Reducing microplastic exposure before clinical cardiovascular intervention is required: a call for a policy-based approach

INTRODUCTION: Microplastics and nanoplastics (MNPs) are detectable in human tissues and healthcare supply chains, raising concern that periprocedural exposure may add avoidable particulate burden during a thrombo-inflammatory vulnerable period. This Special Report examines why healthcare-mediated MNP exposure is a plausible policy target in cardiovascular care. AREAS COVERED: Literature for this Special Report was identified through focused searches of PubMed/MEDLINE and Google Scholar for relevant English-language publications published from January 2010 to March 2026, supplemented by reference-list screening and review of relevant regulatory and standards documents. Community exposures are summarized briefly for context, but the main focus is periprocedural healthcare-mediated exposure through infusions, extracorporeal circuits/dialysis, and perioperative environments. We propose a tiered precautionary bundle including in-line filtration for compatible infusions, lower-shedding fluid pathways, standardized device handling, dialysis/extracorporeal controls, and targeted environmental measures integrated into existing hospital quality systems. EXPERT OPINION: These measures should be viewed as precautionary exposure reduction strategies informed by the current evidence, and not as interventions with proven clinical benefit. Future research should prioritize standardized sampling and reporting, bench shedding studies, and pragmatic multicenter evaluations using auditable process measures together with short-term biomarker and clinical endpoints.