Countries around the globe have made progress reining in their use of plastic bags and bottles, but the plastic problem is both bigger and much smaller than this. In addition to the plastic refuse you can see, there are also the plastic particles that escape the eye.

Nanoplastics, minute particles of plastic are everywhere. High concentrations of nanoplastics have been found in bottled water.

Chemicals from plastics leach out and contaminate the environment. They can also disturb the body’s endocrine system, contributing to conditions such as cancer, diabetes, reproductive problems and neurological damage to developing fetuses and young children.

Phthalate exposure, which is associated with preterm birth, low sperm count and childhood obesity, accounted for $67 billion in healthcare costs.

The medical costs of these conditions are incredibly high. Researchers at New York University found that these endocrine-disrupting chemicals (EDCs) cost the U.S. an estimated $250 billion in 2018 alone. Given the economic and medical cost of EDCs, interventions to reduce exposure to them and protect public health and the environment are being discussed as part of a Global Plastics Treaty.

“Our study found plastics contribute significantly to disease and social costs in the U.S.,” Leonardo Trasande, first author of the study, said in a statement. The findings highlight the need to reduce EDCs used in plastics, he added. Actions outlined in the Global Plastics Treaty and other policy initiatives will reduce the healthcare costs associated with EDCs in direct proportion to how much they reduce EDC exposure.

The endocrine-disrupting compounds commonly found in plastics include:

Analyzing the findings of earlier studies, the researchers were able to determine the percentage of health conditions associated with the presence of EDCs in plastics, updating the previously published data on these conditions to 2018. Then they calculated the medical costs of treating these conditions.

Almost 98 percent of health conditions associated with EDCs were linked to the use of BPA or bisphenol A in plastic polymers; 98 percent were linked to di-2-hexylethylphthalate use; 100 percent were linked to the use of butyl- and benzyl-phthalates; 98 percent to PBDE-47 use; and 93 percent to PFAS use.

Most of the healthcare costs were attributed to PBDE exposure, which can cause a range of health conditions, including cancer. Phthalate exposure, which is associated with preterm birth, low sperm count and childhood obesity, accounted for $67 billion in healthcare costs.

Exposure to PFAS, which has been linked to kidney failure and gestational diabetes, resulted in about $22 billion in costs.

Future studies will aim to obtain more accurate estimates of the percentage of health conditions associated with the EDCs. This could include what percent of conditions are linked to the plastics used in food packaging and other sources.

The study is published in the Journal of the Endocrine Society.