Forensic Science International

Presence of microplastics in human stomachs

Sait Özsoy, Sedat Gündoğdu, Sermet Sezigen, Esra Tasalp, Durmuş Arınç Ikiz, Ahmet Erkan Kideys

Forensic Science International 365 (2024) 112246 · doi:10.1016/j.forsciint.2024.112246

What this paper found

Researchers examined stomach contents from 26 cadavers and found microplastic particles in every single individual. A total of 97 particles were extracted, with fibers being the dominant shape (52%). Polyethylene was the most common polymer (30.5%). Based on gastric transit times, the estimated daily intake is approximately 32 microplastic particles per day — and this likely underestimates the true number, since particles below 50 μm could not be reliably measured.

100% Prevalence in cadavers
97 Particles extracted
32.2 Est. daily intake
<20μm Absorbed through gut wall
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Contents

  1. Abstract
  2. Introduction
  3. Materials and Methods
  4. Results
  5. Discussion
  6. References
Abstract

This study presents the first definitive confirmation of microplastic presence in the human stomach, based on samples from 26 cadavers. 97 microplastic particles were extracted from stomach contents, across all 26 individuals, revealing a universal prevalence of microplastics in the cadavers.

Morphological analysis of the extracted particles unveiled distinct shapes, with fibers constituting the majority (52.04%), followed by fragments (39.80%) and films (8.16%). The average quantity of microplastics per individual was calculated to be 9.4 ± 10.4 particles, with an estimated daily intake of microplastics at 32.2 particles per day.

These figures are lower than estimates derived from both daily microplastic consumption alone and notably, those calculated from stool analyses. The study also suggests that the breakdown or transformation of microplastics cannot be ruled out during their passage through the digestive tract. Although the number of microplastics in stomach contents reported in this study was even lower than the daily microplastic intake rates reported in the literature, it provides conclusive evidence for the presence of microplastics in the human stomach and provides important preliminary data in terms of the risks that may arise for human health.

Introduction

The escalating production demand and subsequent environmental leakage make plastic pollution a paramount global issue, directly impacting human health. By the end of 2019, global plastic production was close to 10 billion tons.1OECD (2022) Global Plastics Outlook: Economic Drivers, Environmental Impacts and Policy Options. Open → Of this total, roughly 10% underwent recycling, and 14% underwent incineration, leaving the remaining 76% in landfills, dumps, or dispersed in the natural environment.2Geyer R (2020) Production, use, and fate of synthetic polymers. In: Letcher TM (ed.) Plastic Waste and Recycling, Academic Press. Open →

Microplastics (MPs) are defined as plastic particles with sizes ranging from 1 μm to 5 mm.3Arthur C, Baker J, Bamford H (2009) Proceedings of the International Research Workshop on the Occurrence, Effects and Fate of Microplastic Marine Debris. NOAA Technical Memorandum NOS-OR&R-30. The 22 million tons of plastics estimated to have leaked into the environment in 2019 alone results in a staggering approximately 5 × 1026 micro-particles when hypothetically broken down to a size of 100 μm in diameter, posing a significant impact on the world's ecosystems and eventually to humans.

Micro- or nanoplastics traverse the food web, reaching higher organisms, including humans. Microplastic contamination has been found in a wide variety of food items, including table salts,17Gündoğdu S (2018) Contamination of table salts from Turkey with microplastics. Food Addit Contam A 35(5):1006–1014. meat products,18Kedzierski M et al. (2020) Microplastic contamination of packaged meat. Food Packag Shelf Life 24:100489. Open → rice,20Dessì C et al. (2021) Plastics contamination of store-bought rice. J Hazard Mater 416:125778. Open → vegetables and fruits,21Conti GO et al. (2020) Micro- and nano-plastics in edible fruit and vegetables. Environ Res 187:109677. Open → fish,6Güven O et al. (2017) Microplastic litter composition of the Turkish territorial waters. Environ Pollut 223:286–294. Open → and various beverages.24Shruti VC et al. (2020) First study on microplastic contamination of soft drinks, cold tea and energy drinks. Sci Total Environ 726:138580. Open →

The widespread presence of microplastics has been detected in human blood,12Leslie HA et al. (2022) Discovery and quantification of plastic particle pollution in human blood. Environ Int 163:107199. lungs,27Jenner LC et al. (2022) Detection of microplastics in human lung tissue using μFTIR spectroscopy. Sci Total Environ 831:154907. Open → saliva,28Baeza-Martínez C et al. (2022) First evidence of microplastics isolated in European citizens' lower airway. J Hazard Mater 438:129439. Open → placenta,30Zhu L et al. (2023) Identification of microplastics in human placenta using laser direct infrared spectroscopy. Sci Total Environ 856:159060. Open → stool,31Schwabl P et al. (2019) Detection of various microplastics in human stool. Ann Intern Med 171:453–457. Open → liver,34Horvatits T et al. (2022) Microplastics detected in cirrhotic liver tissue. EBioMedicine 104147. Open → and urine.35Pironti C et al. (2022) First evidence of microplastics in human urine. Toxics 11(1):40. Open →

Key context: Despite microplastics being detected in virtually every organ system, no studies had specifically detected microplastics within human stomach contents — even though the gastrointestinal system is the primary target of toxic effects from ingested microplastics.37Zhao B et al. (2024) The potential toxicity of microplastics on human health. Sci Total Environ 912:168946. Open → This study fills that gap.

Potential toxicity mechanisms of microplastics include oxidative stress due to increased intracellular reactive oxygen species (ROS), induced inflammatory response, and disruption of energy homeostasis and metabolism — which could lead to cytotoxicity, genotoxicity, metabolic disorders, and even carcinogenicity.15Ali N et al. (2024) The potential impacts of micro-and-nano plastics on various organ systems in humans. EBioMedicine 99:104901. Open → Nanoplastics have been found to interact with the brain's naturally occurring protein α-synuclein, resulting in alterations associated with both Parkinson's disease and certain forms of dementia.39Liu Z et al. (2023) Anionic nanoplastic contaminants promote Parkinson's disease-associated α-synuclein aggregation. Sci Adv 9:eadi8716. Open →

Materials and Methods

Sample collection

Microplastic samples were procured from the stomachs of 26 cadavers during autopsy, with individuals having empty stomachs or gastrointestinal injuries systematically excluded. Authorization was granted by the Scientific Research Committee of the Presidency of the Forensic Medicine Institute of Istanbul, Türkiye.

Metal equipment was rinsed with distilled water and pre-filtered acetone. Amber-coloured glass laboratory bottles (100 mL) with aluminium screw caps were used for sample collection. During autopsy, the stomach was removed and dissected from the pylorus, and 50 mL of stomach-duodenum content was transferred into each bottle. All sampling procedures were executed within a Biosafety Level Two (BSL-2) autopsy laboratory, featuring HEPA filters and a dedicated aeration system.

Extraction and analysis

Microplastics extraction followed established methodology using a 30% KOH:NaClO solution for organic material digestion, kept at 50°C for one week. After density separation with NaI solution (5 M, 1.6 g/mL), samples were filtered through GF/C filter paper with a pore size of 0.45 μm.

Chemical characterization was performed using a Renishaw InVia Qontor confocal Raman microscopy system with 532 nm and 785 nm lasers. Particles were examined at 50x magnification and spectra were compared to the STJapan microplastics library.

Quality assurance

All analyses were conducted inside an enclosed laminar flow cabinet. Dummy samples were processed in four replicates to control for surgical environment contamination, and three laboratory control samples were also examined. Control results showed only cellulose fibers (no synthetic polymers), confirming no apparent contamination from either the surgical or laboratory environment.

Results

Demographics

The study comprised 20 male (76.9%) and 6 female (23.1%) individuals. The median age was 46.8 years, ranging from 18 to 72 years. Among the participants, 14 individuals (53.8%) had normal weights (BMI 18.5–24.9), while 12 (46.2%) were classified as obese (BMI ≥ 30). Autopsies were performed within 105 to 1140 minutes after death, with a mean duration of 534.6 minutes.

Polymer identification

Comprehensive Raman analysis was performed on 36 microplastic-like particles (out of 97 total), constituting 37% of all particles. This led to identification of 8 synthetic polymers plus cellulose.

Bar chart showing percentage distribution of polymer types identified by Raman analysis. Polyethylene (PE) dominates at 30.5%, followed by Polypropylene (PP) and Polymethyl methacrylate (PMMA) at 13.9% each.
Figure 1. Percentage distribution of polymer types identified by Raman analysis, encompassing 36 MP-like particles out of a total of 97 microplastics extracted from cadavers. Polyethylene (PE) was the most prevalent polymer at 30.5%.

Predominantly detected particles included Polyethylene (PE, 30.5%), Polypropylene (PP, 13.9%), Polymethyl methacrylate (PMMA, 13.9%), Nylon-6 (Polyamide, 11.1%), and Polyethylene terephthalate (PET)/Polyester (11.1%).

Key finding: Microplastics were identified in the stomachs of all 26 cadavers — a 100% prevalence rate. The average count was 9.4 ± 10.4 particles per individual, with a range of 1 to 39 particles per person.

Microplastics in the stomachs

A total of 97 microplastic particles were extracted from the stomach contents of all 26 individuals. The observed range of microplastics in each 50 mL sample varied from 1 to 14 particles. When assessing the overall gastric content, the total number ranged from 1 to 39 particles per individual.

Correlation analyses revealed no significant trends between the quantity of microplastics in the stomach and body mass index (BMI, r2 = 0.0002), age (r2 = 0.02), or post-mortem interval (PMI, r2 = 0.05). The average count of microplastics in females (7.1 ± 6.9, n = 6) was approximately 30% higher than observed in males (10.2 ± 10.3, n = 20), though this difference was not statistically significant.

Morphology and size distribution

The morphology analysis revealed distinct shapes: fibers comprised the majority (52.04%), followed by fragments (39.80%) and films (8.16%). Eight different colour variations were observed, with blue (38.8%) and black (24.5%) being most prevalent.

Microscopy photos showing various types and shapes of microplastics extracted from cadaver stomachs: films, fragments, and fibers in blue, black, transparent, yellow, green, and red colors.
Figure 2. Photos showing various types and shapes of microplastics extracted from the stomachs of cadavers. a) film and fragment, b) fragment, c) film, d) fiber, e) fiber, and f) fiber. Scale bars shown.

The average length of extracted microplastics was 802.1 ± 858.6 μm, with a minimum size of 51.53 μm and a maximum size of 4789.1 μm. Fibers were largest (1196.6 ± 907.1 μm), followed by films (635.6 ± 310.8 μm) and fragments (330.4 ± 261.4 μm).

Histograms showing the length frequency distribution of 96 microplastics by type (fiber, film, fragment) and total. Distribution is strongly skewed left, with most particles below 1000 microns.
Figure 3. The length frequency distribution of the 96 microplastics extracted from the cadavers, broken down by type (fiber, film, fragment) and total. A pronounced left skewness indicates the abundance of smaller-sized microplastics.

Discussion

This study marks the first confirmation of microplastics' presence in the human stomach, aligning with expectations given the consistent detection in stool samples. Schwabl et al. found microplastics in the faeces of all eight healthy volunteers aged 33–65,31Schwabl P et al. (2019) Detection of various microplastics in human stool. Ann Intern Med 171:453–457. Open → Zhang et al. found 95.8% of participants positive for faecal microplastics,32Zhang N et al. (2021) You are what you eat: Microplastics in the feces of young men living in Beijing. Sci Total Environ 767:144345. Open → and Yan et al. found microplastics in the faeces of all 102 individuals tested.33Yan Z et al. (2022) Analysis of Microplastics in Human Feces Reveals a Correlation between Fecal Microplastics and Inflammatory Bowel Disease Status. Environ Sci Technol 56(1):414–421. Open →

Estimated daily intake

Given a presumed gastric transit time of ~3.5 hours and a feeding period of 12 hours for humans, the estimated average daily intake of microplastics was calculated as approximately 9.4 particles multiplied by the ratio of feeding period to gastric transit time, yielding ~32.2 microplastic particles per day.

Cox et al. estimated daily microplastic consumption (including particles < 50 μm) varies from 107 to 142 particles depending on age and sex, and up to 247 for individuals who rely exclusively on bottled water.44Cox KD et al. (2019) Human consumption of microplastics. Environ Sci Technol 53(12):7068–7074. Open → This study's lower value (32.2) is expected, as the minimum detectable size was ~50 μm — while other studies detected particles as small as 10–20 μm.

Why the count is likely underestimated: Qian et al. recently demonstrated that actual concentrations of micro/nanoplastics in bottled water are two to three orders of magnitude higher (averaging 24,000 particles per liter) than previously reported results that focused only on larger microplastics.46Qian N et al. (2024) Rapid single-particle chemical imaging of nanoplastics by SRS microscopy. PNAS 121:e2300582121. Open →

Breakdown in the digestive tract

Stool studies report substantially more microplastics than this study found in stomachs. Schwabl et al. and Zhang et al. reported concentrations yielding 3,500–4,700 microplastics in the entire stool per day — significantly exceeding both the daily stomach value and consumption estimates. This discrepancy suggests that larger microplastics may break down into smaller fragments during digestive transit, especially in the stomach's highly acidic environment (pH 1.5–3.5).

The absence of larger particles (> 800 μm) in stool studies, contrasted with fibers up to nearly 5 mm found in stomachs, hints at chemical and/or mechanical breakdown of fibers during transit, resulting in elevated levels of smaller microplastics in stool.

Absorption across the gut wall

The potential breakdown of microplastics into smaller particles raises concerns, as they could more readily be absorbed along the intestinal tract and enter the circulatory system. According to WHO, microparticles > 150 μm are less likely to be absorbed, with absorption increasing as particle size decreases.13WHO (2022) Dietary and inhalation exposure to nano- and microplastic particles and potential implications for human health. Geneva: World Health Organization.

Particles below 20 μm cross the gut wall. Translocation and absorption of microparticles < 10 μm across microfold cells has been observed, involving active phagocytic transport from the gut lumen.54Hussain N, Jaitley V, Florence AT (2001) Recent advances in the understanding of uptake of microparticulates across the gastrointestinal lymphatics. Adv Drug Deliv Rev 50:107–142. Larger microplastics (5–150 μm) can undergo “persorption” — passive absorption through gaps in the single-layered intestinal epithelium.55,56Volkheimer G (2001) The phenomenon of persorption; Volkheimer G (1974) Passage of particles through the wall of the gastrointestinal tract. Environ Health Perspect 9:215–225. Volkheimer's experiments demonstrated detection of starch particles up to 130 μm in diameter in the bloodstream following ingestion.57Volkheimer G (1975) Hematogenous dissemination of ingested polyvinyl chloride particles. Ann NY Acad Sci 246:164–171.

Health implications

Once microplastics enter the gastrointestinal tract, there is potential for release of constituent monomers, additives, and absorbed toxins, posing risks from oxidative stress to potential carcinogenic behaviour.58Wang F et al. (2018) Interaction of toxic chemicals with microplastics: A critical review. Water Res 139:208–219. Li et al. proposed that as microplastics traverse the GI tract, their interaction may compromise the protective colonic mucus layer, elevating colorectal cancer risk.59Li S et al. (2023) Could microplastics be a driver for early onset colorectal cancer? Cancers 15(13):3323. Open →

Cetin et al. found significantly higher numbers of microplastics in tumoral colon tissues (TCT) compared to non-tumoral tissues and healthy controls, identifying polyethylene, PMMA, and nylon — the same dominant polymers found in this study.40Cetin M et al. (2023) Higher number of microplastics in tumoral colon tissues from patients with colorectal adenocarcinoma. Environ Chem Lett 21:639–646. Open →

The accumulation of knowledge on the levels and effects of microplastics and nanoplastics in various human tissues is crucial for understanding the significance of these contaminants for human health. The continual surge in plastics production suggests a probable escalation in the levels of microplastics and nanoplastics in human tissues and vital organs over time.

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This article was originally published in Forensic Science International by Elsevier (doi:10.1016/j.forsciint.2024.112246). All data and findings are attributed to the original authors: Özsoy S, Gündoğdu S, Sezigen S, Tasalp E, Ikiz DA, Kideys AE. Download the original PDF. Presented by DetoxBio for educational purposes under fair use.

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