Philipp Schwabl, MD; Sebastian Köppel, Dipl-Ing(FH); Philipp Königshofer, DVM; Theresa Bucsics, MD; Michael Trauner, MD; Thomas Reiberger, MD; Bettina Liebmann, PhD
Disclosures: Dr. Schwabl reports nonfinancial support from AbbVie, Gilead Sciences, Falk, and Roche outside the submitted work. Dr. Bucsics reports support from AbbVie and Bristol-Myers Squibb outside the submitted work and other support from Gilead Sciences. Dr. Trauner reports support from AbbVie, Albireo, BiomX, CymaBay Therapeutics, the Falk Foundation, GENFIT, Gilead Sciences, Intercept Pharmaceuticals, Merck, Novartis, Phenex Pharmaceuticals, Regulus Therapeutics, and the Takeda Medical Research Foundation outside the submitted work and holds a patent on medical use of 24-norursodeoxycholic acid. Dr. Reiberger reports other support from AbbVie, F. Hoffmann-La Roche, Gilead Sciences, and Merck. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0618.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Reproducible Research Statement:Study protocol and statistical code: Available on reasonable request from Dr. Schwabl (e-mail, firstname.lastname@example.org). Data set: FT-IR image data are available in PerkinElmer image file format (.fsm) on reasonable request from Dr. Liebmann (e-mail, email@example.com).
Corresponding Author: Philipp Schwabl, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Schwabl, Königshofer, Bucsics, Trauner, and Reiberger: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Mr. Köppel and Dr. Liebmann: Environment Agency Austria, Spittelauer Laende 5, 1090 Vienna, Austria.
Author Contributions: Conception and design: P. Schwabl, S. Köppel, T. Bucsics, T. Reiberger, B. Liebmann.
Analysis and interpretation of the data: P. Schwabl, S. Köppel, T. Reiberger, B. Liebmann.
Drafting of the article: P. Schwabl, B. Liebmann.
Critical revision of the article for important intellectual content: P. Schwabl, S. Köppel, T. Bucsics, M. Trauner, T. Reiberger, B. Liebmann.
Final approval of the article: P. Schwabl, S. Köppel, P. Königshofer, T. Bucsics, M. Trauner, T. Reiberger, B. Liebmann.
Provision of study materials or patients: P. Schwabl, P. Königshofer, T. Reiberger.
Statistical expertise: P. Schwabl, B. Liebmann.
Administrative, technical, or logistic support: P. Schwabl, P. Königshofer, T. Bucsics, M. Trauner, T. Reiberger, B. Liebmann.
Collection and assembly of data: P. Schwabl, S. Köppel, B. Liebmann.
Microplastics are ubiquitous in natural environments. Ingestion of microplastics has been described in marine organisms, whereby particles may enter the food chain.
To examine human feces for the presence of microplastics to determine whether humans involuntarily ingest them.
Prospective case series in which participants completed a food diary and sampled stool according to step-by-step instructions.
Europe and Asia.
Eight healthy volunteers aged 33 to 65 years.
After chemical digestion, Fourier-transform infrared microspectroscopy was used to analyze the presence and shape of 10 common types of microplastic in stool samples.
All 8 stool samples tested positive for microplastics. A median of 20 microplastics (50 to 500 µm in size) per 10 g of human stool were identified. Overall, 9 plastic types were detected, with polypropylene and polyethylene terephthalate being the most abundant.
There were few participants, and each provided only 1 sample. The origin and fate of microplastics in the gastrointestinal tract were not investigated.
Various microplastics were detected in human stool, suggesting inadvertent ingestion from different sources. Further research on the extent of microplastic intake and the potential effect on human health is needed.
Schwabl P, Köppel S, Königshofer P, et al. Detection of Various Microplastics in Human Stool: A Prospective Case Series. Ann Intern Med. [Epub ahead of print 3 September 2019]:. doi: 10.7326/M19-0618
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Published: Ann Intern Med. 2019.
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