{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:54:34Z","timestamp":1791410074110,"version":"4.3.3"},"reference-count":122,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Plastic production and subsequent environmental contamination have increased substantially in recent decades, resulting in pervasive human exposure to microplastics (MPs), nanoplastics (NPs), and plastic-associated additives such as bisphenols and phthalates. These substances are known to induce toxic effects via multiple biological mechanisms, including oxidative stress, inflammation, apoptosis, immune system disruption, and genotoxicity. While exceptions exist, current research generally indicates that these exposures may adversely affect fertility. Notably, children constitute the most vulnerable demographic due to behavioral tendencies, higher intake-to-body-weight ratios, underdeveloped detoxification systems, and critical developmental periods of susceptibility. Evidence demonstrates that exposure commences in utero, with MPs, NPs, and additives identified in placental tissue, amniotic fluid, cord blood, and meconium\u2014factors associated with impaired fetal growth and reduced gestational duration. After birth, additional exposure occurs through diet, inhalation, household dust, feeding equipment, toys, and consumer products. Experimental and epidemiological studies suggest that plastics may adversely affect multiple physiological systems. Reported outcomes include altered pubertal development, reduced fertility, neurodevelopmental abnormalities, respiratory diseases such as asthma, and increased risks of metabolic disorders, including obesity and insulin resistance. However, substantial knowledge gaps remain: the relative toxicity of different polymers and additives, dose\u2013response relationships, critical exposure periods, and long-term consequences are not yet fully defined. Given growing concern and mounting evidence of harm, precautionary measures are warranted. Reducing nonessential plastic use, strengthening regulatory actions, improving product labeling, and promoting public awareness are urgent priorities, particularly in vulnerable and resource-limited communities. Further mechanistic studies and longitudinal human research are essential to clarify health risks, guide safer material substitutions, and inform evidence-based policies aimed at protecting children from avoidable plastic-related toxicity.<\/jats:p>","DOI":"10.3390\/jcm14238399","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"8399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Plastic Pollution and Child Health: A Narrative Review of Micro- and Nanoplastics, Additives, and Developmental Risks"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3468-5568","authenticated-orcid":false,"given":"Nicola","family":"Principi","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Argentiero","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice Rita","family":"Campana","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajrie","family":"Seferi","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cinti","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","unstructured":"British Plastic Federation (2025, September 22). Plastic Applications. Available online: https:\/\/www.bpf.co.uk\/plastipedia\/applications\/Default.aspx#:~:text=What%20sectors%20use%20plastic?,and%20electronics%20and%20industrial%20machinery."},{"key":"ref_2","unstructured":"United Nations (2025, September 22). Beat Plastic Pollution. Available online: https:\/\/www.un.org\/pl\/node\/71013#:~:text=Beat%20plastic%20pollution,more%20if%20inhalation%20is%20considered."},{"key":"ref_3","unstructured":"(2025, September 22). OECD Global Plastics Outlook. Available online: https:\/\/www.oecd.org\/content\/dam\/oecd\/en\/publications\/support-materials\/2022\/02\/global-plastics-outlook_a653d1c9\/Global%20Plastics%20Outlook%20I.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e02044","DOI":"10.1002\/eap.2044","article-title":"What is known and unknown about the effects of plastic pollution: A meta-analysis and systematic review","volume":"30","author":"Bucci","year":"2020","journal-title":"Ecol. Appl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1126\/science.abh0945","article-title":"Plastic ingestion as an evolutionary trap: Toward a holistic understanding","volume":"373","author":"Santos","year":"2021","journal-title":"Science"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1038\/s41559-025-02678-8","article-title":"Plastic pollution has the potential to alter ecological and evolutionary processes in aquatic ecosystems","volume":"9","author":"Haney","year":"2025","journal-title":"Nat. Ecol. Evol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"116554","DOI":"10.1016\/j.envpol.2021.116554","article-title":"Understanding plastic degradation and microplastic formation in the environment: A review","volume":"274","author":"Zhang","year":"2021","journal-title":"Environ. Pollut."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.envpol.2018.01.024","article-title":"Current opinion: What is a nanoplastic?","volume":"235","author":"Gigault","year":"2018","journal-title":"Environ. Pollut."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kochanek, A., Gr\u0105z, K., Potok, H., Gronba-Chy\u0142a, A., Kwa\u015bny, J., Wiewi\u00f3rska, I., Ciu\u0142a, J., Basta, E., and \u0141api\u0144ski, J. (2025). Micro- and Nanoplastics in the Environment: Current State of Research, Sources of Origin, Health Risks, and Regulations\u2014A Comprehensive Review. Toxics, 13.","DOI":"10.3390\/toxics13070564"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"120747","DOI":"10.1016\/j.envpol.2022.120747","article-title":"Microplastics and plastics-associated contaminants in food and beverages; Global trends, concentrations, and human exposure","volume":"317","author":"Sewwandi","year":"2022","journal-title":"Environ. Pollut."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e202401065","DOI":"10.1002\/cssc.202401065","article-title":"Microplastics in Cosmetics: Open Questions and Sustainable Opportunities","volume":"17","author":"Giustra","year":"2024","journal-title":"ChemSusChem"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"119364","DOI":"10.1016\/j.jenvman.2023.119364","article-title":"Additives of plastics: Entry into the environment and potential risks to human and ecological health","volume":"348","author":"Maddela","year":"2023","journal-title":"J. Environ. Manag."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"118535","DOI":"10.1016\/j.envres.2024.118535","article-title":"The potential impact of nano- and microplastics on human health: Understanding human health risks","volume":"251","author":"Winiarska","year":"2024","journal-title":"Environ. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"168946","DOI":"10.1016\/j.scitotenv.2023.168946","article-title":"The potential toxicity of microplastics on human health","volume":"912","author":"Zhao","year":"2024","journal-title":"Sci. Total. Environ."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Mi\u0161\u013eanov\u00e1, C., Valachovi\u010dov\u00e1, M., and Slez\u00e1kov\u00e1, Z. (2024). An Overview of the Possible Exposure of Infants to Microplastics. Life, 14.","DOI":"10.20944\/preprints202402.0072.v1"},{"key":"ref_16","unstructured":"European Commission (2025, October 01). EU Restrictions on Certain Single-Use Plastics. Available online: https:\/\/environment.ec.europa.eu\/topics\/plastics\/single-use-plastics\/eu-restrictions-certain-single-use-plastics_en."},{"key":"ref_17","unstructured":"(2025, October 01). USEPA Plastics. Available online: https:\/\/environment.ec.europa.eu\/topics\/plastics_en."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"106274","DOI":"10.1016\/j.envint.2020.106274","article-title":"Plasticenta: First evidence of microplastics in human placenta","volume":"146","author":"Ragusa","year":"2021","journal-title":"Environ. Int."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ragusa, A., Matta, M., Cristiano, L., Matassa, R., Battaglione, E., Svelato, A., De Luca, C., D\u2019Avino, S., Gulotta, A., and Rongioletti, M.C.A. (2022). Deeply in Plasticenta: Presence of Microplastics in the Intracellular Compartment of Human Placentas. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811593"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"14782","DOI":"10.1007\/s11356-025-36474-5","article-title":"Adverse effects of a realistic concentration of human exposure to microplastics on markers of placental barrier permeability in pregnant rats","volume":"32","author":"Haddadi","year":"2025","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"108220","DOI":"10.1016\/j.envint.2023.108220","article-title":"Temporal trends in microplastic accumulation in placentas from pregnancies in Hawai\u2019i","volume":"180","author":"Weingrill","year":"2023","journal-title":"Environ. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"159060","DOI":"10.1016\/j.scitotenv.2022.159060","article-title":"Identification of microplastics in human placenta using laser direct infrared spectroscopy","volume":"856","author":"Zhu","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"158699","DOI":"10.1016\/j.scitotenv.2022.158699","article-title":"Detection of various microplastics in placentas, meconium, infant feces, breastmilk and infant formula: A pilot prospective study","volume":"854","author":"Liu","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"17774","DOI":"10.1021\/acs.est.2c04706","article-title":"The Association Between Microplastics and Microbiota in Placentas and Meconium: The First Evidence in Humans","volume":"57","author":"Liu","year":"2023","journal-title":"Environ. Sci. Technol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhu, M., Li, X., Lin, W., Zeng, D., Yang, P., Ni, W., Chen, Z., Lin, B., Lai, L., and Ouyang, Z. (2024). Microplastic Particles Detected in Fetal Cord Blood, Placenta, and Meconium: A Pilot Study of Nine Mother-Infant Pairs in South China. Toxics, 12.","DOI":"10.3390\/toxics12120850"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.toxrep.2020.04.008","article-title":"Phthalate metabolites concentrations in amniotic fluid and maternal urine: Cumulative exposure and risk assessment","volume":"7","author":"Katsikantami","year":"2020","journal-title":"Toxicol. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"130213","DOI":"10.1016\/j.chemosphere.2021.130213","article-title":"Comparison of the materno-fetal transfer of fifteen structurally related bisphenol analogues using an ex vivo human placental perfusion model","volume":"276","author":"Lacroix","year":"2021","journal-title":"Chemosphere"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"135271","DOI":"10.1016\/j.jhazmat.2024.135271","article-title":"Raman-guided exploration of placental microplastic exposure: Unraveling the polymeric tapestry and assessing developmental implications","volume":"477","author":"Yun","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"105314","DOI":"10.1016\/j.envint.2019.105314","article-title":"Microplastics in house dust from 12 countries and associated human exposure","volume":"134","author":"Zhang","year":"2020","journal-title":"Environ. Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1021\/acs.estlett.1c00559","article-title":"Occurrence of polyethylene terephthalate and polycarbonate microplastics in infant and adult feces","volume":"8","author":"Zhang","year":"2021","journal-title":"Environ. Sci. Technol. Lett."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Ragusa, A., Notarstefano, V., Svelato, A., Belloni, A., Gioacchini, G., Blondeel, C., Zucchelli, E., De Luca, C., D\u2019Avino, S., and Gulotta, A. (2022). Raman Microspectroscopy Detection and Characterisation of Microplastics in Human Breastmilk. Polymers, 14.","DOI":"10.3390\/polym14132700"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"121197","DOI":"10.1016\/j.envpol.2023.121197","article-title":"Release of microplastics from breastmilk storage bags and assessment of intake by infants: A preliminary study","volume":"323","author":"Liu","year":"2023","journal-title":"Environ. Pollut."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"121225","DOI":"10.1016\/j.envpol.2023.121225","article-title":"Microplastics in infant milk powder","volume":"323","author":"Zhang","year":"2023","journal-title":"Environ. Pollut."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"158606","DOI":"10.1016\/j.scitotenv.2022.158606","article-title":"Release of microplastics from disposable cups in daily use","volume":"854","author":"Chen","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Amran, N.H., Zaid, S.S.M., Mokhtar, M.H., Manaf, L.A., and Othman, S. (2022). Exposure to Microplastics during Early Developmental Stage: Review of Current Evidence. Toxics, 10.","DOI":"10.3390\/toxics10100597"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"126787","DOI":"10.1016\/j.chemosphere.2020.126787","article-title":"Microplastics from consumer plastic food containers: Are we consuming it?","volume":"253","author":"Fadare","year":"2020","journal-title":"Chemosphere"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"114390","DOI":"10.1016\/j.envres.2022.114390","article-title":"Microplastics in take-out food: Are we over taking it?","volume":"215","author":"Bai","year":"2022","journal-title":"Environ. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"109753","DOI":"10.1016\/j.envint.2025.109753","article-title":"Airborne microplastics and plastic additives in a school environment: Identification, quantification, and associated inhalation risks","volume":"203","author":"Karanasiou","year":"2025","journal-title":"Environ. Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tang, K.H.D. (2025). Genotoxicity of Microplastics on Living Organisms: Effects on Chromosomes, DNA and Gene Expression. Environments, 12.","DOI":"10.3390\/environments12010010"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kadac-Czapska, K., O\u015bko, J., Knez, E., and Grembecka, M. (2024). Microplastics and Oxidative Stress-Current Problems and Prospects. Antioxidants, 13.","DOI":"10.3390\/antiox13050579"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"12602","DOI":"10.1016\/j.jhazmat.2021.126025","article-title":"Polystyrene microplastics trigger hepatocyte apoptosis and abnormal glycolytic flux via ROS-driven calcium overload","volume":"417","author":"Li","year":"2021","journal-title":"J. Hazard. Mater."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"112904","DOI":"10.1016\/j.fct.2022.112904","article-title":"Polystyrene microplastics affect learning and memory in mice by inducing oxidative stress and decreasing acetylcholine levels","volume":"162","author":"Wang","year":"2022","journal-title":"Food Chem. Toxicol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"137582","DOI":"10.1016\/j.chemosphere.2022.137582","article-title":"Evaluation of toxicity of polystyrene microplastics under realistic exposure levels in human vascular endothelial EA.hy926 cells","volume":"313","author":"Chen","year":"2023","journal-title":"Chemosphere"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s12403-021-00419-3","article-title":"Polystyrene and Polyethylene Microplastics Decrease Cell Viability and Dysregulate Inflammatory and Oxidative Stress Markers of MDCK and L929 Cells In Vitro","volume":"14","author":"Palaniappan","year":"2022","journal-title":"Expo. Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"128330","DOI":"10.1016\/j.chemosphere.2020.128330","article-title":"Inhalation toxicity of polystyrene micro(nano)plastics using modified OECD TG 412","volume":"262","author":"Lim","year":"2021","journal-title":"Chemosphere"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Bishop, B., Webber, W.S., Atif, S.M., Ley, A., Pankratz, K.A., Kostelecky, R., Colgan, S.P., Dinarello, C.A., Zhang, W., and Li, S. (2025). Micro- and nano-plastics induce inflammation and cell death in human cells. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1528502"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"106883","DOI":"10.1016\/j.imlet.2024.106883","article-title":"Gut dysbiosis impacts the immune system and promotes prostate cancer","volume":"268","author":"Shyanti","year":"2024","journal-title":"Immunol. Lett."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Umamaheswari, S., Priyadarshinee, S., Kadirvelu, K., and Ramesh, M. (2021). Polystyrene microplastics induce apoptosis via ROS-mediated p53 signaling pathway in zebrafish. Chem. Biol. Interact., 345.","DOI":"10.1016\/j.cbi.2021.109550"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"150817","DOI":"10.1016\/j.scitotenv.2021.150817","article-title":"Microglial phagocytosis of polystyrene microplastics results in immune alteration and apoptosis in vitro and in vivo","volume":"807","author":"Kwon","year":"2022","journal-title":"Sci. Total Environ."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"125969","DOI":"10.1016\/j.jhazmat.2021.125969","article-title":"Adverse effects polystyrene microplastics exert on zebrafish heart\u2014Molecular to individual level","volume":"416","author":"Dimitriadi","year":"2021","journal-title":"J. Hazard. Mater."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"129805","DOI":"10.1016\/j.chemosphere.2021.129805","article-title":"Genotoxic and cytotoxic effects of polyethylene microplastics on human peripheral blood lymphocytes","volume":"272","author":"Cobanoglu","year":"2012","journal-title":"Chemosphere"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1007\/s10695-011-9572-2","article-title":"Erythrocyte damage of crucian carp (Carassius auratus) caused by microcystin-LR: In vitro study","volume":"38","author":"Zhou","year":"2012","journal-title":"Fish Physiol. Biochem."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"118536","DOI":"10.1016\/j.ecoenv.2025.118536","article-title":"Exposure to placental microplastic and placental and umbilical cord blood telomere length","volume":"302","author":"Zhang","year":"2025","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"104467","DOI":"10.1016\/j.etap.2024.104467","article-title":"Exploring novel insights into the molecular mechanisms underlying Bisphenol A-induced toxicity: A persistent threat to human health","volume":"108","author":"Ahmad","year":"2024","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Sree, C.G., Buddolla, V., Lakshmi, B.A., and Kim, Y.J. (2023). Phthalate toxicity mechanisms: An update. Comp. Biochem. Physiol. C Toxicol. Pharmacol., 263.","DOI":"10.1016\/j.cbpc.2022.109498"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Street, M.E., Casadei, F., Di Bari, E.R., Ferraboschi, F., Montani, A.G., Mele, M.C., Shulhai, A.M., and Esposito, S. (2025). ftalatiThe Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity-Part 2, Comorbidities. Nutrients, 17.","DOI":"10.3390\/nu17091487"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"152665","DOI":"10.1016\/j.tox.2020.152665","article-title":"Polystyrene microplastics cause granulosa cells apoptosis and fibrosis in ovary through oxidative stress in rats","volume":"449","author":"An","year":"2012","journal-title":"Toxicology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.envpol.2019.03.085","article-title":"Reproductive toxicity of primary and secondary microplastics to three cladocerans during chronic exposure","volume":"249","author":"Jaikumar","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1073\/pnas.1519019113","article-title":"Oyster reproduction is affected by exposure to polystyrene microplastics","volume":"113","author":"Sussarellu","year":"2016","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"153059","DOI":"10.1016\/j.tox.2021.153059","article-title":"Comparing the effects of polystyrene microplastics exposure on reproduction and fertility in male and female mice","volume":"465","author":"Wei","year":"2022","journal-title":"Toxicology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"113024","DOI":"10.1016\/j.envpol.2019.113024","article-title":"Polystyrene microplastics cause tissue damages, sex-specific reproductive disruption and transgenerational effects in marine medaka (Oryzias melastigma)","volume":"254","author":"Wang","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"34594","DOI":"10.1007\/s11356-021-18218-3","article-title":"Exposure to microplastics leads to a defective ovarian function and change in cytoskeleton protein expression in rat","volume":"29","author":"Haddadi","year":"2022","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"121482","DOI":"10.1016\/j.envpol.2023.121482","article-title":"Reproductive toxicity of microplastics in female mice and their offspring from induction of oxidative stress","volume":"327","author":"Zhang","year":"2023","journal-title":"Environ. Pollut."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"123430","DOI":"10.1016\/j.jhazmat.2020.123430","article-title":"Polystyrene microplastics induced male reproductive toxicity in mice","volume":"401","author":"Jin","year":"2021","journal-title":"J. Hazard. Mater."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Lv, J., Liu, G., Wang, Z., Zhang, J., Li, Y., Wang, Y., Liu, N., Altyn, S., and Jiang, Z. (2025). Internalized polystyrene nanoplastic. s trigger testicular damage and promote ferroptosis via CISD1 downregulation in mouse spermatocyte. J. Nanobiotechnol., 23.","DOI":"10.1186\/s12951-025-03620-7"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"115703","DOI":"10.1016\/j.fct.2025.115703","article-title":"Chronic exposure to polystyrene micro\/nanoplastics triggers testicular dysfunction through PI3K\/AKT\/mTOR signaling-mediated spermatocyte senescence in mice","volume":"205","author":"Zhang","year":"2025","journal-title":"Food Chem. Toxicol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.beem.2005.09.005","article-title":"Pathways of endocrine disruption during male sexual differentiation and masculinization","volume":"20","author":"Sharpe","year":"2006","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"117868","DOI":"10.1016\/j.ecoenv.2025.117868","article-title":"First evidence of microplastics in human ovarian follicular fluid: An emerging threat to female fertility","volume":"291","author":"Montano","year":"2025","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"162713","DOI":"10.1016\/j.scitotenv.2023.162713","article-title":"Detection and characterization of microplastics in the human testis and semen","volume":"877","author":"Zhao","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"165922","DOI":"10.1016\/j.scitotenv.2023.165922","article-title":"Raman Microspectroscopy evidence of microplastics in human semen","volume":"901","author":"Montano","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Zhang, C., Zhang, G., Sun, K., Ren, J., Zhou, J., Liu, X., Lin, F., Yang, H., Cao, J., and Nie, L. (2024). Association of mixed exposure to microplastics with sperm dysfunction: A multi-site study in China. eBioMedicine, 108.","DOI":"10.1016\/j.ebiom.2024.105369"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.envres.2014.08.010","article-title":"In utero and peripubertal exposure to phthalates and BPA in relation to female sexual maturation","volume":"134","author":"Watkins","year":"2014","journal-title":"Environ. Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"119745","DOI":"10.1016\/j.envpol.2022.119745","article-title":"Associations of maternal urinary bisphenol and phthalate concentrations with offspring reproductive development","volume":"309","author":"Blaauwendraad","year":"2022","journal-title":"Environ. Pollut."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1152\/physrev.00017.2015","article-title":"Male reproductive disorders and fertility trends: Influences of environment and genetic susceptibility","volume":"96","author":"Skakkebaek","year":"2016","journal-title":"Physiol. Rev."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"110056","DOI":"10.1016\/j.envres.2020.110056","article-title":"Association between phenols exposure and earlier puberty in children: A systematic review and meta-analysis","volume":"190","author":"Bigambo","year":"2020","journal-title":"Environ. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1039\/C9EM00512A","article-title":"Association of phthalate exposure with precocious and delayed pubertal timing in girls and boys: A systematic review and meta-analysis","volume":"22","author":"Golestanzadeh","year":"2020","journal-title":"Environ. Sci. Process Impacts"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"15254","DOI":"10.3390\/ijerph121214974","article-title":"Association of PAEs with precocious puberty in children: A systematic review and meta-analysis","volume":"12","author":"Wen","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1080\/10937404.2018.1505354","article-title":"Systematic reviews and meta-analyses of human and animal evidence of prenatal diethylhexyl phthalate exposure and changes in male anogenital distance","volume":"21","author":"Dorman","year":"2018","journal-title":"J. Toxicol. Environ. Health Part B"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1093\/biolre\/ioz200","article-title":"In utero exposure to persistent and nonpersistent endocrine-disrupting chemicals and anogenital distance: A systematic review of epidemiological studies","volume":"102","author":"Nelson","year":"2020","journal-title":"Biol. Reprod."},{"key":"ref_80","first-page":"937","article-title":"Polycystic ovary syndrome is associated with anogenital distance, a marker of prenatal androgen exposure","volume":"32","author":"Wu","year":"2017","journal-title":"Hum. Reprod."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.fertnstert.2020.06.029","article-title":"Anthropometric biomarkers for abnormal prenatal reproductive hormone exposure in women with Mayer-Rokitanksy-K\u00fcster-Hauser syndrome, polycystic ovary syndrome, and endometriosis","volume":"114","author":"Peters","year":"2020","journal-title":"Fertil. Steril."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Eisenberg, M.L., Hsieh, M.H., Walters, R.C., Krasnow, R., and Lipshultz, L.I. (2011). The relationship between anogenital distance, fatherhood, and fertility in adult men. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0018973"},{"key":"ref_83","first-page":"646","article-title":"Re: Anogenital Distance is Associated with Semen Quality but Not Reproductive Hormones in 1106 Young Men from the General Population","volume":"202","author":"Niederberger","year":"2019","journal-title":"J Urol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.envint.2008.05.012","article-title":"Association between prenatal exposure to phthalates and the health of newborns","volume":"35","author":"Huang","year":"2009","journal-title":"Environ. Int."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1289\/ehp.1509870","article-title":"Prenatal exposure to phthalates and anogenital distance in male infants from a low-exposed Danish cohort (2010\u20132012)","volume":"124","author":"Jensen","year":"2016","journal-title":"Environ. Health Perspect."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1289\/ehp.8100","article-title":"Decrease in anogenital distance among male infants with prenatal phthalate exposure","volume":"113","author":"Swan","year":"2005","journal-title":"Environ. Health Perspect."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1093\/humrep\/deu363","article-title":"First trimester phthalate exposure and anogenital distance in newborns","volume":"30","author":"Swan","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Huang, B., Wang, Z., Kong, Y., Jin, M., and Ma, L. (2023). Global, regional and national burden of male infertility in 204 countries and territories between 1990 and 2019, an analysis of global burden of disease study. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16793-3"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"120174","DOI":"10.1016\/j.envpol.2022.120174","article-title":"Placental plastics in young women from general population correlate with reduced foetal growth in IUGR pregnancies","volume":"314","author":"Amereh","year":"2022","journal-title":"Environ. Pollut."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"35670","DOI":"10.1007\/s11356-019-06589-7","article-title":"Association of exposure to phthalates with cardiometabolic risk factors in children and adolescents: A systematic review and meta-analysis","volume":"26","author":"Golestanzadeh","year":"2019","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"3583","DOI":"10.3109\/14767058.2016.1139570","article-title":"High bisphenol A (BPA) concentration in the maternal, but not fetal, compartment increases the risk of spontaneous preterm delivery","volume":"29","author":"Behnia","year":"2016","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1289\/ehp.1205296","article-title":"Fetal growth and prenatal exposure to bisphenol A: The generation R study","volume":"121","author":"Snijder","year":"2013","journal-title":"Environ. Health Perspect."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12940-021-00747-6","article-title":"Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort","volume":"20","author":"Sol","year":"2021","journal-title":"Environ. Health"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"108378","DOI":"10.1016\/j.envint.2023.108378","article-title":"Prenatal phenol and paraben exposures and adverse birth outcomes: A prospective analysis of US births","volume":"183","author":"Trasande","year":"2024","journal-title":"Environ. Int."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"115446","DOI":"10.1016\/j.envpol.2020.115446","article-title":"Association between phthalate exposure and risk of spontaneous pregnancy loss: A systematic review and meta-analysis","volume":"267","author":"Zhang","year":"2020","journal-title":"Environ. Pollut."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"3251","DOI":"10.31557\/APJCP.2019.20.11.3251","article-title":"Neonatal weight and prenatal exposure to polychlorinated biphenyls: A meta-analysis","volume":"20","author":"Zou","year":"2019","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1289\/ehp.1307154","article-title":"Prenatal exposure to phthalate esters and behavioral syndromes in children at 8 years of age: Taiwan Maternal and Infant Cohort Study","volume":"123","author":"Lien","year":"2015","journal-title":"Environ. Health Perspect."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"4814","DOI":"10.1038\/s41380-023-02225-6","article-title":"Prenatal exposure to common plasticizers: A longitudinal study on phthalates, brain volumetric measures, and IQ in youth","volume":"28","author":"Ghassabian","year":"2023","journal-title":"Mol. Psychiatry"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.envpol.2017.06.083","article-title":"Phthalate esters and childhood asthma: A systematic review and congener-specific meta-analysis","volume":"229","author":"Li","year":"2017","journal-title":"Environ. Pollut."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"110981","DOI":"10.1016\/j.envres.2021.110981","article-title":"Early life exposure to phthalates and the development of childhood asthma among Canadian children","volume":"197","author":"Navaranjan","year":"2021","journal-title":"Environ. Res."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1007\/s40201-025-00951-3","article-title":"Association of prenatal exposure to phthalates with risks of asthma, wheeze, and allergic diseases during childhood: A systematic review and meta-analysis","volume":"23","author":"Yang","year":"2025","journal-title":"J. Environ. Health Sci. Eng."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"122714","DOI":"10.1016\/j.envpol.2023.122714","article-title":"Phthalate exposure and risk of metabolic syndrome components: A systematic review","volume":"340","author":"Arrebola","year":"2024","journal-title":"Environ Pollut."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"109602","DOI":"10.1016\/j.envres.2020.109602","article-title":"Fetal exposure to bisphenols and phthalates and childhood bone mass: A population-based prospective cohort study","volume":"186","author":"Trasande","year":"2020","journal-title":"Environ. Res."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"67001","DOI":"10.1289\/EHP11545","article-title":"Associations of gestational perfluoroalkyl substances exposure with early childhood BMI Z-scores and risk of overweight\/obesity: Results from the ECHO cohorts","volume":"131","author":"Liu","year":"2023","journal-title":"Environ. Health Perspect."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12989-020-00385-9","article-title":"Nanopolystyrene translocation and fetal deposition after acute lung exposure during late-stage pregnancy","volume":"17","author":"Fournier","year":"2020","journal-title":"Part. Fibre Toxicol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11306-022-01967-8","article-title":"Maternal exposure to polystyrene microplastics alters placental metabolism in mice","volume":"19","author":"Aghaei","year":"2022","journal-title":"Metabolomics"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"158666","DOI":"10.1016\/j.scitotenv.2022.158666","article-title":"Maternal exposure to polystyrene nanoparticles retarded fetal growth and triggered metabolic disorders of placenta and fetus in mice","volume":"854","author":"Chen","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"113122","DOI":"10.1016\/j.envpol.2019.113122","article-title":"Maternal exposure to different sizes of polystyrene microplastics during gestation causes metabolic disorders in their offspring","volume":"255","author":"Luo","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"10978","DOI":"10.1021\/acs.est.9b03191","article-title":"Maternal polystyrene microplastic exposure during gestation and lactation altered metabolic homeostasis in the dams and their F1 and F2 offspring","volume":"53","author":"Luo","year":"2019","journal-title":"Environ. Sci. Technol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.reprotox.2021.10.002","article-title":"Polystyrene microplastics disturb maternal-fetal immune balance and cause reproductive toxicity in pregnant mice","volume":"106","author":"Hu","year":"2012","journal-title":"Reprod. Toxicol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s11306-023-02061-3","article-title":"Maternal exposure to polystyrene nanoplastics alters fetal brain metabolism in mice","volume":"19","author":"Mercer","year":"2023","journal-title":"Metabolomics"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1093\/biolre\/ioad126","article-title":"Polystyrene micro- and nanoplastics cause placental dysfunction in mice","volume":"110","author":"Dibbon","year":"2024","journal-title":"Biol. Reprod."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"138640","DOI":"10.1016\/j.jhazmat.2025.138640","article-title":"Lifelong exposure to polystyrene-nanoplastics induces an attention-deficit hyperactivity disorder-like phenotype and impairs brain aging in mice","volume":"494","author":"Vignon","year":"2025","journal-title":"J. Hazard. Mater."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"134800","DOI":"10.1016\/j.jhazmat.2024.134800","article-title":"Effects of nanoplastic exposure during pregnancy and lactation on neurodevelopment of rat offspring","volume":"474","author":"Tian","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Wen, J., and Lin, Y. (2025). Invisible invaders: Unveiling the carcinogenic threat of microplastics and nanoplastics in colorectal cancer\u2014A systematic review. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1653245"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1056\/NEJMoa2309822","article-title":"Microplastics and Nanoplastics in Atheromas and Cardiovascular Events","volume":"390","author":"Marfella","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Bao, Q., Huang, Y., Deng, M., Zhang, C., Zu, D., He, H., Hu, Y., Zhong, Y., Liang, C., and Liu, H. (2025). PVC Nanoplastics Exposure Exacerbates Asthma through R-Loop Accumulation and Subsequent STING Activation in Macrophages. Adv. Sci., e02223.","DOI":"10.1002\/advs.202502223"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"122124","DOI":"10.1016\/j.envres.2025.122124","article-title":"The threat of microplastics to human kidney health: Mechanisms of nephrotoxicity and future research directions","volume":"283","author":"Tan","year":"2025","journal-title":"Environ. Res."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"108532","DOI":"10.1016\/j.reprotox.2023.108532","article-title":"Effect of prenatal exposure to phthalates on birth weight of offspring: A meta-analysis","volume":"124","author":"Pang","year":"2024","journal-title":"Reprod. Toxicol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.anai.2020.03.022","article-title":"Longitudinal effect of phthalates exposure on allergic diseases in children","volume":"125","author":"Podlecka","year":"2020","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1038\/s41366-023-01401-6","article-title":"Exposure to perfluoroalkyl and polyfluoroalkyl substances and pediatric obesity: A systematic review and meta-analysis","volume":"48","author":"Frangione","year":"2024","journal-title":"Int. J. Obes."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1016\/S2542-5196(23)00270-X","article-title":"Prenatal phthalate exposure and adverse birth outcomes in the USA: A prospective analysis of births and estimates of attributable burden and costs","volume":"8","author":"Trasande","year":"2024","journal-title":"Lancet Planet. 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