Plastic pollution is a significant problem in Indonesia, blocking rivers, fouling beaches, and piling up in communities. But its impact on innocent lives extends beyond what we can see. More than just an environmental issue; it is an accelerating health risk for millions of Indonesians.
Every year, Indonesia generates over 34 million tonnes of garbage, with plastic accounting for nearly one-fifth of the total volume1. Unfortunately, less than half of this waste is properly managed. In many areas of the nation, especially where waste collection services are limited, burning plastic is a quick solution. However, this seemingly simple fix has severe health repercussions, including toxic air.
Pollutants like dioxins, furans, and small particles are released into the air when plastic is burned. Invisible, odourless chemicals. That harm not only the environment, but damage our lungs, hearts, and overall health. Plastic pollution is therefore as dangerous a public health crisis as it is an environmental emergency.
What Happens When Plastic is Burned
Burning plastic does not make it disappear. It might be invisible, but it is still there. Transforming into a toxic mix of airborne threats. Alongside harmful gases like carbon monoxide and carbon dioxide, plastic burning releases dangerous chemicals such as volatile organic compounds (VOCs), dioxins, and furans. These pollutants linger in the air, contributing to climate change and heightening health risks for those inhaling them.
Perhaps less visible, but no less alarming, is the release of microplastics, the tiny plastic particles less than 5 millimetres in size resulting from the breakdown of larger plastic items. These microscopic fragments become airborne during combustion and are easily inhaled. Once inside the body, they can collect in organs and tissues, causing inflammation and other chronic health problems. Unlike many contaminants, microplastics do not degrade rapidly, posing long-term risks towards global health.
As these particles disperse through the air, they settle into the soil and water bodies, contaminating ecosystems far from the original burn sites. The combined impact of chemical emissions and persistent microplastics makes open plastic burning one of the most damaging and overlooked contributors to environmental pollution and human diseases.
How This Contributes to NCDs
The smoke from burning plastic does not just smell bad per se; a silent and hidden threat to our health. But one of the biggest hazards it poses, is how it pollutes the air, especially with harmful substances like fine particulate matter (PM2.5), nitrogen dioxide (NO₂), and ozone (O₃). These tiny particles, smaller than a hair’s width, and gases can travel deep into our lungs, causing real, irrevocable damage to our organs.
Air pollution is known to worsen respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD) and increases the risk of lung cancer. The toxic particles from burning plastic irritate and inflame the airways. Over time, repeated exposure can scar lung tissue, block airflow, and destroy the tiny air sacs in the lungs that help us breathe. These effects are not limited to cities. In rural areas, where people often burn plastic waste in backyards or small workshops, the air can become dangerously polluted, putting entire communities at risk.
Air pollution also harms the heart. Inhaling polluted air triggers inflammation in the body, which can lead to heart disease, high blood pressure, stroke, and heart failure. Tiny particles from burning plastic can enter the bloodstream, damaging arteries and worsening existing heart conditions. Studies show that people over 40 years of age, who are regularly exposed to polluted air are at a higher risk of developing cardiovascular diseases. These risks increase further when combined with other health factors like smoking, poor diet, and lack of exercise.
Plastic pollution is not only an environmental issue. It is fueling a health crisis, especially for older adults and vulnerable communities. The longer we wait to act, the more the danger grows, and the greater the threat becomes.
New Science: Inflammation, Gene Expression, and Biological Pathways
Recent studies have uncovered mechanisms linking burning plastic, air pollution, and the rise of non-communicable diseases (NCDs) like heart disease, respiratory problems, diabetes, and cancer. Dioxins and furans released by burning plastics into the air can trigger inflammation in the body. Inflammation occurs when the immune system reacts to harmful substances, and over time, it can damage organs and tissues, raising the risk of chronic diseases.
Research also suggests that compounds found in plastic burning emissions affects gene expression, which is how our cells read and respond to genetic instructions. These changes can activate biological pathways that lead to diseases, including diabetes. Exposure to pollutants from burning plastic has been co-related to an increase in the production of cytokines, small proteins that help regulate the immune system. However, when produced in excess, they contribute to chronic inflammation and diseases. Additionally, exposure to these pollutants can lead to increased expression of genes involved in breaking down harmful substances, a process called xenobiotic metabolism2. These disruptions in gene function can impair the body’s ability to regulate blood sugar, raising the risk of diabetes and other diseases.
These findings highlight the biological impact of plastic pollution and reinforce the urgent need for stronger waste management policies and targeted health interventions, such as early screening, community education, and environmental health monitoring, to reduce exposure and protect vulnerable populations.
Why Health Systems Must Adapt—The Role of Primary Care in Early Detection and Education
Health systems need to adapt to this growing crisis by strengthening their ability to manage and treat diseases linked to plastic-related pollution. Primary care plays a vital role in early detection, as primary care providers are often the first point of contact for individuals with symptoms of chronic diseases like COPD or heart disease. Including environmental health concerns into routine screenings can help primary care teams spot early warning signs and intervene early, improving patient outcomes.
Moreover, primary care providers are uniquely positioned to educate the public about the risks of plastic burning and air pollution. They can raise awareness about how air pollution contributes to NCDs and guide patients on ways to reduce exposure. In rural areas, where air purifiers may not be available, simple actions like wearing face masks can help protect against the harmful effects of polluted air. Face masks designed to filter fine particles can shield the respiratory system from toxins released by burning plastic.
Primary care providers also need to monitor local air quality and inform the community about pollution levels. By staying updated on air-quality data, they can offer timely advice, such as recommending people to stay indoors or limit outdoor activities during high pollution events. Alongside disease prevention, primary care providers can promote healthier lifestyles—encouraging proper nutrition, regular exercise, and avoiding smoking. By taking a proactive approach to both detection and education, primary care can help protect the health of communities and guide individuals toward healthier, more sustainable habits.
Reducing plastic waste is vital towards mitigating the environmental and health impacts of plastic pollution. Equally crucial is the strengthening of our health systems to effectively respond to the rising threat of non-communicable diseases linked to air pollution from plastic burning. The fight against plastic pollution requires a dual approach—tackling waste at its source while ensuring that our health systems are prepared and equipped to manage its long-term effects on public health. Only through both actions can we safeguard the well-being of future generations.
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This blog has been co- written by Asri Maharani and Harun Al Rasyid.
About the authors:
Asri Maharani- Asri Maharani is a Senior Lecturer in Public Health and Epidemiology at the Manchester Metropolitan University. Her work focuses on the intersection of environmental and mental health, exploring how air pollution and plastic burning contributes to non-communicable diseases and mental health. Professor Maharani brings her invaluable experience as a practising physician to her study of public health challenges and how their solutions can aid communities. Her work examines how health systems can help combat the adverse affects of plastic burning through early detection, public education, and preventive care in vulnerable communities.
Harun Al Rasyid- Harun is a lecturer and public health researcher at the Faculty of Medicine, University of Brawijaya, Indonesia. Currently, in the NIHR Global Health Research Centre for Non-Communicable Diseases (NCDs) and Environmental Change, Harun is focusing on strengthening primary health care (PHC) and essential public health services in Indonesia. He is working on developing sustainable solutions to help prevent non-communicable diseases in high-risk communities. Harun’s work evaluates how primary healthcare interventions can help address the rising burden of NCDs linked to air pollution exposure in Indonesia.
This research was funded by the NIHR (Global Health Research Centre for Non-communicable Diseases and Environmental Change) using UK international development funding from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.
