastic. But in the last few months, several studies have demonstrated the astonishing ubiquity of microplastics and the potential danger they pose to our bodies—especially our endocrine and cardiovascular systems. Today’s guest is Philip Landrigan, an epidemiologist and pediatrician, and a professor in the biology department of Boston College. We start with the basics: What is plastic? How does plastic become microplastic or nanoplastic? How do these things get into our bodies? Once they’re in our bodies what do they do? How sure are we that they’re a contributor to disease? What do the latest studies tell us—and what should we ask of future research? Along the way we discuss why plastic recycling doesn’t actually work, the small steps we can take to limit our exposure, and the big steps that governments can take to limit our risk. If you have questions, observations, or ideas for future episodes, email us at [e-mail]. Host: Derek Thompson Guest: Philip Landrigan Producer: Devon Baroldi Links: "Plastics, Fossil Carbon, and the Heart" by Philip J. Landrigan in NEJM https://www.nejm.org/doi/full/10.1056/NEJMe2400683 "Tiny plastic shards found in human testicles, study says" https://www.cnn.com/2024/05/21/health/microplastics-testicles-study-wellness/index.html Consumer Reports: "The Plastic Chemicals Hiding in Your Food" https://www.consumerreports.org/health/food-contaminants/the-plastic-chemicals-hiding-in-your-food-a7358224781/#:~:text=BEVERAGES,in%20this%20chart Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Let me start by saying something nice about plastics. Plastic is a life-saving technology. Plastic medical equipment, like disposable syringes and IV bags, reduce deaths in hospitals. Plastic packaging keeps food fresh for longer. Plastic parts in cars make cars lighter, which could make them less deadly in accidents. My bike helmet? Plastic. My smoke detector?

Plastic. The safety gate for my baby. Plastic. I'm not the sort of person who is naturally afraid of plastics or really any environmental harms. When my wife told me to stop microwaving food in plastic. containers, I was slow to convert to this new hygiene regime. Among my friends, I might be the least neurotic of all of them about germs. Five-second rule? I say challenge accepted. Make it seven seconds. But in just the last few weeks, I've read several articles, papers, and reports that are

beginning to shift my feelings about plastics and the chemicals we use to treat them to make them colorful, shiny, water-resistant. These are sometimes called plasticizers. First, a week ago, I came across an article with the following, undeniably alarming headline. Quote, tiny plastic shards found in human testicles, study says. End quote. Without pause, I clicked. The article described a new paper in the journal,

Toxicological Sciences, which found that so-called microplastics and nanoplastics were found in surprisingly high concentrations inside cadavers. The same week, I saw something else. In February this year, consumer reports published an analysis, one of many that they do, of the presence of plasticizers in fast foods and supermarket staples. From this consumer reports analysis, quote, we found high levels in, among other products,

Del Monte sliced peaches, chicken of the sea pink salmon, Fair Life core power, high-protein chocolate milkshakes, Yoplai original French vanilla low-fat yogurt, and several fast foods, including Wendy's crispy chicken nuggets, a Chipotle, chicken burrito, and a Burger King Whopper with cheese. End quote. Truly all the best things in life. Research on these plasticizers is still developing, but it suggests that their presence in high levels in our bodies can disrupt our endocrine systems,

contributing to heart disease, cancer, infertility, or diabetes. Even still, I might have closed these tabs and gone on with life if I didn't also come across and New York Times report on Tuesday. Attorneys are now preparing for a wave of lawsuits against the manufacturers of PFAS, so-called forever chemicals. Light plastic, PFAS are manufactured chemical materials whose main feedstock is fossil fuels, gas, oil, coal.

They are virtually indestructible, and they're found in countless everyday objects. Take-out containers, frying pans. PFS are in much of what we eat, drink, and use. And scientists are only, beginning to understand how they affect our health. And its journey of understanding took a big leap forward in the last few months. In an editorial published in the New England Journal of Medicine this spring by Philip Landrigan, an epidemiologist and pediatrician and professor of biology at

Boston College, entitled Plastics, Fossil Carbon, and the Heart, Landrigan offered a brief history of plastics, what they are, where they come from, how nano and micropastics come from are plastic containers, why some scientists have been concerned about them. But here's the most important part. Landrigan explained the significance of a new study, perhaps the first study of its kind ever, which has found that microplastics and nanoplastics are associated with an extraordinary increase in cardiovascular disease outcomes in humans. Until now, Landrigan wrote, information on the health effects in humans of ingested or inhaled microplastics. has been scanned. We've had an excuse for years, maybe for decades, to ignore this issue

of plastics and microplastics. But we no longer have that excuse. The evidence is mounting. Microplastics are everywhere, and they might be very, very bad for us. Today's guest is Philip Landrigan. We start with the basics. What is plastic? How does plastic become microplastic or nanoplastics. How do these things get into our bodies? Once they're in our bodies, what do they do? Where do they go? How sure are we that they're a contributor to any kind of disease? And along the way, we discuss why plastic recycling doesn't actually work, the small steps we can take to limit our exposure, and the big steps that government can take to limit our risk. I'm Derek Thompson. This is plain English.

Philip Landrigan, welcome at the show. Thank you. Thank you, Derek. What are plastics? Plastics are manufactured chemical materials. Made, for the most part, 99% made from fossil carbon, from gas, from oil, from coal. All plastics have two main components. First is the polymer, which is the structure, the skeleton of the plastic. And the polyvinyl chloride include some familiar names like polyvinyl chloride,

polystyrene, polyurethane, and so on. And then secondly, are the chemical additives, at least 16,000 different chemicals, most of them petrochemicals that come from fossil carbon, that are inserted into the polymer matrix to give the plastic particular properties, like color, like stability, like water resistance, like flame resistance. And there are some familiar names Among these additives, for example, phthalites, which are plasticizers that give the plastic flexibility, bisphenol A, BPA, PFA, the Forever chemicals, some of them are used in plastics, others are used elsewhere. Flame retardants like ruminated flame retardants to make the plastic fire resistant. those go into plastics destined to be included in computers, and then chemicals that make the plastic resistant to water and grease.

And what are micoplastics for nanoplastics? So microplastics and nanoplastics are the materials that are formed when plastic breaks down in the environment. So, for example, when a large piece of plastic, let's say a plastic deterrenties, bottle, goes into the ocean, it's hit with wave action, with sunlight, with heat, with cold, with erosion against rocks and beaches. And over time, it breaks down into smaller and smaller particles. If the particles are one micron in diameter or less, they're known as microplastics, and if they're a thousand times smaller than that, they're known as nanoparticles.

Before we get into how these get into our bodies, is the only way that plastic becomes microplastic or nanoplastic confrontation with elements like an ocean or sunlight? Or if I buy a bottle of water, or if I buy a thing of yogurt, is it possible that the sheer passage of time or the rubbing up of the food against the plastic will create micro or nanoplastics by the time I consume whatever is in those containers? Yeah, the short answer to that question is, question is yes, the erosion in the oceans is only one source of microplastics. Whenever you drink a bottle, when you drink bottled water, whenever you eat yogurt out of a plastic container, whenever you heat something in a plastic cup in the microwave, you'll be pushing plastics

into the water, into the food, and that's a common path of entry. And let's continue to story. We've explained how plastic becomes micro or nanoplastic. How does that microananoplastic get into our bodies and cause the kind of disruption that scientists are starting to fear? So, microplastics and nanoplastics can get into our body by two routes. The most common route is by ingestion in food, in water, but also some of them are airborne. They get lofted into the air, and then you can inhale them, and so they're taken into the lungs. Once those particles get into the gastrointestinal tract or into the lung, some of them have the ability to cross the membrane into the bloodstream.

And the basic rule of thumb here is that the smaller the particle, the more easily it can traverse the membrane and get into the bloodstream. And then once the particle is in the bloodstream, it can basically go anywhere in the body to the heart, the lungs, the reproductive organs, the liver, anywhere at all. and if it's small enough, it can then pass from the bloodstream into the cells of the organ. There's a lot of research right now in the possible danger of nano and microplastics. I wonder why do you think we haven't quite paid closer attention to this?

We're talking about a technology, at least in terms of basic synthetic plastics. It's been around for a century, but I feel like it doesn't quite have the same level of popularly understood alarm that say carcinogens have, cigarettes have. Why has it taken so long, do you think, for people to pay closer attention to the danger of micro-nanoplastics? Yeah, I think there are several reasons. I think, firstly, it's been invisible

until recently, when it's just become more and more obvious that there's an awful lot of plastic pollution out there. Secondly, the life cycle of plastics is long and complex, and the harms associated with plastics occur at different points along this complex life cycle. People haven't put the pieces together until recently. And then thirdly, it's been overshadowed by other big issues, most notably climate change,

which is quite rightfully at the forefront of many people's minds these days. After reading your work, it seems like we've slowly learned more and more about how plastic harms human health at every stage of the life cycle of the manufacturing of synthetic plastics. So you start with mining and drilling. You said these are fossil fuel products. Then there's the workers who make the plastics, transportation, disposal into the environment. In this conversation with you, I want to focus on the effects of microplastics on consumers, the end user of this cycle.

But I do want to do a pit stop on how we understand the hazards for workers who make the plastics. because it seems to me like, as it's so often the case, with new hazards, we discover the health risks for workers that are right up close to this substance before we see the effect on populations. So what was the first indication that plastics might be harmful for human workers? No, you're absolutely correct that workers are often the canaries in the coal mine. They're heavily exposed. They're exposed before the general population. and the first signal of a new hazard has very frequently arisen in workers.

And that's absolutely true in the case of plastic. So the first signal that I know dates back to 1976 when there was a cluster of four cases of a very rare cancer called angiosarconer of the liver that arose among workers in a factory in Louisville, Kentucky who are making polyvinyl chloride. And it turns out that the chemical agent that caused the cancer was a gas called vinyl chloride monomer. And this is the monomer which is polymerized to form PVC. These workers were very heavily exposed to the vinyl chloride monomer and they developed the liver cancers.

Another early example was chronic lung disease in people that were making nylon flock, the material that goes into fleece jackets. and these workers were inhaling microplastic fibers that was getting stuck in their lungs and causing the lung disease. Even five, ten years ago, it seems like there wasn't a lot of research

on the negative health effects on plastics for consumers. But in March this year, you published an editorial in the New England Journal of Medicine that talked about a new study by Marfella at all on the association of micro and nanoplastics with cardiovascular outcomes. This is a study that included 312 patients. They underwent carotid artery procedures.

What did the study find, and why do you think it's so important? So the study by Marfella and his colleagues is important because it's the first study that actually links microplastics in the human body to disease. There had been previous reports that found microplastics in various organs in the gastrointestinal tract, in the placenta, in the liver, and so on. But what the Marfella paper did was that they looked at 312 patients who underwent carotid end artorectomy, which is a procedure in which plaque, arterioschlorotic plaque, is removed from the lining of the carotid artery.

The carotid artery is the main artery in the neck that surprised the brain. There's one on each side. Marfella and his colleagues took this material. material, and they analyzed it for the presence of micro and nanoplastic particles. And they found micro and nanoplastics in about 60% of the patients, 40% did not have detectable particles. Then they followed these patients for the next three years. What they found was really very striking. They found that the 60% of their patients who had detectable micro and nanoplastic particles, had a 4.5 fold, that is to say, a 450% increased risk over the next

three years of heart attack, stroke, or death. And when we hear about that risk, 4.5X, how should we think about that? Like, is this a small increase? Are we talking about something approaching the effect of cigarettes on lung health? Is there any context you can give to what a 4.5x increase in risk is akin to? It's a huge access risk. If it's confirmed by other studies, and that's a big if it's confirmed by other studies, that's a huge risk. Cigarette smoking increases the risk of lung cancer by about 10fold.

Asbestos increases the risk of lung cancer by about fivefold. So it's in the same range as asbestos. And how sure are we about causality here? Because this is, as you said, it's a landmark study. It might be the first paper that has ever linked the presence of micro nanoplastics to disease. I think that is a signal of both its significance, but also it should give us a little bit of humility about interpreting the results. So a question about causality, it seems possible to me that the group with more microplastics

and nanoplastics, maybe they were just eating more. more junk food that contain plastic wrapping. And so what we're really measuring is the causality or the effect of the food that was wrapped than the effect of the wrapping on cardiovascular disease. Maybe it's possible that these folks who had micro-nanoplastics in their system were living in low-income areas

with higher levels of environmental pollution. So what we're really picking up here is the negative effect of pollution rather than the danger of plastics. How would you think about interpreting causality in these results? Yeah, there's no way from a single study that anyone can say this is cause and effect, because all of those potential confounding factors that you rattled off could be at play here.

But that's not to say that within the next couple of years, we can't prove causality here. And the way in which causality will be established or alternatively the way it will be disproven is that other scientists will do other studies in other populations, and they will be looking to see if they come up with convergent results. And if other human studies, clinical studies and epidemiologic studies, find results that point in the same direction as the Marfella study, that will be powerful confirmation of causality. Also, I suspect that some of the people that work with experimental animals with rats and mice, will be doing studies exposing those animals to microplastics and seeing if the findings in the animals align with the human findings. And it'll be the

analysis of that body of evidence over the next few years that proves or disproves causality here. Were you surprised that this paper only found that about half of people studied had micro or nanoplastics in their carotid artery? Like, this seems like something. that should affect everyone. It's not like cigarettes, which is very cut and dry. You either smoke or you don't. Secondhand smoke exists, but people tend to know even if they have exposure

to secondhand smoke. Whereas with nano and microplastics, to one of the first points that you made in this episode, they are invisible. We cannot see them. And so I just kind of assume that they're everywhere. Were you surprised that, what it was, 40% of people in this study

seem to not have detectable levels of micro nanoplastics in their carotid? Yeah, it's an intriguing finding. I don't know the explanation for it. And again, that's why other studies, more studies are going to have to be done to either confirm or refute them in our fellow findings. There's another study that came out, relatively the same week as the Marfella study, and your editorial, totally separate investigation that got a lot of fanfare because the headline of that study, at least in CNN, was a quote, tiny plastic sharp found in human testicles. What happened is scientists tested, at least according to the CNN article, tested 23 preserved testes from cadavers, age 16 to 88 at the time of their death, and compared those

with dog testes and found that the levels of microplastic shards and the human testes were three times higher than those found in dogs. This is important because it might be relevant not only to some of the health effects that we're going to talk about in a second, but there's this ongoing mystery of why sperm counts have declined throughout the world by up to 50% in the last 50 years. Tell me a little bit about what your reaction to that, this other more lurid study seemed to find. So any study involving the testicles gets a lot of attention, human nature. But again, it's only one study.

I think it's probably generally credible because it's, it, it, it, it, it, it, it, It parallels the finding of microplastic nanoplastic particles and many other organs in the human body. I have no idea whether or not it correlates with declining sperm counts. I just don't know. This is an area of research that is growing. It's emerging. But we have some nascent theories about what is happening at a mechanical, molecular level when micropastics and nanoplastics build up inside of us. A lot of research in this space seems to suggest that these little shards are endocrine disruptors.

What does that mean? And how specifically do we think these shards might be disrupting our hormones? So I think broadly speaking, there's two mechanisms by which microplastics can cause disease and dysfunction in the human body. One mechanism is simply mechanical that these little tiny particles get into cells and by their very presence disrupt the normal function of the cells and tissues of the human body. The other mechanism is that they act as Trojan horses are vectors. Remember, these microplastic particles carry within them all of the thousands of chemicals, the phthalates, the P-Fest, the flame retardants that go into plastics. And so when microplastic or nanoplastic particles get into a tissue, they are carrying these toxic

chemicals with them. And then once the particle is inside the tissue, these chemicals can leach out. They're not firmly bound to the polymer matrix. They can leach out. And because some of these chemicals are endocrine disruptors, because others are toxic to the nervous system, because still others are capable of causing cancer, once these toxic chemicals are released inside cells, they have the potential to cause havoc. So there's the wrench in the gears theory, or the micro wrench in the microgears theory, that the sheer presence of these shards disrupts cellular function. and then you told us a bit about the Trojan horse theory. That's the invasion of these plastics into our bodies.

Do our bodies have a way of fighting back? Is there any evidence, for example, that we clear micro-nanoplastics as we age, as we live, as we metabolize stuff, or does it simply accrete like plastic in an ocean inside of us? Yeah, I don't think anybody knows. certainly a lot of the microplastics that we ingest in a given day simply pass through the gastrointestinal tract and come out the other end in the stool. But the microplastics that penetrate through and get into the tissue, I don't think anybody knows at this point in time how persistent those particles are in the human body.

I want to talk a little bit of that solutions, and I want to take some inspiration from something you said earlier in the interview about how we should think about plastics as existing at different stages. There's a production stage where we found, going back to the 1970s, that workers get sick from their exposure to plastic components. There's the use stage, the consumer stage, where these chemicals get into us. And then finally, there's a recycling stage. I think a lot of people coming into a show about, you know,

the health effects of plastics are going to think about, you know, mountains of plastics building on the ocean rather than thinking about plastics inside of themselves. So let's talk about all three of these stages. First, at the production stage, what work is being done with lawsuits being filed, research being done on how to make the production of plastics safer? Because if we're being honest, we're not going to live in a world without plastic bags and plastic wrapping and plastic toys and plastic in our electronics. But what can we do? What are we thinking about making the production stage safer? Okay. Before we get into the details of that, let me back up a bit and talk about plastic production in general. Because plastic production is increasing

exponentially. It's increased 200 times since the first commercial plastics came on the market in around 1950, it's on track to double by 2040 and triple by 2016. And there's been an evolution of the type of plastic produced over time. So most of the early plastics were meant to be durable products. Today, by contrast, something like 40% of all the plastics produced is single-use plastic stuff that's made to be used and thrown away like plastic bags. and so when any of us talk about reducing plastic production, we're being very careful to distinguish between the essential plastics and the pointless plastics.

As a once practicing doctor, I know that I could not practice medicine without certain plastics, but I certainly know that I could live without plastic sheets on the bed. to change after every patient and throw away. So that distinction is very important. So now backing up, talking about plastic production, how is plastic produced? It begins with a fracking well, an oil well, or a coal mine, because 99% of all plastic comes from fossil carbon. And so the first group of workers who are the fracking operators, the oil workers,

the coal miners who pull these materials out of the ground. And those are hazardous jobs. They always have been. There's the risk of fire. There's the risk of explosion. For the miners, there's the risk of cave-in. For all of them, there's the risk of toxic chemical exposure. Then the next stage is transport.

The gas, the oil, or the breakdown products, have to be put on rail cars or ships or trucks. And we all know what happened last year. And he's Palestinian-Hire. Whether it was that terrible explosion, the chemical that exploded was vinyl chloride monomer, a plastics chemical. Then there's the production phase. Enormous factories known as cracking plants are where the oil, the gas, the feedstocks are through the miracle of modern chemistry,

are converted into thousands of plastic products. Then there's the use phase where people are exposed to plastic products in their homes and their work. And then finally, the disposal phase, which includes recycling. it includes landfilling. It includes putting scrap plastic waste on ships and sending it overseas to low-income and middle-income countries. So it's a long and complex life cycle, and we know that people are exposed to hazardous chemicals at every stage of the life cycle and that there's increased risk of disease and death at every stage of the plastic life cycle. Second, after the production process, we come to consumer use. I want to

know what you do. You're close to the ground. You read the research. You understand the dangers or potential dangers of micro nanoplastics and plasticizers and forever chemicals. How do you live your life in a modern world that is surrounded by and filled with all of this stuff? How do you think you go about your life in a way that might be subtly different from the average person who is not immersed in research on the dangers of plastics? Well, the answer is it's not at all easy. We are surrounded by so many hundreds, thousands of plastic products that it's impossible to escape.

And that's not accidental. You know, the plastic producing industry has been producing more and more single-use, disposable plastics, the plastic wrap that's around every single vegetable in the supermarket, the two and three legs. of plastic packaging in the product that should buy at the drugstore. That's very intentional. If you think back 10 or 15 years, that was paper or glass or metal or some other material. But there's been a very concerted push to flood the market with single-use plastics to lock us in.

So there's no way to escape it completely. It's impossible in today's world. But people can take steps. one is to carry a reusable bag to the supermarket or if you forget to carry the reusable bag, bring your groceries home on a paper bag instead of in a plastic bag. Think about using paper bags for your trash instead of plastic bags. Use glass containers instead of plastic containers and storing your food. Never microwave your food and plastics because when you microwave, that pushes the microwave.

plastic particles directly into the food that you're about to eat. If you have a choice in your water, in your water source, I know not all people do, but if you have a choice, avoid water that comes in plastic bottles, take water from the tap if it's safe, or carry your water around in a steel cup instead of a plastic junk. So if we're thinking about sort of enumerating this for myself, my own edification, number one, reduce exposure to plastic bags of all you say paper when they ask you paper or plastic or bring a reusable back to the supermarket. Number two, whenever possible, use glass containers rather than plastic containers when, for example, you are saving food, maybe in the refrigerator. Number three, do not microwave food in plastic containers.

Fortunately, that is one that I am already doing. That was my wife's idea. I think she might have read maybe some of your articles or maybe something else that was published elsewhere. And then finally, on water, don't buy plastic water bottles. and when you carry around water, use a container that is metal rather than plastic. Finally, on recycling, thinking of this again in stages,

there's the production stage, there's the use stage, and then finally there's the recycling stage. What should we be doing that we're not doing? Well, you have to understand that plastic recycling fundamentally does not work. I know most people don't realize that, but unfortunately it doesn't work.

in contrast to glass or paper or cardboard or aluminum, so a very, very high percentage of glass, paper, cardboard, and aluminum get recycled. People are very conscientious, and there are good systems in place to recycle and reuse those products. When it comes to plastic, people are conscientious. I see students on our campus very diligently placing waste plastic in the proper container. So the problem is not that people don't care. The problem is that the plastic itself resists recycling. The many different polymers that go into plastic cannot be mixed together to make a reusable product. That's one problem.

A second problem is that because plastics contain so many toxic chemicals, the stuff that comes out of the recycling unit is loaded with toxins, and it's simply not suitable for most usage. So the net effect of all this is that less than 10% of all the plastic used around the world is recycled. The actual figure is somewhere around 6 or 8%. And basically plastic recycling, people have to understand that plastic recycling is a scam. It's been pushed very hard by the plastic manufacturing industry because they want people to think that people can put the plastics in the proper bin and it will be properly taken care of. But what happens when it goes into that bin is that it ends up in one of three places. Either it gets put into a landfill, either it gets burned, or it gets put on a ship and sent overseas to a poor country. And only a tiny fraction of the plastic is actually recycled and reused.

This is the biggest untold story, I think, in the whole plastic lifecycle. If plastic recycling is a lie, what are we doing? I mean, should we just throw it out? Is that your suggestion that it makes no difference? Or are you saying, well, at least 6.8% of it is going to be recycled anyway. So if you put it in its proper bin, you're increasing the likelihood of something being recycled by a little bit, but you should place it in that blue bin rather than the green bin with the understanding that 93.2% of what you think you're recycling is actually not going to be recycled at all that's going to be burned, put on a ship buried in a land. so. Yeah. So I think folks need to realize that plastic recycling is very different from glass or paper

recycling. When they conscientiously put a glass bottle or a newspaper into the right bin, it's going to be recycled, 80, 90%. But the stuff you put in the plastic bin is mostly going to end up as plastic waste and not be reused and recycled. And the only way out of this, I think I don't, I don't, it's It's beyond the power of the individual consumer, but there are a few things people can do. One thing is that people can speak up as citizens. Many cities and many towns across the United States have now banned, have now banned plastic bags because we all realize that they're one-shot use for the most part and they get tossed away. Some states, led by California, have put in place what's called extended producer responsibility,

EPR, which means that the manufacturer of plastic is responsible for taking the plastic back after it's been used. A common example is the deposit laws on beverage containers. And finally, there are efforts underway at the global level. The United Nations is in the process of developing a global plastics treaty. and one, that treaty is still in negotiation, it's still in the drafting stage, it's not yet finalized, but one option for developing that treaty is to make the centerpiece of it a global cap on plastic production, which is a very efficient means of getting rid of the pointless, unnecessary, one-shot plastics,

and yet at the same time retaining the plastics that are essential and necessary. In 1987, we as a planet came together with the Montreal Protocol and signed a global agreement to phase out ozone-depleting substances like CFCs, chloro-fluorocarbons. And this was a global movement that came from science. We realized that we were burning a hole in the ozone layer with the production of chemical. that we thought would be useful, realized they were doing, they had some use from a production standpoint, but they were terrible for the biosphere,

and we did something about it. Plastics, it seems to me, are going to be a lot harder because while there are replacements for CFCs, plastics are never going to be phased out. We're just never to your... You said this several times this episode. We're not going to replace plastics with paper in our lifetime. We're not going to replace it with glass in our lifetime.

They exist. They're growing exponentially, and they will continue to exist. How would you compare the kind of global agreement we need on plastics to the kind of incredibly successful agreement that we had in 1987 where the Montreal Protocol really was directly responsible for the rejuvenation of the ozone layer? Yeah, so you're absolutely right. The Montreal Protocol has been an enormous success. Another huge success that most people are not aware of is the success we've had in the United States in reducing air pollution.

So we've reduced air pollution in this country by 77% since passage of the Clean Air Act in 1970. And that has saved tens of thousands of lives. And I think the blueprint for dealing with plastics is in broad outline is going to be the same as the blueprint for dealing with air pollution and chloroplorocarbans. It's going to involve a combination of national level efforts in countries and global efforts. So at the national level, countries and states like California, like New York, are going to have to pass laws that restrict one-shot plastic. There's a big bill in the New York State Legislature right now that have successfully passed will greatly reduce plastic packaging. There's got to be enforcement. of those laws that's got to be monitoring.

And there have got to be a combination of penalties for the people that violate the law and incentives for the people that do the right thing. And those are exactly the strategies we've used to knock down air pollution by 77%. I think that the global plastics treaty, if it does incorporate a global cap on plastic production, will basically specify country by country by country, how much plastic each country can make. And then countries are going to have to make choices between the plastics that they want to keep, the essential plastics, and the pointless plastics that they can live without. I want to put two things that you set together and ask you whether you see attention.

On the one hand, we're talking right now about a UN treaty on plastics production that is similar to the Montreal protocol that limited the use of CFCs that were depleting the ozone. That protocol was reached after decades of research and overwhelming evidence that these chemicals were responsible for ozone depletion. You've said, however, that we're not entirely sure about the effect of micro and nanoplastics on our endocrine system or our cardiovascular system. We're not exactly sure what plasticizers like phthalates are doing to us. We're not exactly sure maybe even what forever chemicals are doing to us. us. Is there a danger of moving too quickly with global regulation in a way that the regulation flies ahead of the science? Yeah. So let me revisit your analogy there. When the Montreal

protocol was established, we didn't know everything there was to know about chloro-floricarbons and the ozone hole. There was a lot of evidence. There was a lot of suspicion. But even at that time, the folks who made chloroflorocarbons, the chemical industry, was saying, no, there's too much uncertainty. We shouldn't be precipitous. We shouldn't move ahead here. They wanted to slow things down.

But the nations of the world said, no, we know enough to take action. And we know that if we do not take action, things are going to get worse. I think that's the place we are today with plastics. Are there unknowns? Absolutely. Are those unknowns fairly substantial? Yes, they are. But we know that we have a big problem. We know that plastic waste is clogging the world. We know that that plastic waste is loaded with toxic chemicals. And we know that if plastic production continues to increase exponentially, for example, to double by 2040, we're going to have twice as much of this plastic waste and twice as much of those toxic chemicals. in the environment. And I think we have to ask ourselves,

do we know enough to take action? As a person who practiced pediatrics for many years, I see the situation here analogous to the situation that confronts a pediatrician who's in an emergency room at 11 o'clock at night when parents bring in a child with a bad bellyache. And the pediatrician has to make a decision within a fairly short period of time,

is this just a little bit of gastroenteritis that's going to go away, or is this a hot appendix that I need to call a surgeon and operate on it within the next two or three hours? And it's never an easy decision. You never have all the answers.

Sometimes you get it wrong in either direction. But when you look at the relative risks, there's very little risk to opening the child's belly in finding that the appendix is not inflamed. The risk is minuscule. Whereas the risk of leaving the appendix in place and allowing it to burst and fill the child's belly with pus

and cause peritinitis means that you're consigning that child to a life of disability. I think that's the analogous situation we're in today with plastics. We can sit on it until it bursts or we can take action. Philip Landrigan. Thank you very much. Thank you for listening. Plain English is produced by Devin Biroldi. We've got new episodes every Tuesday and Friday. If you like what you're hearing, give us five stars and a nice review on Apple Podcasts or Spotify or wherever you get your podcast.

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