Plastics in water bottles are slowly killing us; Leo Trasande, M.D.

Hi, it's Doctor Robert Seikard with Episode #30 of The Doctor Podcast Show. Thanks very much for tuning in today and please subscribe and like and repost if you like the program. Today we're talking about a very important topic and we have a a great guest to discuss it. You've probably all seen recently that there is a plastics pollution, there are tiny nanoplastic microscopic particles everywhere in our environment including in drinking waters from bottles and it's posing a a great risk and health hazard to everyone.

And today I have one of the world's top experts on this subject, Doctor Leo Trasande. Dr. Trasande is a professor of Pediatrics and also a professor of population health at the NYU Langone Medical Center and the NYU Grossman School of Medicine in New York City. Doctor Trasande has done lots of research on environmental health and its impact on on the health of people and he's also done many NIH studies and written articles and books on the subject. Doctor Trisandi has also written a great book. It's called Sicker, Fatter, Poorer.

It's about environmental health and endocrinological damage that has occurred in the environment from various chemicals that are present. And that's available on Amazon.com. It's it's a great book. Thanks very much for coming today, Leo. I appreciate your taking the time to come and talk about this very important subject. I got the idea to invite you because I've been seeing articles every day about how plastics are polluting our food, our air, our water on our environment. And you're one of the top experts on the planet on this, so it's great that you were able to come here.

My pleasure. Tell us a little bit about your background, how you got interested in environmental health. So I it wasn't a linear path. I went to medical school during the then President Clinton healthcare debates and I would get all these questions during my medical school interviews. What do you think of the Clinton healthcare plan? And at one point I decided to ask an interviewer out of the blue wasn't a smart idea. What do I learn about health policy in the medical school curriculum? And you might imagine I got a bit of a Stonewall Face of silence, if you will.

And that really got me thinking about getting more health policy perspective in my medical training. So I got a Master's in public policy at the Kennedy School of Government, great program combined with the medical degree. And that really opened my mind to the broader impact that we can have not just one patient at a time, writing prescriptions, treating laid hands, if you will, but the fact that we could do so much at a population level. So I decided to get some additional experience working on Capitol Hill for then Senator Hillary Rodham Clinton.

What a wonderful year I had. There was a great opportunity, and I was asked to work on children's and environmental health, and I figured I had the child health policy part down pat. But the environmental health part? I figured I'd wing it and and work it out. Boy, was I in for surprise. That experience really opened my eyes to the broad impact of environmental contaminants on all of us, frankly. And that set me on a different course and trajectory in my career and brought me to where I am today.

That's a very interesting story and you met a lot of interesting people there along the way. I'm sure it was quite exciting. You mentioned the the Kennedy School. Where where is that? It's in Cambridge, MA, just across the river from Harvard Medical School, where I did my medical training, and there I got exposed not just to healthcare policy people, but people from a host of of of of scopes and gamuts from education policy and military policy. It really broadened my horizons in a way that if I'd gotten, let's say, a conventional public health degree, I wouldn't have had that same broad mindset.

You know, no offense to public health people, I I do public health for a living. But having that broader experience at that formative age and stage of my career was really important. Right. How did you get to NYU from that? So I I, you know, I'm a native New Yorker. I and I had worked for Senator Clinton, and after my eyes had been open to environmental health, I decided to get some fellowship training a little bit north of NYU at Mount Sinai School of Medicine, stayed on there as faculty, doing children's environmental health research for about a decade.

And then I, I I figured I wanted to set up my own shop, if you will, and build a portfolio and team of researchers. And I've really just had a wonderful time at NYU Gross. When we have a Center for the Investigation of Environmental Hazards, we're growing a larger base of research, not just focusing on children. I mean, as a pediatrician, that's going to be near and dear to my heart, but the reality is that these exposures affect all of us from cradle to grave. Right. You know, what you mentioned brings back memories for me.

When I went to medical school, there was 0 on population health, zero on environmental health, and we, those words were never even mentioned in the years that I went to medical school. So we've evolved a lot, thanks to people like you and the people who trained you. So that that's great. So tell us about plastics pollution. I've been reading about it almost every day and and every media, online, newspapers on, on TV. What's going on? Why is the entire world polluted? And did it start from that little quote in with Dustin Hoffman in that movie where the guy whispered to him plastics?

Right. So. So tell us what's going on with plastics. So back then, we thought plastics was literally the future. We thought it could open our lives in so many ways to move faster, to do more with less. And you know even in the medical field we use plastics for good. And nothing I'm saying here today is suggests that essential plastics can't be used. It's just that there's been an explosion in plastic use and we've really come accustomed to plastic as a non essential uses being widespread and without any consequence.

During the pandemic, you've probably seen the proverbial trays on airplanes where they would literally put have the plastic coverings for various things and then they would wrap it in plastic thinking that that was going to reduce the transmission of COVID. And it didn't even make any sense at the time because COVID was an airborne disease as opposed to a droplet borne disease where you would worry about getting things on your hands and then transmitting it to yourself that way. And I think that through frankly the marketing of plastic, we've seen an aggressive push of plastic onto people without really thinking about the consequences for human health and the environment.

Now, I'm not going to tell you that this isn't a new and emerging issue. We've understood that plastics have impact on wildlife for a long time and burning plastics in particular contributes to the exposure to dioxin is a very potent category of carcinogens. But it really is over the past two decades that we've realized that chemicals used in plastic materials hack. Our hormones are naturally signaling molecules that underlie every biological function known to humankind, temperature, metabolism, salt, sugar, and even sex.

And the consequences of these exposures really start in early life, from brain development in young children to childhood obesity, adult obesity, even adult diabetes. Now, nothing I'm saying here mitigates the importance of healthy diet and physical activity, for example. Those are still crucial factors. But we know that when you have a chemical exposure that comes from plastics, for example, these exposures can change the body's thermostat, for example, and literally turn the body's mechanics into saving calories, rather than expending calories in the context of an energy need.

So part of the obesity epidemic and a diabetes epidemic may be related to plastics in the environment. Absolutely. It's a 3 legged stool, not a two legged stool. So diet and physical activity are two very important aspects of it. But it's not simple as calories in, calories out. We know that there are things in the human body's metabolic response to diet that get modified by these chemical exposures. So that's in your book, the sicker, fat or poor book, you you discuss that, right? Yes. So we talk there more broadly about chemicals that hack our hormones and contribute to disease and disability that affect all of us.

One major source of these chemicals is plastic. When we're talking about the chemicals that we understand to be the greatest concern, we're talking about phthalates that make plastic bendable and soft. You think of that that nice sound that plastic makes when you have food packaging rubbing up against each other. The phthalates are what actually make the Poly vital. Chloride soft and squishy and flexible. Those chemicals antagonized testosterone, the male sex hormone, and can have effects not just on men, but they can have effects on all of us because they Causeway inflammation in the blood vessels and contribute thereby to heart disease.

We've done a series of studies documenting that nearly 100,000 Americans die each year due to early cardiovascular mortality due to phthalate exposures. Ultimately, you've. Actually proven that statistically that that it's directly related. Well, we're never going to say that anyone study proves something definitively, but they in the context of other animal evidence and laboratory evidence that shows that these chemicals do that. We did a study where we looked at populations over about 10 years from a nationally representative survey.

We look back at a measure of these chemicals in the urine of these people before they were followed over time. And the ones with the higher exposures were more likely to die from heart disease. They were not more likely to die from cancers. So it was a very specific effect. And we looked at diet, we looked at physical activity, we looked at heavy metal exposures. So we've really tried to be expansive in looking for other explanations. I'm not. It's not a randomized control trial, but you have to think about the ethics of running an intentional exposure trial.

Right. You can't do that. Right. Ethically, it's because it's a potential hazard that you're giving people that that you would have to really weigh that in a way that that people can't readily do. Right now you wrote a recent article which I read, which is fascinating, just published a couple of weeks ago. Which journal was that? In in the Journal of the Endocrine Society. Right. And that was a fascinating article because it broke down to different types of plastics that are toxic. And also you categorize the different diseases that each of the plastics causes, which was really fascinating and interesting.

All these years when I've been drinking water out of plastic bottles, I just assumed the plastic stays in the bottle, but it really doesn't. Can you explain how the the plastic from a water bottle or other plastics we eat from get out of there or leach out of there into the water and the food? So there are two ways that that can happen. One you mentioned earlier where we're talking about micro and nanoplastics. So these plastic materials are polymers, so chains of the same molecule repeating over each other that the bigger they get the bigger they become a solid and and and the kind of materials you see and they break off over time with heat and with harsh conditions.

So that's one way. But the other thing that people don't think about is there are these additives. So it's already alluding to phthalates used in softer plastics. Phthalates are a great example because they're not covalently bound to the plastic they absorb into food and water because of that, especially with harsh temperatures and harsh conditions. So like, microwaving plastic is real disaster. It's not a good idea to microwave plastic. Some of these plastics say microwave safe, so they're really not microwave safe.

That's misleading, unfortunately. Microwave safe really is meant for gross misshaping or warping of the plastic in the machine itself at a microscopic level. You can see these chemicals absorbing more readily, Unfortunately, and those microplastics and nanoplastics, we don't actually understand as much about the effects of them. What we understand the most is about the chemicals used in plastics, and what we think is going on is one of two things. One is the chemicals are absorbing, running into food.

The other possibility is that the micro and nanoplastics are uniquely poised as carrier pigeons for these chemicals. There's a lot of new nanotechnologies that we're using to treat patients and deliver drugs. And in a similar way, these nanoplastics might actually be bringing the chemicals along for the ride, docking them in cells, and then transmitting them to cells, thereby causing disarray. I see. Yeah, we mentioned the word nanoplastics. How? How small is a nanoplastic? You know, people may be looking in the water balance saying, I don't see any plastic in there.

How tiny is that and why can't you really see it? Well it's we're talking about less than the visible spectrum. So this is one one thousandth of a millionth when we're talking about nano. So 1 * 10 to the -9 of a meter. So really not even thumbnail size, like way smaller, way out of the range if you're. Talking about molecule size basically. Basically, you're in the range of molecules, yes. Right now, in the last year or two, I've seen a lot of articles published about PFAS plastics and initially it was just limited.

Now it seems to be everything. And about six months ago, I read that the PFAS plastics are actually in contact lenses that I prescribed for my patients and fit with. And there's concerns that those PFAS plastics in the contact lens may get into the eye and cause problems. So we don't know that, but tell us about PFAS Plastics specifically. So PFAS is for PER and polyfluoroalkyl substances. A big mouthful. But to to simplify it, they're called forever chemicals because they have a notorious habit of staying in the body for years at a time.

That's because they're based on fluorine atoms in the body bound to carbons. That carbon fluorine bond is really robust, very few things. You could subject it to 1000° temperatures and that bond would stay really strong and most of us would melt. So when you use that in a product, it means it offers a lot of stability and to thermal wear and other aspects of resistance. So for many years we've come accustomed to either adding it to even oil and water resistant clothing because that would repel stains in particular.

So carpeting got that for a long time, and furniture even has gotten it. And now what we've learned is you can make a plastic polymer out of these fluorochemicals, like many of the nonstick cookware now is made of this plastic polymer made of P Foss. What we know is that when these get in the body, they do a lot of different things. They mess with thyroid hormone, which is crucial for brain development as well as heart function, body temperature, among other things. We also know that it messes with metabolism in that particular way.

There's a study that showed that people who had lost weight through healthy diet and physical activity when they measured the level of P Foss and followed the population after the weight loss intervention, the people with the higher P Foss had more weight gained back. And so, you know, these are people who really fought hard to lose weight, and yet they're suffering the consequences of an exposure they didn't sign up for. Right, so instead of getting weird of plastics, we're taking Ozempic. Right.

Yeah, it seems seems kind of contradictory. So the PFAS Plastics are now in everything pretty much. I mean, you mentioned it's on clothes, it's on furniture, it's in the bottles. They're the most rapidly growing type of plastic because a lot of attention has been given to the chemicals used In Poly vinyl chloride, for example, there are polycarbonate plastics we haven't talked about BPA. Bisphenol A is the basic monomer used in many of those plastics. A lot of attention has been put to that because they're synthetic estrogens and make fat cells bigger, not to mention antagonize heart protective proteins.

So we've gone away from bisphenol or polycarbonate plastics and even Poly vinyl chloride plastics and much like we try to tweak things through chemistry and try to make things better, unfortunately what that does is it whacks the mole, it creates regrettable substitutes. So in many cases what we're starting to see is that the P phos based plastic, these per and polyfluoralkyl substance based plastics are replacing some of the older plastics that we know have health effects. Big trouble there. Now, in your article that came out a few weeks ago, read your article, you listed several different diseases that are caused by plastics.

From the research that you've done, can you go through those different diseases that that are caused by plastics? Happy to. It's been. It was about a decade's worth of work across a lot of different studies really taking. These are not single study based speculative hypotheses. These are multiple, not randomized controlled trials mind you, but multiple epidemiologic studies carefully controlled further factors that had identified consistent exposure related effects on these outcomes. And we're talking about everything from early brain development and cognitive deficits including intellectual disability in so far as populations get shifted from the normal range to the abnormal range.

We're talking about effects on childhood obesity, adult obesity, which are alluded to adult diabetes and we're even talking about certain cancers. So these non state chemicals, the P phos have been associated with testicular and kidney cancer just to name a couple. And then many of these chemicals mess with fertility. So we know that phthalates, for example, disrupt genital development. There's a particular anatomical distance called anogenital distance that's predictive of fertility in men. And we know that the AGD gets shortened by phthalates, for example.

We know that in addition, there are cardiovascular risks. I've alluded to, we alluded to the 100,000 people a year that die of early heart disease as a result of phthalate exposures. So you know at every stage and phase of life we were able to find basically about 25 to 30 conditions that are directly related to phthalates, bisphenols or P phos as well as flame retardant chemicals. Flame retardants you don't think of as part of plastics, but they keep fires from happening in plastics. And so for example, for many years we used in polyurethane foams.

We added that they're used in furniture to make cushions like the one I'm sitting on feel good, but they were added to prevent the spread of fires. Unfortunately, they didn't really save any lives and unfortunately they contaminated us. So for a generation until California were a lot required that they be rolled out. So you didn't have to add flame retardants to furniture, but that's an example where you added an additive to a plastic to have a plastic function and flame retardants are really impactful on brain development as I alluded to earlier in kids.

So when you add disease burden to all of these conditions, you then can put a cost either due to direct medical care or due to, let's say lost economic productivity. These are all social costs and the total cost across all these conditions. When you take a cut to focus only on the cost of these chemicals due to plastics. Mind you, this is super conservative. We really tried to whittle down and hone in on the source $250 billion a year. Billion. Billion with AB. Right, That's a a massive cost there.

What about diseases like autism? You know that's a raging debate. As a pediatrician, you know all about that and what causes that and we still don't know Is there any connection with autism and plastics? So I want to address this in a couple ways. I I I hear a lot as a pediatrician. The focus on vaccines as it it's raged for a long period of time. We have studied vaccines assiduously for many years and haven't found a smoking gun, if you will. We've looked really hard when you look at chemicals used in pesticides, flame retardants.

I already alluded to even phthalates. We've seen studies show links to increases in autistic and related behaviors, right. So when I, you know, when I counsel a family, you know it's painful to talk about because there's not really a lot you can do other than provide educational support and other related services to make that child the most optimally functioning, supportive member of society. But when they when the focus turns to vaccines, I say, well, why not channel your energy, your concern, your anger, even at chemicals with a lot more evidence supporting the effects related to autism.

And then we could get around an issue that affects, unfortunately, too many people. With 3% of boys having autism, this is going to be something we're going to live with for a generation or beyond. Right. So I notice a lot of the baby products, the the bottles that contain formula and now they have these pouches that kids are sucking on all day. They're all made out of plastics. So that that may be the culprit. It we don't know as much about childhood exposure, what we think that these chemicals in particular about autism and related conditions is it's early pregnancy.

It's really important because a baby's thyroid hormone comes from mother through the 1st 2 trimesters and then the baby's thyroid kicks in and and those chemicals seem to mess with thyroid which is a crucial growth hormone for the brain. That's.

Pretty frightening. What about you mentioned infertility? Recent studies in last year or two show a huge decrease in fertility rate in men around the world. Is is there good evidence connecting that in plastics? Yes. So I've already alluded to phthalates, and particularly in early in in pregnancy there is a key developmental window that is disrupted by chemicals and antagonized, testosterone in particular. But that's not the whole story here. We've looked at adult men, unfortunately, and we've seen that phthalates, bisphenols and P phos are all associated with reduced sperm count and other aspects of function.

Now let's not forget the other partner here, because bisphenols, for example, are exquisitely effective at impairing ovarian function. So there are potentially effects on both sides of the coin. And studies have shown that phthalates contribute to endometriosis, which increases infertility, not to mention contributes to a very painful condition that affects too many women. So not only are they killing us, the plastics, but they're also preventing reproduction and and having new people last year too.

I've also seen a lot of studies that show that cancer is occurring at a much younger age. For example colon cancer and breast cancer occurring in people in their 30s and 40s. In the old days it was usually older people, 60s, seventies 80s. Is there a connection of getting cancer at a young age? And plastics. There's a lot more we need to do on this front. I'm very concerned that microplastics either again deliver chemicals to colon cells that thereby set changes in genes that thereby trigger cancer development, or there's something directly irritating about the chemicals or the microplastics themselves that causes a problem.

Now, the one other wild card here is we have another organ system living in our gut. It's called the microbiome. And what might be happening is, ironically, that the microplastics and chemicals may be disrupting the microbiome and thereby contributing to the development of cancers. That is an open field for research, to be perfectly honest. So I think for colon cancer, the jury is still out, but there are some very concerning smoke signals. All right. So the microbiome are these bacteria that live in our intestines and they kind of live happily there and they secrete certain chemicals and substances that are helpful to us.

So the plastics may be killing the good bacteria, may be allowing other bacteria strains to grow that are are not helpful and not healthy is that that's works. That's a reasonable explanation. Now we do need more studies to really tease that out. You're talking about a complicated it's not just an exposure in a human and a disease. You have an exposure, a human and then the microbiome to consider. So it's not like you're now at three factors. You've gone up to four factors in complexities you have to think through.

From a statistical perspective, it gets even harder to tease that out. Right 'cause there are multiple variables involved. Exactly all. Right, so now that we know about all this, what do we do to protect ourselves? I almost had a water bottle here for you. And in case you got, and then I said, whoa, I'd better not do that, 'cause he's he's not going to do the interview, right, if I have a plastic water bottle. So what do we do? Because we also hear the drinking water from the tap may not be healthy as well.

So how does a person, and the population in general protect themselves from these plastics? So let's start by talking about essential versus nonessential plastics. So the proverbial non essential plastic to me is the plastic wrap around the cucumber that you see in the supermarket. You're like, why do I really need what's what purpose is that actually serving the the cucumber is going to decay whether it's wrapped in a plastic thing or not. So that's a prototype example for me of plastics that we don't really need and we have to take a step back and think about reducing our plastic footprint as a planet.

Now as we talked about before we started this interview, there is so much of A legacy that we've built up and almost we've become inured to accepting plastic as a new normal. We're probably going to have to redesign our systems, our food supply systems and other aspects of our lives to reduce our plastic footprint. But there are safe and simple steps we can all take to reduce our use of plastic and reduce our particularly our use of toxic chemicals in plastic in particular. So let's take the reduction of plastic.

Take your You know, we all often will get on an airplane to go from point A to point B. Maybe it's time to take a stainless steel water bottle. I do it all the time. It's empty when I clear security because they don't want water in them in in those machines, you fill that water bottle before you take off. That doesn't maybe get you 12 hours if you're going to a very far-flung place, but it can get you a few hours. And OK, so maybe you need one plastic bottle to get you through the rest of it. That speaks to reducing your plastic footprint.

We've already talked about microwaving plastic as a real no no, because that's inviting the chemicals used in plastics to get into our body machine. Dishwashing plastic is another problem, because that etches or scratches the plastic at a microscopic level. And if it's obviously etched or scratched, it's time to throw it away. So wait, plastic dishes in a dishwasher? Bad news. Hand wash it. And. Soap and old school soap and water. Is everybody going to do that out there? Hand washed plastic dishes.

I'm sure we'll get a comment in in the in the YouTube section about that so, but it's it's supported by science. Those are great tips, Any any other tips on on how to avoid? Plastics. So they're recycling numbers to watch out for. The numbers three, six and seven are the ones to avoid across the board. Three is for phthalates, those softer PVC plastic I've already talked about. Six is styrene, a known carcinogen and seven are those bisphenols I've talked about. So when when you think about plastic, we also have to think about places where we're given plastic just as a given.

Sometimes it's good to just say no to plastic. You're saving the the store or the company. You're working with a little bit of money and you're saving people a lot of hassle in the process, particularly those workers that have to deal with the plastic day in, day out. Right. So it's those are things to avoid. It's still very difficult because there's plastic everywhere now. Plastic comes from fossil fuels, right? That's right. It comes from oil and fossil fuels. So maybe as we get away from that, as we go more towards clean energy, we'll be able to reduce plastics.

There's one asterisk to that phenomenon and that is that many companies are seeing their off ramp from burning fossil fuels to converting fossil fuels to plastic. So that is where I want to pull my hair out. But the the fact is that we need to reduce our dependency on fossil fuels in the 1st place. So there is a global plastics treaty that's being negotiated right now where we're really addressing the broader plastic footprint. Because we're not just talking about effects on people. Trust me, that matters a lot.

But we're talking about effects on wildlife. We're talking about the Great Pacific Garbage Patch and other beaches land masses that are being occupied by plastic. Plastic waste is a huge problem globally and particularly in low and middle income countries where plastic use is exponentially increasing. We only have recycled 9% of our plastic cumulatively in the planet, and we are increasing our use of plastic literally almost 100% a year. 100% a year. So if we do not turn the top off somehow, we are just going to have more of a waste problem and more of a chemical exposure problem to the things that we've talked about.

So that's why countries across the planet are trying to negotiate a solution. And you know how we talked about reduce, reuse and recycle? A lot of people put the emphasis on recycle and a lot of people pushing a circular economy as a catch all solution. But if you don't reduce your production of plastic, even if you recycle 50% of plastic, which no company is doing on the planet right now, it's roughly 30% is the best in show. You are literally just going to have more plastic in the supply over the next ten, 20-30 years, and we're going to have a worse problem, not a better problem.

So we need a global plastics treaty that reduces our addiction to plastic. Is the United States involved in that? It is, and that's where things get interesting because we are a major producer of plastic and Petro chemicals. I think you mentioned in your article what what percentage of plastics in the world are are made by the USA. Those numbers are hard to really get a a a decent read on because in terms of Brazil and Russia and India and China, their uses are exploding, but it's between 10 and 20% by most estimates.

So we really are big players in the plastic market. It's you know, globally plastics is a $700 billion market. But the reason we published that $250 billion cost which is an annual cost that continues insofar as exposures contribute at current levels is to try to give people in the policy world and ideally in the public a real sense of the trade-offs involved. We're talking about 1% of our gross domestic product that we are losing and those are that's being lost off our backs, literally the backs of our health.

And someone is literally profiting off of our contamination from plastics and our increase in disease. So we've got a real perverse incentive involved. So our hope is that this kind of information resets the debate. I'm all forgoing the economy, don't get me wrong, but this is actually hurting our economy. They mentioned recycling. Does that really work? Because I've heard that when you put the bottle in the recycle bin, it really just goes in the same place later as old garbage. Is that right? Or is it really recycled?

And how does that happen? During the pandemic, it essentially shut down because people were afraid of the contamination in viruses due to plastic. Most of the plastic we've recycled never ends up being recycled because that plastic is often contaminated. It needs chemicals to rejuvenate the plastic into something that's reusable and reusable. Plastics, when they are recycled, they actually carry contaminants from the previous generation of the use such that you actually have more contamination even with heavy metals, not just chemicals used in plastic.

Heavy metals come along for the ride with these materials, so I'm not suggesting don't drink recycled plastic. But let's be honest about what we're doing when we're emphasizing the message that we need to recycle our way out of this crisis. What about I've read in recent years that there are new biodegradable plastics. Is is that real or is that just another marketing gimmick? I'm empathetic to the idea, but the execution is awful right now. So there are studies that have looked at the hormone changes in response to to bioplastics, and unfortunately they're more problematic than the chemically based plastics in the first place.

Because they might interact more with our organic chemicals in the body Because they're biodegradable. Right. So let's take I'm going to shift examples completely. Tea tree oil has been marketed as a natural and therefore safe additive to soaps. Similarly speaking, tea tree oil is very hormonally active such that it's actually been associated certain cases with breast bud development. So natural doesn't necessarily mean safe when it comes to our way out of this. So bioplastics similarly are not necessarily a good off ramp.

So that that's not safe either. How far along are we with the global plastics treaty? When do you think that'll be become law or policy? Right. So it will, it's planned to be finalized by 2025. This is a very fast process. Now the proof will be in the pudding. The question is, is it going to be more like the Paris Accords which were not really that effective because they were voluntary agreements to vaguely commit to reducing our fossil fuel addiction? Or is it going to be like more like the Montreal Accords which really reduced ozone levels in a way that have fundamentally changed our viability on this planet?

We were in a crisis in the 80s with ozone and we've really brought science to the table that informed that treaty and it made it effective such that we all benefit from the legacy of that treaty. So if we have a more Paris Style Accord on plastic, we're in for a rough ride and we we may be back at the table in 10 years. If we do a Montreal style Accord that really rigorously reduces our consumption of plastic turns off the tap, then we might have something that protects human health. So you need to have some teeth in the policy, some enforcement, otherwise people aren't going to do it, it seems like, right?

And there's some fierce countries, including the United States, who have plastic companies knocking on their doors and fossil fuel companies knocking on their doors, saying please don't undermine our ability to profit. And particularly in Brazil, Russia, India and China, the arguments that you're going to grow the economy by using and producing plastics are very potent. So it seems like now I know why Elon Musk wants to go to Mars and start. All over. There's no plastic on Mars. Unfortunately, yeah.

And he's probably not bringing us along for the ride. So that won't work for for most of us, that four billion 7 billion people on the planet. Right. Not for a while. So this has been extremely informative conversation. I learned a lot. I'm sure the the audience has as well. I really appreciate you taking time to come today and and explain this. Now that more people know about it, maybe we can talk to our leaders and get more enforcement quicker because we're hurting ourselves with plastics. Absolutely.

And if folks out there want to hear more about the work that we're doing, Leo Trasande, TRASAND e.com. I'm on the various socials as Leo Trasande, so Twitter, Instagram and such things that way as well, if that's helpful. Yeah. I'll put those links on the program when I post it online. Wonderful. Thanks very much for coming today, Leon. I really appreciate it. Fascinating discussion. Thanks a lot. My pleasure. Thank you.

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