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In this work a suspect-screening approach was employed to assess the polymers and plastic additives of micro(nano)plastics (NPL/MPLs) of size ranges from the nm range to 20 μm present in seawater from the top 5 cm of the Mar Menor lagoon during two sampling campaigns (summer and winter), as well of other potentially adsorbed compounds onto the plastic particles surfaces and suspended material. The identification of NPL/MPLs has been based on characteristic Kendrick Mass Defect analysis for each polymer type in mass spectra. The applied methodology allowed to identify NPLs/MPLs of polystyrene (PS), polyethylene (PE), polyisoprene (PI), polybutadiene (PBD), polypropylene (PP), polyamides (PA), polyvinylchloride (PVC), n-isopropylacrylamide (PNIPAm), and polydimethylsiloxanes. In addition, PS, PE, PI, PBD, PP, PA, and PVC were confirmed with standards, and the equivalent concentrations were quantified. The results of this study showed that most frequently found compounds were PP, PE, PA and PNIPAm, while the compound found at higher concentrations was by far PP reaching the 9,303 ± 366 ng/mL in one of the samples. A total number of 135 chemical compounds were tentatively identified, 74 of them plastic additives and compounds used in the polymers manufacture or coming from the polymer’s decomposition. In relation to plastic additives, the more frequently tentatively identified compounds were plasticizers such as phthalates group; stabilizers such as antioxidants (e.g., distearyl 3,3′-thiodipropionate, 2,5-di-tert-butylhydroquinone), and UV filters as benzotriazoles. Several flame retardants of the group of phosphates were as well detected. The other compounds tentatively identified in the samples were pharmaceuticals, pesticides, food additives, flavors and natural products that were attached onto the plastic particles and particulate matter from surrounding waters. In regards to the seasonal variation, during the summer a major number of compounds were tentatively detected, while de concentrations of polymers were slightly higher in winter. The spatial distribution showed higher contamination in the southern part of the coastal lagoon.

6648 Background: Prehabilitation is increasingly being recognised as a high-priority intervention to improve physical and psychological health in cancer patients, prevent treatment-related functional decline and to reduce the incidence and severity of post-surgical complications. The aim of this study is to develop a health economic (HE) model to evaluate the impact of prehabilitation in patients undergoing gastrointestinal cancer surgery. Methods: The objective of the HE model is to estimate the impact of prehabilitation on reducing treatment costs. Data was extracted from systematic reviews and meta-analysis on the effects of prehabilitation in gastrointestinal cancer surgery to identify: i) treatment pathway, ii) prehabilitation components (nutrition/exercise/psychological intervention), and iii) effects on three study outcomes (length of hospital stay, reduction of post-operative complications, and reduced Intensive Care Unit (ICU) stay). The modelling study accounts for the number of hospital admissions and unit costs from NHS hospitals, including cost per bed-day from NHS Reference costs 2017-18 and complication costs and ICU cost from NHS Reference National Cost Schedule 2019-20. Double counting has been corrected to account for the compounded effects on length of stay and complications. The HE model considers the average effect of each study outcome and their confidence intervals. This provides a range of potential impact of prehabilitation in terms of cost reduction based on NHS tariff. Results: Patient weighted average cost savings from prehabilitation was £785, excluding ICU costs. Breakdown of cost savings include £178.6 from reduced length of hospital stay, £214.8 and £434.5 cost savings originating from reductions in minor and major complications, respectively (excluding ICU complication costs). ICU cost savings from prehabilitation were £1,620. For the NHS, based on 237,000 annual surgical procedures, this amounts up to £186,082,321 in cost savings, from a reduction in complications and 421,840 hospital days, and £52,761,227 from ICU stay. Conclusions: In addition to the impact on post-operative complications and hospital stay, this study has demonstrated that prehabilitation results in significant costs savings to healthcare systems. The cost savings are largely from a reduction in the incidence and severity of post-operative complications. The latter contributing to reduced ICU costs.

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