Fish, birds, and crustaceans aren’t the only marine organisms affected by plastic pollution.

Coral reefs are also being menaced by water bottles, food containers, straws, toys, and all the other endless forms that plastic takes around the world, according to a new study published in the journal Science.

Researchers from Cornell University set out study the health of reefs in Myanmar, Thailand, Indonesia, and Australia, and they were surprised to learn that plastic pollution correlated strongly with disease and death, according to the Atlantic.

Take Action: Take Three Pieces of Garbage With You When You Leave the Beach

In normal conditions, around 4% of corals suffer from disease. When corals encounter plastic pollution, that rate jumps to 89%.

The reason for the staggering increase isn’t precisely understood, the Atlantic reports, but the team of researchers have a few theories.

For instance, plastic can end up covering a coral, blocking the sunlight, and allowing diseases that thrive in shaded places to take root.

Or sharp pieces of plastic can stab a coral, creating a wound for bacteria to infect. Plastic can also act as a raft for pathogens to travel on, making it more likely for them to come into contact with corals.

Further, plastic pollution can work in conjunction with other afflictions that affect corals to weaken the overall resilience of reefs. For example, rising ocean temperatures are causing corals to bleach, which is when they expel the symbiotic organisms that live on them and give them color. The prevalence of plastic waste can make it harder for corals to rebound from this sickly fate once temperatures cool.

Read More: Underwater Sculptor’s Coral Bleaching Exhibit Is One Everyone Needs to See

The range of ways that plastic can harm corals is broad, but the overall effects are clear — plastic pollution is causing a widespread decline, the Atlantic reported.

The team studied 124,000 corals over a four-year period and plastic pollution was most severe in Indonesia, Myanmar, and Thailand. The problem was less pronounced in Australia.

“We came across chairs, chip wrappers, Q-Tips, garbage bags, water bottles, old nappies,” Joleah Lamb, lead researcher of the study, told the Atlantic. “Everything you see on the beach is probably lying on the reef. And it seems like it’s getting worse.”

The researchers believe that reefs around the world are covered by at least 11 billion pieces of plastic, but stress that this is likely an underestimate because it doesn’t include an analysis of the reefs in waters around China, which is the biggest producer and consumer of plastic in the world.

Globally, around 380 million metric tons of plastic are being created annually. Meanwhile, an estimated 8 million metric tons of plastic enter the oceans each year, which is like emptying a garbage truck of plastic into an ocean every minute.

Read More: Australia Commits $60M to Save the Great Barrier Reef

As the negative consequences of plastic waste continue to accumulate, political action has become more feasible.

Recently, the UN drafted a resolution that would compel countries to prevent plastic from entering oceans, Canada intends to encourage G7 members to drastically curb plastic waste, and countries and cities around the world are beginning to ban types of plastic.

Global Citizen campaigns on curbing plastic use and pollution and you can take action on this issue here.

Ultimately, experts believe that problem of plastic pollution can be solved — but it’s going to take action from local and national governments, businesses, and global citizens.

“Plastics are something that can be managed at the local level, with greater success than perhaps efforts to reduce global warming,” Rebecca Vega Thurber, a coral reef expert at Oregon State University, told the Atlantic. “And unlike with climate change, the reduction of plastic pollution is not a controversial topic and might be an issue that could garner international support.”