Mapping the evidence on the role and impact of plastics in the context of health products and their packaging: A scoping review

Le résumé fourni par la source

Objective: To map the global research on the impact of plastic-based health products and their packaging across the product lifecycle in order to inform equitable, sustainable governance for the role of plastics in health products. Design: A scoping review of primary research and systematic reviews examining plastic-related outcomes in the context of health products or packaging using a systematic search of the MEDLINE, EMBASE, SCOPUS, GEOBASE and Compendex databases November 2024 with no date or language restrictions. Setting: Studies spanning global and disciplinary contexts. Participants: Primary research or systematic reviews that examined plastic-related outcomes in the context of health products or packaging. Main outcome measures: We descriptively analyzed characteristics and outcomes of the included articles according to the product lifecycle stage. Results: We screened 14,695 articles and included 572 articles published between 1960-2024. Only 8% (45/572) of articles studied more than one lifecycle stage. The evidence is otherwise siloed by focus, setting, and discipline: articles focused on clinical use and storage outcomes (266/572, 46.5%), were conducted primarily in high income countries (230/266, 86.5%) and within biomedical disciplines (207/266, 86.5%); articles focused on end-of-life outcomes (n=257/572, 44.9%) were conducted more frequently in middle-income countries (158/257, 61.7%), and within engineering and environmental sciences (208/257, 80.9%). We documented a multi-decade interest in plasticizer leaching from plastic devices and packaging. Conclusions: A research agenda that is lifecycle oriented, prevention focused, and precautionary will produce robust, actionable evidence to support treaty decision-making and implementation. We conclude with recommendations for research priorities that include interventions to reduce the use of plastics in healthcare, to measure the health and environmental impacts of the chemicals in plastics, and identification and assessment of safe, toxics-free, sustainable alternatives.

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