The Environmental, Public Health, and Economic Impacts of Plastic-Polluted Seas

Currently, most of the region lacks adequate infrastructure for the collection, treatment, and disposal of hazardous and medical waste, and most of the waste gets mixed with municipal solid waste, thus ending up in open dumps. Pictures of masks and gloves littering the streets, rivers, and beaches have made visible the recent impact of the increased use of plastics.

The COVID-19 global health crisis is putting additional pressure on already weakened waste management practices. Moreover, as lockdowns took effect to slow the spread of the virus, the global demand for petroleum collapsed. As a result, oil prices plummeted, making the manufacture of virgin plastics from fossil fuels much less expensive than recycling. This cost incentive, along with the lifestyle change, has complicated the challenge of overcoming plastic pollution (Adyel 2020). Although the rise in demand is expected to be temporary, behavioral barriers and misperceptions might make these “new” norms particularly sticky and hinder society’s ability to transition to more sustainable practices and reduce the consumption of plastic products. As events continue to evolve and research progresses, it is expected that this new context will exert even more pressure on degraded environmental systems.

THE ENVIRONMENTAL, PUBLIC HEALTH, AND ECONOMIC IMPACTS OF PLASTIC-POLLUTED SEAS

Decades of weak SWM infrastructure and lack of proper regulation have taken a toll, and the ecological health of the Middle East and North Africa’s seas is in decline. The Mediterranean Sea is among the most plastic-polluted seas in the world, with plastic concentrations comparable to the five large accumulation zones of the five subtropical gyres (Cózar et al. 2014).6 In fact, only the garbage patch (a large area of captured marine debris) at the inner accumulation zone of the South Atlantic Gyre has a higher average concentration of plastics. When compared with five major oceanic zones,7 the Mediterranean outpaces their average plasticconcentration rates by far (Cózar et al. 2014). Large amounts of both macroplastics (items 5 millimeters or larger) and microplastics (items smaller than 5 millimeters) are entering the Mediterranean every year (Boucher and Billard 2020).

Regarding microplastics, the Mediterranean has been found to be the most polluted in terms of particles, with estimates ranging between 21 percent and 54 percent of all global microplastic particles (van Sebille et al. 2015).8 Such levels of plastic pollution in the Mediterranean have many negative effects. Among others, they reduce the productivity of certain blue economy sectors, result in losses of safe habitats for a host

of marine and coastal species, and are detrimental to human health. This section discusses these effects, in turn, on ecosystems and biodiversity, public health, and the region’s economy.

The Toll on Local Ecosystems and Biodiversity

The Mediterranean is one of the world’s most highly valued seas, with a vast set of coastal and marine ecosystems that make it one of the world’s biggest marine and coastal biodiversity hot spots. Sixty percent of its flora is unique to the region, and even though it represents less than 1 percent of the world’s ocean surface, it is home to 28 percent of the world’s endemic species (Vié, Hilton-Taylor, and Stuart 2009).

Plastic waste has severe impacts on Mediterranean ecosystems and local biodiversity. The increase in plastic pollution is reducing biodiversity, for example by entangling wildlife, which leads to high mortality rates. Of all entangled wildlife, 35 percent are birds, and hence most affected, followed by fish (27 percent), invertebrates (20 percent), and mammals (13 percent) (UNEP 2015). Recent studies show that certain consumer plastic items—plastic bags, packaging, and sheets; fishing nets and monofilament line; and balloons and other latex products— are disproportionally lethal to marine megafauna (Roman et al. 2020). Smaller items, although abundant, are seldom implicated in mortality. However, understanding which items disproportionately result in mortality and determining whether these items originate from land or sea provides an opportunity to prioritize policies that could help reduce debris-related mortality of threatened marine megafauna.

Sea-based debris (including fishing nets and ropes, fishing hooks, lines, and tackle) contribute less pollution than land-based sources, but they are an important source of animal mortality. In some geographical locations, especially in the Great Pacific Garbage Patch, fishing debris amounts to almost half of all plastic debris by weight (Lebreton et al. 2018). As for the Mediterranean, studies in Morocco confirm that marine debris from fishing contributes around 3–5 percent of total plastic debris (Nachite et al. 2019).

The impact on megafauna of ingesting sea-based debris may be underestimated because of spatial biases in data collection. Because lethality estimates are driven by the relative frequency of presence and absence of ingested items, spatial factors are ultimately less important than the physiological impact of different debris items within the animal’s gut (López-Martínez et al. 2021; Roman et al. 2020).9 Studies confirm that sea-based debris are important causes of mortality across all megafauna groups (López-Martínez et al. 2021; Roman et al. 2020; UNEP 2015).

Microplastics are the most abundant debris reported floating in the marine environment. Quantities of microplastics in marine spaces are increasing exponentially, mostly resulting from the surface-weathering degradation of plastic debris and other sources such as tire abrasion, production pellets, textiles, and personal care products carried from wastewater and surface runoff into the soil, rivers, lakes, and ultimately the oceans (Lebreton et al. 2017; Pew Charitable Trusts and SYSTEMIQ 2020).

The smaller the microplastics, the wider the range of marine organisms able to ingest or interact with them. Microplastics can also absorb and concentrate hydrophobic pollutants present in seawater at very low concentrations, increasing the adverse effects of ingestion by animals. At present, over 660 species—ranging from seabirds, fish, and mollusks to the zooplankton at the bottom of marine and food chains—are known to be affected by plastic debris (Lebreton and Andrady 2019).

Filling knowledge gaps will allow a better understanding of the tipping points and environmental thresholds for marine-plastic pollution and improve policy design specifically to address this issue and its consequences for human health.

The Consequences for Public Health

We are only beginning to understand the negative health consequences of plastics in the seas for human health; research on the impacts is at its infancy. A 2019 study by the University of Newcastle, Australia, found that an average person could be ingesting as much as 5 grams of plastics every week (Senathirajah and Palanisami 2019).10 Other studies estimate that children and adults might ingest from dozens to 100,000 microplastic specks each day (Nor et al. 2021). Through the different ways that waste is mismanaged (for example, ending up in marine spaces but also often burned and thereby entering the air), the exposure routes have been expanded from the food chain to contaminated food and drinks and, more recently, to inhalation (Zhang et al. 2020).

In sum, plastics have been found in the food we eat (fish that have eaten plastics), the water we drink (microplastics in the drinking water), and the air we breathe (airborne plastic particles from uncontrolled waste burning).

Exposure Routes

Microplastics have recently been detected in the atmosphere of urban, suburban, and even remote areas far from source regions of microplastics, suggesting long-distance atmospheric transport of microplastics. In addition, emerging evidence suggests the presence of microplastics in human

stool and colectomy specimens, confirming its presence in the human colon through ingestion (D’Angelo and Meccariello 2021; Ibrahim et al. 2021).

Microplastics are commonly found in marine-related produce such as seafood and table salt. In humans, most of the microplastic ingestion from seafood is likely from species eaten in their entirety, such as mussels, oysters, shrimps, crabs, and some small fish. For example, microplastics have been found in the digestive tract of many commercial species, such as Atlantic mackerel (Scombrus scombrus), herring (Clupea harengus), and plaice (Pleuronectes plastessa) as well as the digestive tract within the shell and in the muscle tissue of wild tiger prawns (Penaeus semiculcatus) and brown shrimp (Crangon crangon). Microplastics have been found in all samples of mussels purchased from UK supermarkets (CIEL 2019). Regarding seaweed, at high exposure, microplastic particles could stick to the surface of edible species (such as Fucus vesiculosus), although washing reduced the number of particles by 94.5 percent.

Microplastic particles have been found in commercial table salt derived from sea, lake, and rock salt, which suggests the high-level contamination of the environmental background (CIEL 2019). Consumers who drink three cups of coffee in disposable paper cups are ingesting about 75,000 microplastic particles from the thin layer of plastic inside the cup (D’Angelo and Meccariello 2021).

Morbidity and Mortality Risks

Evidence regarding microplastic toxicity and epidemiology is emerging. From a human health perspective, the effects of inhaled or ingested microplastics depend on factors such as size, chemical composition, and shape. The absorbed particles can affect the body through chemical toxicity, and the smallest particles can be taken in by cells, potentially being transferred to human body tissues and causing inflammations comparable to the impacts of particulate matter. The interaction between microplastics and other gut contents, including proteins, lipids, and carbohydrates, appears to be highly complex (CIEL 2019; Dalberg Advisors 2019a; Lim 2021; Pew Charitable Trusts and SYSTEMIQ 2020) but potentially dangerous. Initial results showed that the accumulation of microplastics in the human body could lead to inflammation, tissue damage, cell death, or carcinogenesis (Wright and Kelly 2017).

In addition, there is growing evidence that plastics may be contributing significantly to exposure to complex mixtures of chemical contaminants (such as chemicals either intentionally added during the production process, originating from ultraviolet [UV] radiation, coming from the waste-recycling process, or absorbed from environmental

pollution) that cause endocrine disruptions from inhalation, ingestion, or both inhalation and ingestion of microplastics (Gallo et al. 2018).

Finally, some of the most recent research has examined potential reproductive effects. Microplastics accumulate in placentas during pregnancies and are a potential threat to male fertility. Several microplastic fragments were detected in placenta samples in a recent study collected from pregnant women. Possible entry points include the bloodstream but also respiratory and gastric organs (Ragusa et al. 2021). Ingested microplastics can also bioaccumulate in mammalian tissue, affecting rodents’ semen quality, as a consequence of inflammation and oxidative stress damage. Furthermore, the morphological features of microplastics can make them an ideal vehicle for additional environmental pollutants (D’Angelo and Meccariello 2021). That microplastic exposure affects sperm quality in animals highlights possible reproductive risks for humans as well, a topic where further research is needed.

The Costs to the Blue Economy

The Mediterranean’s “blue economy” is among the most valued in the world, and its coastal and marine areas represent one of the Middle East and North Africa region’s most important economic assets. The Mediterranean Sea’s vast coastal and marine ecosystems deliver important economic and environmental benefits. The “shared wealth fund”— that is, the value of the Mediterranean coastal and marine assets dependent on functional ecosystems—was calculated to total about US$5.6 trillion, comprising marine fisheries (US$39 billion), sea grass (US$716.9 billion), productive coastline (US$4.65 trillion), and carbon absorption (US$173.5 billion), and generating economic output of about US$450 billion per year (Randone, Di Carlo, and Constantini 2017). The tourism sector accounts for 92 percent of the total value, followed by ecosystem services enabled by the ocean (6 percent), and fisheries and aquaculture (2 percent). Before the COVID-19 pandemic, the Mediterranean region attracted one-third of all global tourism, and several Middle East and North Africa countries rely on this sector for much of their income.

Moreover, the Mediterranean Sea brings innumerable other benefits not included in this valuation, including ecosystem services such as coastal protection and climate regulation. The Mediterranean also provides strong interdependencies with other critical sectors for the region’s economy such as transportation, clean energy, and cultural tourism.

Marine-plastic pollution causes heavy economic losses to this economic wealth. Losses from plastic pollution are estimated at €641 million per year for the Mediterranean, including up to €268 million in tourism,

€235 million in the maritime industry, and €138 million in fisheries (Dalberg Advisors 2019d), as follows:

• Tourism-related costs are linked to the expenses incurred by coastal towns to clean up beaches from additional waste generated during the tourist season. Marine litter also affects the aesthetic value (which is difficult to quantify) and attractiveness of the beaches and shorelines for recreational purposes, such as diving, snorkeling, and recreational fishing (during which plastics can affect catch amounts and damage gear) (UNEP 2016).

• The maritime industry reliant on propeller boats (in marine transportation and fishing, for example) is particularly vulnerable to collisions with large plastic objects that become entangled with propeller blades and clog water intakes for engine cooling systems. Costs are calculated in vessel downtime, delays, and additional maintenance costs.

• Port facilities are at risk of damage from plastic pollution, including the clogging of waterways, which creates delays and causes additional cleanup costs.

• For the fishing sector, the largest costs come from vehicle damage and maintenance caused by plastic debris, collision with plastics, and delays when fishing nets fill up with plastics rather than fish (Dalberg

Advisors 2019d).

In addition to the significant costs of plastic waste to the tourism, fishing, and shipping industries, the plastics-producing industry also consumes large amounts of fossil fuels, directly as feedstock and indirectly in the form of produced electricity, leading to high climate and air pollutant emissions. Over 90 percent of plastics produced are derived from virgin fossil feedstocks (EMAF 2016). Feedstock prices are the most influential factor in determining regional production advantages because these prices are a major part of the overall cost structure for petrochemicals (IEA 2018) and are a major determinant of overall costs for plastic production.

In the Middle East and North Africa, more precisely in the Middle East, feedstock prices account for around one-fourth to one-third of total costs (for products using ethane as feedstock), while comparable feedstock accounts for about 50 percent of total costs in Europe and the United States. The Middle East and North Africa’s low prices for fossil fuels and (in some countries) heavy subsidies to the fossil fuel sector drive down overall costs for petrochemicals and plastic production (as the Policy Review section discusses in more detail). Research indicates that 8 percent of the world’s oil production is used to make plastics, half