Association Between Plastic Exposure and Arterial Plaque in Vascular Surgery Patients in Khyber Pakhtunkhwa, Pakistan

Abstract

Background: Arterial plaque formation is a major contributor to cardiovascular disease, and emerging evidence suggests that microplastics, nano plastics, and plastic‑associated chemicals may play a role in vascular inflammation and atherosclerosis. Pakistan faces high daily plastic exposure due to widespread use of plastic-packaged food, drinking containers, and single-use plastic items.

Methodology: This cohort study was conducted on 271 vascular surgery patients recruited from Lady Reading Hospital, Peshawar.  A validated questionnaire that assessed frequency and type of daily plastic exposure. Statistical analysis, including Pearson’s Chi-square tests, evaluated associations between categories of plastic use and arterial plaque. A p-value < 0.05

Results: 55.4% of participants had a confirmed diagnosis of arterial plaque. Significant associations were found between arterial plaque and the use of plastic-packaged food, plastic cutlery, plastic straws, and plastic wrap (p < 0.05). No statistically significant associations were observed with plastic bottles, water storage containers, cooking/heating utensils, or plastic bags. Several variables showed trends toward association but did not reach statistical significance.

Conclusion: Plastic exposure especially those involving direct food contact such as plastic-packaged food, cutlery, straws, and wrap were significantly associated with arterial plaque in vascular surgical patients. These findings highlight the potential cardiovascular risks linked to microplastic ingestion and plastic derived chemical exposure.