Pathogens and polymers
can separately cause disease; however, environmental
and medical researchers are increasingly investigating the capacity
of polymers to transfer pathogenic bacteria, and cause disease, to
hosts in new environments. We integrated causal frameworks from ecology
and epidemiology into one interdisciplinary framework with four stages
(colonization, survival, transfer, disease). We then systematically
and critically reviewed 111 environmental and medical papers. We show
58% of studies investigated the colonization-stage alone but used
this as evidence to classify a substratum as a vector. Only 11% of
studies identified potential pathogens, with only 3% of studies confirming
the presence of virulence-genes. Further, 8% of studies investigated
μm-sized polymers with most (58%) examining less pervasive cm-sized
polymers. No study showed bacteria can preferentially colonize, survive,
transfer, and cause more disease on polymers compared to other environmental
media. One laboratory experiment demonstrated plausibility for polymers
to be colonized by a potential pathogen (Escherichia coli), survive, transfer, and cause disease in coral (Astrangia
poculata). Our analysis shows a need for linked structured
surveys with environmentally relevant experiments to understand patterns
and processes across the vectoral stages, so that the risks and impacts
of pathogens on polymers can be assessed with more certainty.