{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:42:49Z","timestamp":1793392969860,"version":"4.5.0"},"reference-count":61,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>The rising incidence of microplastics (MPs) is a possible health risk to humans. The present study aims to analyze the presence of MPs in intravenous (IV) infusions and compare MP concentrations from multiple brands. The IV solutions of 29 medical devices (IV-MDs) from seven brands commercialized in Ecuador, Spain, and Italy have been selected under specific consideration to carry out the study. The detection of MPs has been quite obvious in almost all of the samples from brands in the mentioned countries. MP concentrations ranged from 9 to 20 MPs\/L in glass containers to 166\u2013299 MPs\/L in plastic bags, with the majority of fragments (63%) on fibres (37%) and more than 60% of particles less than 100 \u00b5m. Nine different types of MPs were identified in this study. High clinical risk was indicated by markings with &gt;200 MPs\/L. Nevertheless, the medium polymeric danger index (PHI) was 1.7. According to these outcomes, IV infusion is a direct exposure to MPs that may have harmful medical repercussions. It is imperative that MPs\u2019 limitations be included in pharmacopoeic monographs and in vivo toxicological and epidemiological studies. The present study aims to analyze the presence of MPs in IV-MDs and compare MP concentrations from multiple IV-MD brands.<\/jats:p>","DOI":"10.3390\/toxics13070597","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T12:55:00Z","timestamp":1752670500000},"page":"597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Health Risks from Microplastics in Intravenous Infusions: Evidence from Italy, Spain, and Ecuador"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1806-4825","authenticated-orcid":false,"given":"Claudio","family":"Casella","sequence":"first","affiliation":[{"name":"Department of Chemistry, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Cornelli","sequence":"additional","affiliation":[{"name":"School of Medicine, Loyola University, Chicago, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Zanoni","sequence":"additional","affiliation":[{"name":"Department of Chemistry, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0686-3187","authenticated-orcid":false,"given":"Pablo","family":"Moncayo","sequence":"additional","affiliation":[{"name":"Ingenier\u00eda Agroindustrial, Universidad de Las Am\u00e9ricas (UDLA), Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Ramos-Guerrero","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Bio-Quimioinform\u00e1tica, Carrera de Ingenier\u00eda Agroindustrial, Facultad de Ingenier\u00eda y Ciencias Aplicadas, Universidad de Las Am\u00e9ricas (UDLA), Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63382","DOI":"10.1007\/s11356-023-27151-6","article-title":"Microplastics in Sewage Sludge: A review","volume":"30","author":"Casella","year":"2023","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1007\/s11270-024-07589-1","article-title":"The current situation of the legislative gap on microplastics (MPs) as new pollutants for the environment","volume":"235","author":"Casella","year":"2024","journal-title":"Water Air Soil Pollut."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Casella, C., Sol, D., Laca, A., and D\u00edaz, M. (2025). Microplastic Retention in Secondary Sewage Sludge: Characterization and Influence of Solid Concentration. Appl. Sci., 15.","DOI":"10.3390\/app15073557"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Casella, C., Cornelli, U., Ballaz, S., Zanoni, G., Merlo, G., and Ramos-Guerrero, L. (2025). Plastic Smell: A Review of the Hidden Threat of Airborne Micro and Nanoplastics to Human Health and the Environment. Toxics, 13.","DOI":"10.3390\/toxics13050387"},{"key":"ref_5","unstructured":"(2025, March 25). Plastics Europe 2024\u2014The Fast Facts 2024 Plastics Europe. Available online: https:\/\/plasticseurope.org\/knowledge-hub\/plastics-the-fast-facts-2023."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"109377","DOI":"10.1016\/j.envint.2025.109377","article-title":"Characteristics and influencing factors of microplastics entering human blood through intravenous injection","volume":"198","author":"Li","year":"2025","journal-title":"Environ. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"104307","DOI":"10.1016\/j.etap.2023.104307","article-title":"Human health risk assessment of potentially toxic elements and microplastics accumulation in products from the Danube River Basin fish market","volume":"104","author":"Simionov","year":"2023","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e28291","DOI":"10.1016\/j.heliyon.2024.e28291","article-title":"Micro and nano plastics in fruits and vegetables: A review","volume":"10","author":"Milea","year":"2024","journal-title":"Heliyon"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"453","DOI":"10.7326\/M19-0618","article-title":"Detection of various microplastics in human stool: A prospective case series","volume":"171","author":"Schwabl","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"107199","DOI":"10.1016\/j.envint.2022.107199","article-title":"Discovery and quantification of plastic particle pollution in human blood","volume":"163","author":"Leslie","year":"2022","journal-title":"Environ. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1007\/s10661-025-13850-9","article-title":"Hidden hazards: Microplastics in intravenous admixtures and their path into the body","volume":"197","author":"Pal","year":"2025","journal-title":"Environ Monit. Assess."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Rotchell, J.M., Jenner, L.C., Chapman, E., Bennett, R.T., Bolanle, I.O., Loubani, M., and Palmer, T.M. (2023). Detection of microplastics in human saphenous vein tissue using \u03bcFTIR: A pilot study. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0280594"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"10911","DOI":"10.1021\/acs.est.2c07179","article-title":"Detection of various microplastics in patients undergoing cardiac surgery","volume":"57","author":"Yang","year":"2023","journal-title":"Environ. Sci. Technol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jare.2022.09.004","article-title":"Pigment microparticles and microplastics found in human thrombi based on Raman spectral evidence","volume":"49","author":"Wu","year":"2023","journal-title":"J. Adv. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"159164","DOI":"10.1016\/j.scitotenv.2022.159164","article-title":"Microplastic diagnostics in humans:\u201cThe 3Ps\u201d Progress, problems, and prospects","volume":"856","author":"Shruti","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1002\/jat.4598","article-title":"Genotoxic and neurotoxic potential of intracellular nanoplastics: A review","volume":"44","author":"Casella","year":"2024","journal-title":"J. Appl. Toxicol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ragusa, A., Matta, M., Cristiano, L., Matassa, R., Battaglione, E., Svelato, A., and Nottola, S.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_18","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1126\/science.abe5041","article-title":"Microplastics and human health","volume":"371","author":"Vethaak","year":"2021","journal-title":"Science"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"135227","DOI":"10.1016\/j.chemosphere.2022.135227","article-title":"Plastic particles in medicine: A systematic review of exposure and effects to human health","volume":"303","author":"Gopinath","year":"2022","journal-title":"Chemosphere"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1021\/envhealth.4c00210","article-title":"MPs Entering Human Circulation through Infusions: A Significant Pathway and Health Concern","volume":"3","author":"Huang","year":"2025","journal-title":"Environ. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"343982","DOI":"10.1016\/j.aca.2025.343982","article-title":"Systematic characterisation of microplastics released from disposable medical devices using laser direct infrared spectroscopy","volume":"1355","author":"Chen","year":"2025","journal-title":"Anal. Chim. Acta"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1021\/acs.estlett.3c00905","article-title":"Microplastics entry into the blood by infusion therapy: Few but a direct pathway","volume":"11","author":"Zhu","year":"2023","journal-title":"Environ. Sci. Technol. Lett."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hu, Z., Yin, L., Wen, X., Jiang, C., Long, Y., Zhang, J., and Liu, R. (2021). Organophosphate esters in China: Fate, occurrence, and human exposure. Toxics, 9.","DOI":"10.3390\/toxics9110310"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2500117","DOI":"10.1002\/gch2.202500117","article-title":"A Ray of Hope: Gamma Radiation for Microplastic Remediation","volume":"9","author":"Vadivel","year":"2025","journal-title":"Glob. Chall."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"144752","DOI":"10.1016\/j.scitotenv.2020.144752","article-title":"A critical review of human exposure to organophosphate esters with a focus on dietary intake","volume":"771","author":"Gbadamosi","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1080\/10643389.2020.1859307","article-title":"A critical review of human internal exposure and the health risks of organophosphate ester flame retardants and their metabolites","volume":"52","author":"Yang","year":"2022","journal-title":"Crit. Rev. Environ. Sci. Technol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"126279","DOI":"10.1016\/j.jhazmat.2021.126279","article-title":"Human internal exposure to organophosphate esters: A short review of urinary monitoring on the basis of biological metabolism research","volume":"418","author":"Wang","year":"2021","journal-title":"J. Hazard. Mater."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"137728","DOI":"10.1016\/j.jhazmat.2025.137728","article-title":"Reactive oxygen species drive aging-associated microplastic release in diverse infusion ingredients","volume":"490","author":"Zhang","year":"2025","journal-title":"J. Hazard. Mater."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tarafdar, A., Xie, J., Gowen, A., O\u2019Higgins, A.C., and Xu, J. (2025, March 25). Microplastic Transfer into the Bloodstream from Intravenous Fluid Infusion Systems. Available online: https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=4709116.","DOI":"10.2139\/ssrn.4709116"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"133246","DOI":"10.1016\/j.jhazmat.2023.133246","article-title":"Quantitative analysis of microplastics and nanoplastics released from disposable PVC infusion tubes","volume":"465","author":"Zheng","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"135769","DOI":"10.1016\/j.jhazmat.2024.135769","article-title":"Is intravenous infusion an unrecognized route for internal microplastic human exposure? A general assessment","volume":"480","author":"Cui","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"136193","DOI":"10.1016\/j.jhazmat.2024.136193","article-title":"Rapid detection of microplastics\/nanoplastics directly exposed to blood during intravenous injections via mie scattering spectra","volume":"480","author":"Mou","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"104411","DOI":"10.1016\/j.etap.2024.104411","article-title":"Intravenous hypertonic fluids as a source of human microplastic exposure","volume":"107","author":"Ramos","year":"2024","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"133179","DOI":"10.1016\/j.jhazmat.2023.133179","article-title":"Evaluation of microplastics release from solar water disinfection poly (ethylene terephthalate) and polypropylene containers","volume":"465","author":"Matikainen","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_35","unstructured":"Mordor Intelligence (2025, March 25). Forecast 2024. Available online: https:\/\/www.mordorintelligence.com\/industry-reports\/glucose-iv-solutions-market."},{"key":"ref_36","unstructured":"(2025, March 25). EU Country Cancer Profile: Italy. Available online: https:\/\/www.oecd.org\/en\/publications\/eu-country-cancer-profile-italy-2025_1e742c63-en.html."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.56048\/MQR20225.7.1.2023.1592-1612","article-title":"Enfermedades cr\u00f3nicas no transmisibles y la calidad de vida en el Ecuador","volume":"7","author":"Moreira","year":"2023","journal-title":"MQRInvestigar"},{"key":"ref_38","unstructured":"(2025, March 25). WHO Mortality Database. Available online: https:\/\/platform.who.int\/mortality\/countries\/country-details\/MDB\/ecuador."},{"key":"ref_39","unstructured":"(2025, March 25). WHO International Agency for Research on Cancer. Available online: https:\/\/canscreen5.iarc.fr."},{"key":"ref_40","first-page":"102332","article-title":"Microplastics in Spanish Eye Drops: Hidden contaminants in ophthalmic formulations","volume":"15","author":"Casella","year":"2025","journal-title":"Res. Chem."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e00203","DOI":"10.1016\/j.teac.2023.e00203","article-title":"Blanks and bias in microplastic research: Implications for future quality assurance","volume":"38","author":"Shruti","year":"2023","journal-title":"Trends Environ. Anal. Chem."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"162610","DOI":"10.1016\/j.scitotenv.2023.162610","article-title":"Common laboratory reagents: Are they a double-edged sword in microplastics research?","volume":"875","author":"Shruti","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"172648","DOI":"10.1016\/j.scitotenv.2024.172648","article-title":"Advanced optical photothermal infrared spectroscopy for comprehensive characterization of microplastics from intravenous fluid delivery systems","volume":"929","author":"Tarafdar","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"143428","DOI":"10.1016\/j.chemosphere.2024.143428","article-title":"Microplastics release from coronary catheters: Insights from catheter analysis","volume":"366","author":"Dewika","year":"2024","journal-title":"Chemosphere"},{"key":"ref_45","unstructured":"(2025, March 25). ARCSA-DE-2024-047-DASP. Available online: https:\/\/www.controlsanitario.gob.ec\/wp-content\/uploads\/downloads\/2025\/06\/25.06.06_borrador-de-IE_Requisitos-para-la-certificacion-BPADT.pdf."},{"key":"ref_46","unstructured":"(2025, March 25). Regulation (EU) 2017\/745 of the European Parliament and of the Council. Available online: https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/PDF\/?uri=CELEX:32017R0745."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e35101","DOI":"10.1016\/j.heliyon.2024.e35101","article-title":"Identification and quantification of micro\u2013nano-plastics in polypropylene-bottled injections","volume":"10","author":"Wang","year":"2024","journal-title":"Heliyon"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Kadac-Czapska, K., O\u015bko, J., Knez, E., and Grembecka, M. (2024). Microplastics and oxidative stress\u2014Current problems and prospects. Antioxidants, 13.","DOI":"10.3390\/antiox13050579"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1186\/s12967-024-05731-5","article-title":"Microplastics: An often-overlooked issue in the transition from chronic inflammation to cancer","volume":"22","author":"Cheng","year":"2024","journal-title":"J. Transl. Med."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Lee, Y.H., Zheng, C.M., Wang, Y.J., Wang, Y.L., and Chiu, H.W. (2025). Effects of microplastics and nanoplastics on the kidney and cardiovascular system. Nat. Rev. Nephrol., online ahead of print.","DOI":"10.1038\/s41581-025-00971-0"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"104253","DOI":"10.1016\/j.etap.2023.104253","article-title":"Microplastics and nanoplastics in haemodialysis waters: Emerging threats to be in our radar","volume":"102","author":"Passos","year":"2023","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1038\/s41578-021-00411-y","article-title":"Risk assessment of microplastic particles","volume":"7","author":"Koelmans","year":"2022","journal-title":"Nat. Rev. Mater."},{"key":"ref_53","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_54","doi-asserted-by":"crossref","first-page":"119498","DOI":"10.1016\/j.envres.2024.119498","article-title":"Detection and analysis of microplastics in tissues and blood of human cervical cancer patients","volume":"259","author":"Xu","year":"2024","journal-title":"Environ. Res."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Lee, D.W., Jung, J., Park, S.A., Lee, Y., Kim, J., Han, C., and Hong, Y.C. (2024). Microplastic particles in human blood and their association with coagulation markers. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-81931-9"},{"key":"ref_56","first-page":"103329","article-title":"Microplastics and cancer progression: A comparative study of 2D and 3D gastric cancer models using ISOCompliant protocols","volume":"24","author":"Rafazi","year":"2024","journal-title":"Res. Eng."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Scuto, M., Lombardo, C.M.G., Lo Sasso, B., Di Fatta, E., Ferri, R., and Trovato Salinaro, A. (2025). Microplastics as Emerging Contaminants and Human Health: Exploring Functional Nutrition in Gastric\u2013Colon\u2013Brain Axis Cancer. Toxics, 13.","DOI":"10.3390\/toxics13060438"},{"key":"ref_58","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_59","doi-asserted-by":"crossref","first-page":"136656","DOI":"10.1016\/j.jhazmat.2024.136656","article-title":"Microplastic changes during the developent of cervical cancer and its effects on the metabolomic profiles of cancer tissues","volume":"483","author":"Xu","year":"2025","journal-title":"J. Hazard. Mater."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Prasanth, M., Jha, N., Precilla, D., Sivachandran, R., Ramprasath, A., Rajkumar, M., and Anitha, T.S. (2025). Microplastics and Cancer: A Comprehensive Review of Their Impact on Tumor Progression and Mechanisms of Carcinogenesis. J. Environ. Pathol. Toxicol. Oncol.","DOI":"10.1615\/JEnvironPatholToxicolOncol.2025054888"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"108454","DOI":"10.1016\/j.isci.2023.108454","article-title":"Direct entry of micro (nano) plastics into human blood circulatory system by intravenous infusion","volume":"26","author":"Li","year":"2023","journal-title":"Iscience"}],"container-title":["Toxics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2305-6304\/13\/7\/597\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:10:40Z","timestamp":1760033440000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2305-6304\/13\/7\/597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,16]]},"references-count":61,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["toxics13070597"],"URL":"https:\/\/doi.org\/10.3390\/toxics13070597","relation":{},"ISSN":["2305-6304"],"issn-type":[{"value":"2305-6304","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,16]]}}}