Phthalate esters in face masks and associated inhalation exposure risk

Wearing face masks as a potential source for inhalation and oral uptake of inanimate toxins - A scoping review

BACKGROUND

From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins.

METHODS

A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation).

RESULTS

24 studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO2.

DISCUSSION

Of course, masks filter larger dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary.

CONCLUSION

Undoubtedly, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins with health threatening and carcinogenic properties at population level with almost zero distance to the airways.

Impact of DEHP exposure on female reproductive health: Insights into uterine effects

Several endocrine disrupting compounds released from plastics, including polyfluoroalkyl substances, bisphenols, flame retardants, phthalates and others, are of great concern to human health due to their high toxicity. This review discusses the effects of di-(2-ethylhexyl) phthalate (DEHP), the most common member of the phthalate family, on female reproduction. In vitro and in vivo studies link DEHP exposure to impaired hypothalamic-pituitary-ovarian s (HPO) axis function, alteration of steroid-hormone levels and dysregulation of their receptors, and changes in uterine morphophysiology. In addition, high urinary DEPH levels have been associated with several reproductive disorders in women, including endometriosis, fibromyoma, fetal growth restriction and pregnancy loss. These data suggest that DEHP may be involved in the pathophysiology of various female reproductive diseases. Therefore, exposure to these compounds should be considered a concern in clinician surveillance practices for women at reproductive age and should be regulated to protect their health and that of their progeny.

Occurrence of phthalates in facemasks used in India and its implications for human exposure

Synthetic polymers with additives are used in the manufacturing of face masks (FMs); hence, FMs could be a potential source of exposure to phthalic acid esters (PAEs). India stands second in the world in terms of the FMs usage since the beginning of Covid-19 pandemic. However, little is known about the PAEs content of FMs used in India. Some PAEs, such as DEHP and DBP are suspected endocrine disrupting chemicals (EDCs); hence, wearing FM may increase the risk of exposure to these EDCs. In this study, we collected 91 samples of FMs from eight Indian cities and analyzed for five PAEs viz. DMP, DEP, DBP, BBP, and DEHP. The PAEs contents in FMs ranged from 101.79 to 27,948.64 ng/g. The carcinogenic risk of N 95 with filter, N-95, and cloth masks was higher than the threshold levels. The findings indicate the need to control PAEs in FMs through regulatory actions.

Prevalence of pharmaceuticals and personal care products, microplastics and co-infecting microbes in the post-COVID-19 era and its implications on antimicrobial resistance and potential endocrine disruptive effects

The COVID-19 (coronavirus disease 2019) pandemic's steady condition coupled with predominance of emerging contaminants in the environment and its synergistic implications in recent times has stoked interest in combating medical emergencies in this dynamic environment. In this context, high concentrations of pharmaceutical and personal care products (PPCPs), microplastics (MPs), antimicrobial resistance (AMR), and soaring coinfecting microbes, tied with potential endocrine disruptive (ED) are critical environmental concerns that requires a detailed documentation and analysis. During the pandemic, the identification, enumeration, and assessment of potential hazards of PPCPs and MPs and (used as anti-COVID-19 agents/applications) in aquatic habitats have been attempted globally. Albeit receding threats in the magnitude of COVID-19 infections, both these pollutants have still posed serious consequences to aquatic ecosystems and the very health and hygiene of the population in the vicinity. The surge in the contaminants post-COVID also renders them to be potent vectors to harbor and amplify AMR. Pertinently, the present work attempts to critically review such instances to understand the underlying mechanism, interactions swaying the current health of our environment during this post-COVID-19 era. During this juncture, although prevention of diseases, patient care, and self-hygiene have taken precedence, nevertheless antimicrobial stewardship (AMS) efforts have been overlooked. Unnecessary usage of PPCPs and plastics during the pandemic has resulted in increased emerging contaminants (i.e., active pharmaceutical ingredients and MPs) in various environmental matrices. It was also noticed that among COVID-19 patients, while the bacterial co-infection prevalence was 0.2-51%, the fungi, viral, protozoan and helminth were 0.3-49, 1-22, 2-15, 0.4-15% respectively, rendering them resistant to residual PPCPs. There are inevitable chances of ED effects from PPCPs and MPs applied previously, that could pose far-reaching health concerns. Furthermore, clinical and other experimental evidence for many newer compounds is very scarce and demands further research. Pro-active measures targeting effective waste management, evolved environmental policies aiding strict regulatory measures, and scientific research would be crucial in minimizing the impact and creating better preparedness towards such events among the masses fostering sustainability.

Correlation between use of different type protective facemasks and the oral ecosystem

BACKGROUND

Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity.

METHODS

34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1).

RESULTS

The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1.

CONCLUSION

It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.

Phthalate acid esters contribute to the cytotoxicity of mask leachate: Cell-based assay for toxicity assessment

After the COVID-19 outbreak, masks have become an essential part of people lives. Although several studies have been conducted to determine the release of hazardous substances from masks, how their co-presence poses a potential exposure risk to human health remains unexplored. In this study, we quantitatively compared the leaching of substances from six different common types of masks, including phthalate acid esters (PAEs), metals, and microplastics (MPs), and comprehensively evaluated the potential cytotoxicity of different leachates. MPs smaller than 3 µm were quantified by Py-GC-MS, and reusable masks showed greater releasing potentials up to 1504 µg/g. We also detected the prevalence of PAEs in masks, with the highest release reaching 42 μg/g, with dibutyl phthalate (DBP), diisobutyl phthalate (DiBP) and bis (2-ethylhexyl) phthalate (DEHP) being the predominant types. Moreover, the antimicrobial cloth masks released 173.0 µg of Cu or 4.5 µg of Ag, representing 2.7% and 0.04% of the original masks, respectively. Our cell-based assay results demonstrated for the first time that mask leachate induced nuclear condensation with DNA damage, and simultaneously triggered high levels of glutathione and reactive oxidative stress production, which exacerbated mitochondrial fragmentation, eventually leading to cell death. Combined with substance identification and correlation analysis, PAEs were found to be the contributors to cytotoxicity. Masks containing Cu or Ag led to acidification of lysosomes and alkalinization of cells. These results strongly suggested that the levels of PAEs in the production of regulatory masks should be strictly controlled.

Exploring the release of hazardous volatile organic compounds from face masks and their potential health risk

Hazardous chemicals released from the petroleum-derived face mask can be inhaled by wearers and cause adverse health effects. Here, we first used headspace solid-phase microextraction coupled with GC-MS to comprehensively analyze the volatile organic compounds (VOCs) released from 26 types of face masks. The results showed that total concentrations and peak numbers ranged from 3.28 to 197 μg/mask and 81 to 162, respectively, for different types of mask. Also, light exposure could affect the chemical composition of VOCs, particularly increasing the concentrations of aldehydes, ketones, organic acids and esters. Of these detected VOCs, 142 substances were matched to a reported database of chemicals associated with plastic packaging; 30 substances were identified by the International Agency for Research on Cancer (IARC) as potential carcinogenic to humans; 6 substances were classified in the European Union as persistent, bioaccumulative, and toxic, or very persistent, very bioaccumulative substance. Reactive carbonyls were ubiquitous in masks, especially after exposure to light. The potential risk of VOCs released from the face masks were then accessed by assuming the extreme scenario that all the VOC residues were released into the breathing air within 3 h. The result showed that the average total concentration of VOCs (17 μg/m3) was below the criterion for hygienic air, but seven substances, 2-ethylhexan-1-ol, benzene, isophorone, heptanal, naphthalene, benzyl chloride, and 1,2-dichloropropane exceeded the non-cancer health guidelines for lifetime exposure. This finding suggested that specific regulations should be adopted to improve the chemical safety of face masks.

Insight into the health risk implicated in mitochondrial toxicity of dibutyl phthalate exposure on zebrafish (Danio rerio) cells

Dibutyl phthalate (DBP) is commonly applied plasticizer in plastic products such as face masks, easily leaches or migrates into environment and its widespread contamination posed profound health risks. Further concerns rise regarding to the toxicity of DBP at subcellular level, while little is known about the ranging effects on mitochondrial susceptibility. Present study investigated the mitochondrial impairments with implicated cell death upon DBP exposure on zebrafish cells. Elevated mitochondrial oxidative stress reduced its membrane potential and count, enhanced fragmentation, and impaired ultrastructure that showed smaller size and cristae rupture. Afterwards, the critical function of ATP synthesis was damaged and the stabilized binding capacity between DBP with mitochondrial respiratory complexes was simulated by the molecular docking. And the top pathways enrichment of mitochondrion and metabolism by transcriptome analyses verified the mitochondrial dysfunction that indicated the human diseases risks. The mitochondrial DNA (mtDNA) replication and transcription with DNA methylation modifications were also disrupted, reflecting the genotoxicity on mtDNA. Moreover, the activated autophagy and apoptosis underlying mitochondrial susceptibility integrated into cellular homeostasis changes. These findings provide the first systemic evidence broadening and illustrating the mitochondrial toxicity of DBP exposure on zebrafish model that raise concern on phthalates contamination and ecotoxicological evaluation.

Occurrence and ecological risks of microplastics and phthalate esters in organic solid wastes: In a landfill located nearby the Persian Gulf

Landfill sites are the main source of plastic waste. Thus, municipal solid waste (MSW) in landfills may act as a reservior of microplastics (MPs) and related pollutants such as phthalate esters (PAEs) into surrounding environment. However, there is limited information on MPs and PAEs in landfill sites. Levels of MPs and PAEs in organic solid waste disposed in a landfill of Bushehr port were investigated for the first time in this study. The mean MPs and PAEs levels in organic MSW samples were 12.3 items/g and 7.99 μg/g, respectively, and the mean PAEs concentration in MPs was 87.5 μg/g. The highest number of MPs was related to the size classes of >1000 μm and <25 μm. The highest dominant type, color, and shape of MPs in organic MSW were nylon, white/transparent, and fragments, respectively. Di (2-ethylhexyl) phthalate (DEHP) and diisobutyl phthalate (DiBP) were the dominant compounds of PAEs in organic MSW. Based on the finding of present study, MPs showed a high hazard index (HI). DEHP, dioctyl phthalate (DOP), and DiBP demonstrated high-level hazards for sensitive organisms in water. This work illustrated considerable MPs and PAEs levels from an uncontrolled landfill without adequate protection, possibly contributing to their release into the environment. The sites of landfill located near marine environments, such as Bushehr port landfill adjacent to the Persian Gulf, may indicate critical threats to marine organisms and the food chain. Continuous landfills control and monitoring, especially the ones near the coastal area, is highly recommended to prevent further environmental pollution.

Chemical-analytical characterization and leaching of heavy metals associated with nanoparticles and microplastics from commercial face masks and the abundance of personal protective equipment (PPE) waste in three metropolitan cities of South America

In this study, we surveyed the presence of personal protective equipment (PPE) waste on the streets of Bogotá-Colombia, Lima-Perú, and Mar del Plata-Argentina. Furthermore, this work is also focused on the release capacity of Ag, Cu, and Zn metals associated with nanoparticles, and microplastics (MPs) from textile face masks (TFMs) and disposable face masks. According to our results, an association between low-income areas and PPE waste was found, which may be related to the periodicity of waste collection and economic activity. Polymers, like polypropylene, cotton-polyester, and additives, such as CaCO₃, MgO, and Ag/Cu as nanoparticles, were identified. TFMs released high levels of Cu (35,900-60,200 μg·L^-1), Zn (2340-2380 μg·L^-1), and MPs (4528-10,640 particles/piece). Metals associated with nanoparticles leached by face masks did not present any antimicrobial activity against P. aeruginosa. Our study suggests that TFMs may leach large amounts of polluting nano/micromaterials in aquatic environments with potential toxicological effects on organisms.

Disposable Polypropylene Face Masks: A Potential Source of Micro/Nanoparticles and Organic Contaminates in Humans

We have been effectively protected by disposable propylene face masks during the COVID-19 pandemic; however, they may pose health risks due to the release of fine particles and chemicals. We measured micro/nanoparticles and organic chemicals in disposable medical masks, surgical masks, and (K)N95 respirators. In the breathing-simulation experiment, no notable differences were found in the total number of particles among mask types or between breathing intensities. However, when considering subranges, <2.5 μm particles accounted for ∼90% of the total number of micro/nanoparticles. GC-HRMS-based suspect screening tentatively revealed 79 (semi)volatile organic compounds in masks, with 18 being detected in ≥80% of samples and 44 in ≤20% of samples. Three synthetic phenolic antioxidants were quantified, and AO168 reached a median concentration of 2968 ng/g. By screening particles collected from bulk mask fabrics, we detected 18 chemicals, including four commonly detected in masks, suggesting chemical partition between the particles and the fabric fibers and chemical exposure via particle inhalation. These particles and chemicals are believed to originate from raw materials, intentionally and nonintentionally added substances in mask production, and their transformation products. This study highlights the need to study the long-term health risks associated with mask wearing and raises concerns over mask quality control.

Current knowledge on the presence, biodegradation, and toxicity of discarded face masks in the environment

During the first year of the COVID-19 pandemic, facemasks became mandatory, with a great preference for disposable ones. However, the benefits of face masks for health safety are counteracted by the environmental burden related to their improper disposal. An unprecedented influx of disposable face masks entering the environment has been reported in the last two years of the pandemic, along with their implications in natural environments in terms of their biodegradability, released contaminants and ecotoxicological effects. This critical review addresses several aspects of the current literature regarding the (bio)degradation and (eco)toxicity of face masks related contaminants, identifying uncertainties and research needs that should be addressed in future studies. While it is indisputable that face mask contamination contributes to the already alarming plastic pollution, we are still far from determining its real environmental and ecotoxicological contribution to the issue. The paucity of studies on biodegradation and ecotoxicity of face masks and related contaminants, and the uncertainties and uncontrolled variables involved during experimental procedures, are compromising eventual comparison with conventional plastic debris. Studies on the abundance and composition of face mask-released contaminants (microplastics/fibres/ chemical compounds) under pre- and post-pandemic conditions should, therefore, be encouraged, along with (bio)degradation and ecotoxicity tests considering environmentally relevant settings. To achieve this, methodological strategies should be developed to overcome technical difficulties to quantify and characterise the smallest MPs and fibres, adsorbents, and leachates to increase the environmental relevancy of the experimental conditions.

Radiolabelling and in vivo radionuclide imaging tracking of emerging pollutants in environmental toxicology: A review

Emerging pollutants (EPs) have become a global concern, attracting tremendous attention because of serious threats to human and animal health. EP diversity emanates from their behaviour and ability to enter the body via multiple pathways and exhibit completely different distribution, transport, and excretion. To better understand the in vivo behaviour of EPs, we reviewed radiolabelling and in vivo radionuclide imaging tracking of various EPs, including micro- and nano-plastics, perfluoroalkyl substances, metal oxides, pharmaceutical and personal care products, and so on. Because this accurate and quantitative imaging approach requires the labelling of radionuclides onto EPs, the main strategies for radiolabelling were reviewed, such as synthesis with radioactive precursors, element exchange, proton beam activation, and modification. Spatial and temporal biodistribution of various EPs was summarised in a heat map, revealing that the absorption, transport, and excretion of EPs are markedly related to their type, size, and pathway into the body. These findings implicate the potential toxicity of diverse EPs in organs and tissues. Finally, we discussed the potential and challenges of radionuclide imaging tracking of EPs, which can be considered in future EPs studies.

Di-n-butyl phthalate stress induces changes in the core bacterial community associated with nitrogen conversion during agricultural waste composting

Nitrogen (N) loss during composting reduces the quality of compost products and causes secondary environmental pollution. Phthalate esters (PAEs) are common pollutants in agricultural wastes. However, little information is currently available on how PAEs affect N conversion during agricultural waste composting. This research systematically analyzed the impact of di-n-butyl phthalate (DBP) pollution on the N conversion and its related microbial community during composting. Our results indicated that DBP stress results in a shorter thermophilic phase, and then slower compost maturation during composting. Notably, DBP stress inhibited the conversion of ammonia to nitrate, but increased the release of NH₃ and N₂O leading to an increased N loss and an elevated greenhouse effect. Furthermore, DBP exposure led to a reduction of bacteria related to NH₄⁺ and NO₃^- conversion and altered the network complexity of the bacterial community involved in N conversion. It also reduced the abundance of a major nitrification gene (amoA) (P < 0.01) and increased the abundance of denitrification genes (nirK and norB) (P < 0.05). Moreover, DBP affected the overall microbial community composition at all tested concentrations. These findings provide theoretical and methodological basis for improving the quality of PAE-contaminated agricultural waste compost products and reducing secondary environmental pollution.

Determination and risk assessment of phthalates in face masks. An Italian study

Serious human health concerns have been recently raised from daily use of face masks, due to the possible presence of hazardous compounds as the phthalic acid esters (PAEs). In this study, the content of 11 PAEs in 35 commercial masks was assessed by applying a specific and accurate method, using Gas Chromatography/Mass Spectrometry. Surgical, FFP2 and non-surgical models, for both adults and children were collected from the Italian market. Analyses showed that four of the target analytes were detected in all tested samples with median total concentrations ranging between 23.6 mg/kg and 54.3 mg/kg. Results obtained from the experimental analysis were used in the risk assessment studies carried out for both carcinogenic and non-carcinogenic effects. Doses of exposure (D_exp) of PAEs ranged from 6.43 × 10^-5 mg/kg bw/day to 1.43 × 10^-2 mg/kg bw/day. Cumulative risk assessment was performed for non-carcinogenic and carcinogenic effects. No potential risk was found for non-carcinogenic effects, yet the 20% of the mask samples showed potential carcinogenic effects for humans. A refined exposure assessment was performed showing no risk for carcinogenic effects. This paper presents a risk assessment approach for the identification of potential risks associated to the use of face masks.

An ecotoxicological perspective of microplastics released by face masks

The accelerated use, massive disposal, and contamination with face masks during the COVID-19 pandemic have raised new questions regarding their negative impact on the environment emerged. One major concern is whether microplastics (MPs) derived from face masks (FMPs) represent an important ecotoxicological hazard. Here, we discussed the shortcomings, loose ends, and considerations of the current literature investigating the ecotoxicological effects of FMPs on aquatic and terrestrial organisms. Overall, there are multiple uncertainties regarding the true impact of FMPs at a certain concentration due to the presence of uncontrolled or unknown degradation products, such as MPs of various size ranges even nano-sized (<1 µm) and chemical additives. It is apparent that FMPs may induce endocrine-disrupting and behavioral effects in different organisms. However, the results of FMPs should be carefully interpreted, as these cannot be extrapolated at a global scale, by taking into account a number of criteria such as face mask manufacturers, providers, consumer preferences, and type of face masks. Considering these uncertainties, it is still not possible to estimate the contribution of face masks to the already existing MP issue.

Disposable face masks release micro particles to the aqueous environment after simulating sunlight aging: Microplastics or non-microplastics?

This study focuses on characterizing microplastics and non-microplastics released from surgical masks (SMs), N95 masks (N95), KN95 masks (KN95), and children's masks (CMs) after simulating sunlight aging. Based on micro-Raman spectrum analysis, it was found that the dominant particles released from masks were non-microplastics (66.76-98.85%). Unfortunately, CMs released the most microplastics, which is 8.92 times more than SMs. The predominant size range of microplastics was 30-500 µm, and the main polymer types were PP and PET. Compared with the whole SMs, the microplastic particles released from the cutting-SMs increased conspicuously, which is 12.15 times that of the whole SMs. The main components of non-microplastics include β-carotene, microcrystalline cellulose 102, and eight types of minerals. Furthermore, non-microplastics were mainly fibrous and fragmented in appearance, similar to the morphology of microplastics. After 15 days of UVA-aging, the fibers of the face layers had cracks to varying degrees. It was estimated that these four types of masks can release at least 31.5 trillion microplastics annually in China. Overall, this study demonstrated that the masks could release a large quantity of microplastics and non-microplastics to the environment after sunlight aging, deserving urgent attention in the future study.

Face Mask: As a Source or Protector of Human Exposure to Microplastics and Phthalate Plasticizers?

Wearing masks has become the norm during the Coronavirus disease pandemic. Masks can reportedly interface with air pollutants and release microplastics and plastic additives such as phthalates. In this study, an experimental device was set up to simulate the impact of five kinds of masks (activated-carbon, N95, surgical, cotton, and fashion masks) on the risk of humans inhaling microplastics and phthalates during wearing. The residual concentrations of seven major phthalates ranged from 296 to 72,049 ng/g (median: 1242 ng/g), with the lowest and the highest concentrations detected in surgical (median: 367 ng/g) and fashion masks (median: 37,386 ng/g), respectively. During the whole inhalation simulation process, fragmented and 20-100 μm microplastics accounted for the largest, with a rapid release during the first six hours. After one day's wearing, that of 6 h, while wearing different masks, 25-135 and 65-298 microplastics were inhaled indoors and outdoors, respectively. The total estimated daily intake of phthalates with indoor and outdoor conditions by inhalation and skin exposure ranged from 1.2 to 13 and 0.43 to 14 ng/kg bw/d, respectively. Overall, surgical masks yield a protective effect, while cotton and fashion masks increase human exposure to microplastics and phthalates both indoors and outdoors compared to no mask wearing. This study observed possible risks from common facemasks and provided suggestions to consumers for selecting suitable masks to reduce exposure risks from microplastics and phthalate acid.

Dynamic variation and inhalation exposure of organophosphates esters and phthalic acid esters in face masks

The coronavirus pandemic (COVID-19) has posed a huge global health threat since December 2019. Wearing face masks is known as an effective measure for controlling the wide spread of COVID-19 and its variants. But on the other hand, face masks could be a potential source of organophosphate esters (OPEs) and phthalic acid esters (PAEs) as they are extensively added in masks. However, knowledge associated with the occurrence as well as inhalation risks of OPEs and PAEs in masks is limited. In this study, OPEs and PAEs were determined in different types of mask samples collected from the local market. OPEs and PAEs were detected in mask samples ranging from 36.7 to 855 ng/g, and from 251 to 3830 ng/g, respectively. Relatively lower OPEs and PAEs concentrations were observed in disposable mask for toddlers. Simulated inhalation experiment indicated that the mass loss of OPEs and PAEs was 136 and 3910 ng/mask in disposable masks, 71.9 and 763 ng/mask in disposable mask for toddlers, 924 and 1020 ng/mask in N95 mask after 12 h, respectively. Significantly negative correlations were exhibited between the decrement of OPEs in masks and the increment of OPEs in corresponding polyurethane foams (PUFs) during the course, elucidating OPEs released from masks could be well captured by PUFs. With regard to the variation over time, predominant OPE and PAE analogues showed semblable release and absorption tendency in mask and corresponding PUF. Inhalation exposure risk of OPEs and PAEs was estimated based on the increment of pollutants in PUF. The estimated daily intakes (EDIs), hazard index (HI) and carcinogenic risk (CR) were also calculated and they were within the threshold levels. This study provides the evidence of OPEs and PAEs releasing from the face masks during wearing and unveiled a potential source of OPEs and PAEs exposure to humans.

Unraveling the potential human health risks from used disposable face mask-derived micro/nanoplastics during the COVID-19 pandemic scenario: A critical review

With the global spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), disposable face masks (DFMs) have caused negative environmental impacts. DFMs will release microplastics (MPs) and nanoplastics (NPs) during environmental degradation. However, few studies reveal the release process of MPs/NPs from masks in the natural environment. This review presents the current knowledge on the abiotic and biotic degradation of DFMs. Though MPs and NPs have raised serious concerns about their potentially detrimental effects on human health, little attention was paid to their impacts on human health from DFM-derived MPs and NPs. The potential toxicity of mask-derived MPs/NPs, such as gastrointestinal toxicity, pneumotoxicity, neurotoxicity, hepatotoxicity, reproductive and transgenerational toxicity, and the underlying mechanism will be discussed in the present study. MPs/NPs serve as carriers of toxic chemicals and pathogens, leading to their bioaccumulation and adverse effects of biomagnification by food chains. Given human experiments are facing ethical issues and animal studies cannot completely reveal human characteristics, advanced human organoids will provide promising models for MP/NP risk assessment. Moreover, in-depth investigations are required to identify the release of MPs/NPs from discarded face masks and characterize their transportation through the food chains. More importantly, innovative approaches and eco-friendly strategies are urgently demanded to reduce DFM-derived MP/NP pollution.

Release of phthalate esters (PAEs) and microplastics (MPs) from face masks and gloves during the COVID-19 pandemic

Marine pollution with personal protective equipment (PPE) has recently gained major attention. Multiple studies reported the release of microplastics (MPs) and chemical contaminants from face masks, the most used PPE type. However, not much is known concerning the release of phthalate esters (PAEs) in aquatic media, as well as the hazard posed by other types of PPE. In the present study, we investigated the release of MPs and PAEs from face masks and gloves recovered from the environment. The results indicated that both PPEs release MPs comparable to the literature, but higher concentrations were presented by face masks. In turn, the total concentration of six PAEs was higher in gloves than in face masks. The release of these contaminants is exacerbated over time. The present study allows researchers to understand the contribution of PPE to marine pollution while accounting for gloves, a generally overlooked source of contaminants.

The plastic pandemic: COVID-19 has accelerated plastic pollution, but there is a cure

Plastic pollution is now present in all areas of our planet, including its last wilderness, Antarctica, and the plastic crisis has further escalated because of COVID-19. The pandemic has caused a significant increase in the global consumption of single-use protective items such as masks and gloves. These and other plastic items add to the suite of plastic pollution issues, from entanglement of wildlife to microplastic bioaccumulation. Given plastics are a major threat facing humans and wildlife, swift action to reduce plastic pollution is urgently needed. Solutions to plastic pollution are within reach. With collective, impactful action we will ensure a better future for our planet and ourselves. Here, we propose several measures for decision-makers to implement to achieve a solution and tackle plastic pollution as a united, global community.

Migration of Microplastics and Phthalates from Face Masks to Water

Since the outbreak of COVID-19, face masks have been introduced in the complex strategy of infection prevention and control. Face masks consist of plastic polymers and additives such as phthalates. The aim of this study was to evaluate the migration of microplastics (MP) and phthalates from face masks to water. Four types of masks including FFP2 masks and surgical were studied. Masks were first characterized to determine the different layers and the material used for their fabrication. Then, masks were cut into 20 pieces of 0.5 cm2, including all their layers, placed in water, and the migration of MP and phthalates was evaluated according to the conditions stated in EU Regulation No 10/2011 on plastic materials and articles intended to come into contact with food. For MP, the morphological analysis (shape, dimension, particle count) was performed using a stereomicroscope, while the identification of both masks and MP released was conducted using μ-Fourier-transform infrared spectroscopy (µ-FT-IR). Migration of phthalates was assessed by ultra-high-performance liquid chromatography coupled to triple quadrupole mass spectrometer (UPLC-MS/MS). Face masks analyzed in the present study were made of atactic polypropylene (PP) as stated by the manufacturer. The μ-FT-IR confirmed that PP and polyamide (PA) were released as fragments, while both PP and polyester (PES) were released as fibers. In addition, 4 phthalates were identified at concentrations between 2.34 and 21.0 µg/mask. This study shows that the migration study can be applied to evaluate the potential release of MP and phthalates from face masks to water and could give a hint for the potential impact of their incorrect disposal on the aquatic resources.

Public face masks wearing during the COVID-19 pandemic: A comprehensive analysis is needed for potential implications

Face mask-wearing as a public health measure has been practiced since the coronavirus 2019 (COVID-19) pandemic outbreak. Extensive research has shown that face masks are an effective non-pharmaceutical measure to contain the spread of respiratory infections. However, recent studies indicate that face masks release microplastics and other contaminants that have adverse health effects on humans. This communication reviews the evidence for face mask as a potential source of contaminants capable of adversely affecting human health. The benefits of face masks in reducing the transmission of SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2) and seasonal communicable diseases were addressed. In addition, the risk of inhaling microplastics and organic contaminants, as well as the associated exposure level, were discussed. Finally, the potential research gaps that need to be addressed were outlined to provide a holistic view of the problem. This communication has illustrated that face mask-wearing as a public health measure to contain the spread of COVID-19 could be a potential risk factor for human health. Very few studies have been done on microplastics, organic pollutants, and trace metal inhalation from surgical masks. However, future work providing a comprehensive understanding of the risk and exposure levels needs to be undertaken.

Personal protective equipment (PPE) pollution driven by the COVID-19 pandemic in coastal environment, Southeast Coast of India

The rise in the use of single-use plastics and personal protective equipment (PPE) has increased plastic waste in the marine environment. In this study, we surveyed the presence of PPE (face masks and gloves) discharged in 6 beaches along the coast of India. A total of 496 PPE were counted with an average density of 1.08 × 10^-3 PPE m^-2. The PPE density found was comparable to previous studies. Face masks were the most recorded type of PPE (98.39%), with gloves accounting for only 1.61% of the total. However, a significant reduction in the appearance of PPE was recorded on all six beaches, likely due to the increase in vaccination rates. The most contaminated places were the beaches with recreational activities + fishing. It has been noticed that the lack of awareness of environmental pollution and the negligence of the population and the mismanagement of municipal waste are the main causes of beach pollution by PPE. This study confirms the potential threat of PPE to terrestrial and aquatic organisms of multiple taxa in India, but further studies are needed to quantify the impact of this type of waste on marine animals.

Personal protective equipment (PPE) pollution driven by the COVID-19 pandemic along the shoreline of Lake Tana, Bahir Dar, Ethiopia

Personal protective equipment (PPE) pollution has become one of the most pending environmental challenges resulting from the pandemic. While various studies investigated PPE pollution in the marine environment, freshwater bodies have been largely overlooked. In the present study, PPE monitoring was carried out in the vicinity of Lake Tana, the largest lake in Ethiopia. PPE density, types, and chemical composition (FTIR spectroscopy) were reported. A total of 221 PPEs were identified with a density ranging from 1.22 × 10^-5 PPE m^-2 (control site S1) to 2.88× 10^-4 PPE m^-2 with a mean density of 1.54 × 10^-4 ± 2.58 × 10^-5 PPE m^-2. Mismanaged PPE waste was found in all the sampling sites, mostly consisting of surgical face masks (93.7%). Statistical analyzes revealed significantly higher PPE densities in sites where several recreational, touristic, and commercial activities take place, thus, revealing the main sources of PPE pollution. Furthermore, polypropylene and polyester fabrics were identified as the main components of surgical and reusable cloth masks, respectively. Given the hazard that PPEs represent to aquatic biota (e.g., entanglement, ingestion) and their ability to release microplastics (MPs), it is necessary to implement sufficient solid waste management plans and infrastructure where lake activities take place. Additionally, local authorities must promote and ensure sustainable tourism in order to maintain the ecosystems in Lake Tana. Prospective research priorities regarding the colonization and degradation of PPE, as well as the release of toxic chemicals, were identified and discussed.

Per- and Polyfluoroalkyl Substances (PFAS) in Facemasks: Potential Source of Human Exposure to PFAS with Implications for Disposal to Landfills

Facemasks are important tools for fighting against disease spread, including Covid-19 and its variants, and some may be treated with per- and polyfluoroalkyl substances (PFAS). Nine facemasks over a range of prices were analyzed for total fluorine and PFAS. The PFAS compositions of the masks were then used to estimate exposure and the mass of PFAS discharged to landfill leachate. Fluorine from PFAS accounted only for a small fraction of total fluorine. Homologous series of linear perfluoroalkyl carboxylates and the 6:2 fluorotelomer alcohol indicated a fluorotelomer origin. Inhalation was estimated to be the dominant exposure route (40%-50%), followed by incidental ingestion (15%-40%) and dermal (11%-20%). Exposure and risk estimates were higher for children than adults, and high physical activity substantially increased inhalation exposure. These preliminary findings indicate that wearing masks treated with high levels of PFAS for extended periods of time can be a notable source of exposure and have the potential to pose a health risk. Despite modeled annual disposal of ~29-91 billion masks, and an assuming 100% leaching of individual PFAS into landfill leachate, mask disposal would contribute only an additional 6% of annual PFAS mass loads and less than 11 kg of PFAS discharged to U.S. wastewater.

Binational survey of personal protective equipment (PPE) pollution driven by the COVID-19 pandemic in coastal environments: Abundance, distribution, and analytical characterization

In the present contribution, two nationwide surveys of personal protective equipment (PPE) pollution were conducted in Peru and Argentina aiming to provide valuable information regarding the abundance and distribution of PPE in coastal sites. Additionally, PPE items were recovered from the environment and analyzed by Fourier transformed infrared (FTIR) spectroscopy, Scanning electron microscopy (SEM) with Energy dispersive X-ray (EDX), and X-ray diffraction (XRD), and compared to brand-new PPE in order to investigate the chemical and structural degradation of PPE in the environment. PPE density (PPE m^-2) found in both countries were comparable to previous studies. FTIR analysis revealed multiple polymer types comprising common PPE, mainly polypropylene, polyamide, polyethylene terephthalate, and polyester. SEM micrographs showed clear weathering signs, such as cracks, cavities, and rough surfaces in face masks and gloves. EDX elemental mapping revealed the presence of elemental additives, such as Ca in gloves and face masks and AgNPs as an antimicrobial agent. Other metals found on the surface of PPE were Mo, P, Ti, and Zn. XRD patterns displayed a notorious decrease in the crystallinity of polypropylene face masks, which could alter its interaction with external contaminants and stability. The next steps in this line of research were discussed.

Degradation of plastics associated with the COVID-19 pandemic

The ongoing COVID-19 pandemic has resulted in an unprecedented form of plastic pollution: personal protective equipment (PPE). Numerous studies have reported the occurrence of PPE in the marine environment. However, their degradation in the environment and consequences are poorly understood. Studies have reported that face masks, the most abundant type of PPE, are significant sources of microplastics due to their fibrous microstructure. The fibrous material (mostly consisting of polypropylene) exhibits physical changes in the environment, leading to its fracture and detachment of microfibers. Most studies have evaluated PPE degradation under controlled laboratory conditions. However, in situ degradation experiments, including the colonization of PPE, are largely lacking. Although ecotoxicological studies are largely lacking, the first attempts to understand the impact of MPs released from face masks showed various types of impacts, such as fertility and reproduction deficiencies in both aquatic and terrestrial organisms.

Recent Advances in Facemask Devices for In Vivo Sampling of Human Exhaled Breath Aerosols and Inhalable Environmental Exposures

Since the COVID-19 pandemic, the unprecedented use of facemasks has been requiring for wearing in daily life. By wearing facemask, human exhaled breath aerosols and inhaled environmental exposures can be efficiently filtered and thus various filtration residues can be deposited in facemask. Therefore, facemask could be a simple, wearable, in vivo, onsite and noninvasive sampler for collecting exhaled and inhalable compositions, and gain new insights into human health and environmental exposure. In this review, the recent advances in developments and applications of in vivo facemask sampling of human exhaled bacteria, viruses, proteins, and metabolites, and inhalable facemask contaminants and air pollutants, are reviewed. New features of facemask sampling are highlighted. The perspectives and challenges on further development and potential applications of facemask devices are also discussed.

An Overview of Chemical Additives on (Micro)Plastic Fibers: Occurrence, Release, and Health Risks

Plastic fibers are ubiquitous in daily life with additives incorporated to improve their performance. Only a few restrictions exist for a paucity of common additives, while most of the additives used in textile industry have not been clearly regulated with threshold limits. The production of synthetic fibers, which can shed fibrous microplastics easily (< 5 mm) through mechanical abrasion and weathering, is increasing annually. These fibrous microplastics have become the main composition of microplastics in the environment. This review focuses on additives on synthetic fibers; we summarized the detection methods of additives, compared concentrations of different additive types (plasticizers, flame retardants, antioxidants, and surfactants) on (micro)plastic fibers, and analyzed their release and exposure pathways to environment and human beings. Our prediction shows that the amounts of predominant additives (phthalates, organophosphate esters, bisphenols, per- and polyfluoroalkyl substances, and nonylphenol ethoxylates) released from clothing microplastic fibers (MFs) are estimated to reach 35, 10, 553, 0.4, and 568 ton/year to water worldwide, respectively; and 119, 35, 1911, 1.4, and 1965 ton/year to air, respectively. Human exposure to MF additives via inhalation is estimated to be up to 4.5–6440 µg/person annually for the above five additives, and via ingestion 0.1–204 µg/person. Notably, the release of additives from face masks is nonnegligible that annual human exposure to phthalates, organophosphate esters, per- and polyfluoroalkyl substances from masks via inhalation is approximately 491–1820 µg/person. This review helps understand the environmental fate and potential risks of released additives from (micro)plastic fibers, with a view to providing a basis for future research and policy designation of textile additives.