Plastic usage increases year by year, and the growing trend is projected to continue. However as of 2017, only 9% of the 9 billion tons of plastic ever produced had been recycled leaving large amounts of plastics to contaminate the environment, resulting in important negative health and economic impacts. Curbing this trend is a major challenge that requires urgent and multifaceted action. Based on scientific and gray literature mainly published during the last 10 years, this review summarizes key solutions currently in use globally that have the potential to address at scale the plastic and microplastic contaminations from source to sea. They include technologies to control plastics in solid wastes (i.e. mechanical and chemical plastic recycling or incineration), in-stream (i.e. booms and clean-up boats, trash racks, and sea bins), and microplastics (i.e. stormwater, municipal wastewater and drinking water treatment), as well as general policy measures (i.e. measures to support the informal sector, bans, enforcement of levies, voluntary measures, extended producer responsibility, measures to enhance recycling and guidelines, standards and protocols to guide activities and interventions) to reduce use, reuse, and recycle plastics and microplastics in support of the technological options. The review discusses the effectiveness, capital expenditure, and operation and maintenance costs of the different technologies, the cost of implementation of policy measures, and the suitability of each solution under various conditions. This guidance is expected to help policymakers and practitioners address, in a sustainable and cost-efficient way, the plastic and microplastic management problem using technologies and policy instruments suitable in their local context.

Accelerating evidence of endocrine-related morbidity has raised alarm about the ubiquitous use of phthalates in the human environment, but studies have not directly evaluated mortality in relation to these exposures. To evaluate associations of phthalate exposure with mortality, and quantify attributable mortality and lost economic productivity in 2013–4 among 55–64 year olds. This nationally representative cohort study included 5303 adults aged 20 years or older who participated in the US National Health and Nutrition Examination Survey 2001–2010 and provided urine samples for phthalate metabolite measurements. Participants were linked to mortality data from survey date through December 31, 2015. Data analyses were conducted in July 2020. Mortality from all causes, cardiovascular disease, and cancer. Multivariable models identified increased mortality in relation to high-molecular weight (HMW) phthalate metabolites, especially those of di-2-ethylhexylphthalate (DEHP). Hazard ratios (HR) for continuous HMW and DEHP metabolites were 1.14 (95% CI 1.06–1.23) and 1.10 (95% CI 1.03–1.19), respectively, with consistently higher mortality in the third tertile (1.48, 95% CI 1.19–1.86; and 1.42, 95% CI 1.13–1.78). Cardiovascular mortality was significantly increased in relation to a prominent DEHP metabolite, mono-(2-ethyl-5-oxohexyl)phthalate. Extrapolating to the population of 55–64 year old Americans, we identified 90,761–107,283 attributable deaths and $39.9–47.1 billion in lost economic productivity. In a nationally representative sample, phthalate exposures were associated with all-cause and cardiovascular mortality, with societal costs approximating $39 billion/year or more. While further studies are needed to corroborate observations and identify mechanisms, regulatory action is urgently needed.