Iatrogenic micro(nano)plastics exposure in healthcare: A review of analytical processes, emerging threats, and perspectives.

Micro(nano)plastics (MNPs) are emerging environmental contaminants, yet pharmaceuticals and medical procedures represent a distinct, direct exposure pathway that bypasses primary physiological barriers. This access, via intravenous administration, implants, or injections, is hypothesized to alter toxicokinetic profiles compared to environmental ingestion, representing a unique but unquantified risk. This review synthesizes current knowledge on MNPs introduced via pharmaceutical and clinical routes through a systematic analysis of 27 core studies identified from Web of Science, PubMed, Scopus, and Google Scholar. Our analysis reveals a bifurcated research landscape: one domain focuses on the intentional engineering of particles for drug delivery systems, while the other investigates unintentional contamination from clinical applications. A critical finding is the disconnection between exposure confirmation and hazard characterization. While studies confirm significant iatrogenic exposure, ranging from thousands of particles in intravenous fluids to millions released from degrading sutures, regulatory-relevant toxicological data linking these exposures to adverse human health outcomes are largely lacking. Furthermore, we identify a lack of standardization in analytical processes; methods vary between direct characterization of engineered particles and inconsistent isolation protocols for detecting contaminants in clinical matrices. Consequently, current evidence establishes the presence of iatrogenic MNPs but remains insufficient for robust risk assessment, underscoring the need for standardized analytical methods and foundational toxicological research to bridge the gap between exposure detection and safety management in healthcare.