Safer Soap

Use of antibacterials may lead to bacterial resistance and other health concerns

How many times a day do doctors wash their hands? Dozens, perhaps. And they encourage us to follow effective hand-washing techniques as well.

“But, the conversation shouldn’t end there”, according to Dr. Paula Kim, MD with Beaumont Health System, clinical professor at Wayne State University’s School of Medicine, and associate professor at Oakland University William Beaumont School of Medicine. She says, “The next questions are: What type of soap is used at home? Is it an antibacterial? Or is it plain soap and water?”

The Centers for Disease Control, American Medical Association, Food and Drug Administration and others overwhelmingly encourage people to use non-antibacterial (plain) soap, warm water and to rub hands together for a minimum of 20 - 30 seconds.

Why plain soap? Isn’t an antibacterial product more effective? In 2013 the FDA challenged manufacturers of antibacterial hand and body soaps (which are Over the Counter drugs) to prove that their products are more effective at killing germs than plain soap and water. And they couldn’t do it.

“There’s no data demonstrating that these drugs provide additional protection from diseases and infections. Using these products might give people a false sense of security,” says Theresa M. Michele, MD, of the FDA’s Division of Nonprescription Drug Products.

In fact, this past September the FDA issued a rule banning manufacturers from using nineteen different antibacterial active ingredients, including the widely-used triclosan. The agency cited health risks, including bacterial resistance, as a main concern. Manufacturers of hand and body soaps (soaps intended to be used with water) have until September 2017 to switch their formulations. The new rule affects the majority of liquid hand soaps and bar soaps currently on the market. It does not affect hand sanitizers or hand wipes.

Health Risks

According to the FDA, “...laboratory studies have raised the possibility that triclosan contributes to making bacteria resistant to antibiotics. Some data shows this resistance may have a significant impact on the effectiveness of medical treatments, such as antibiotics.” The FDA has also expressed concern over triclosan’s potential hormonal effects. According to the FDA, “...recent studies have demonstrated that triclosan showed effects on the thyroid, estrogen, and testosterone systems in several animal species, including mammals, the implications of which on human health, especially for children, are still not well understood.”

A 2014 report, Chemicals in Consumer Products Are Draining Trouble into the Great Lakes Ecosystem, published by the Canadian Environmental Law Association (CELA), found--in addition to concerns about endocrine activity--triclosan carries moderate risks for reproductive toxicity, developmental neurotoxicity, neurotoxicity (a single dose), and human systemic toxicity (repeated dosage).

Exposure

Triclosan is the most commonly used active ingredient in antibacterial products, of which there are thousands. It is added to household cleaners, cosmetics (including soap, deodorant, toothpaste, and mouthwash), clothing, furniture, lunchboxes, backpacks, food packaging, kitchen utensils, children’s toys, and more. But, it doesn’t stay in those products. Researchers have detected triclosan in household dust, in streams and other waterways, in wildlife, in human plasma and breast milk, and in drinking water. Indeed the multitude of exposure paths was a driving factor behind the FDA’s original request for safety and efficacy data from manufacturers. According to a September 2016 FDA Consumer Update fact sheet, Antibacterials? You Can Skip It--Use Plain Soap and Water, “...people’s long-term exposure to triclosan is higher than previously thought, raising concerns about the potential risks associated with the use of this ingredient over a lifetime.”

Environment

Much of the triclosan washed down the drain ultimately finds its way to our local waterways, since wastewater treatment plants are not equipped to filter out the chemical. CELA’s 2014 report found 90% of surface water sampled in the Great Lakes is contaminated with triclosan. They label triclosan “a chemical to be avoided” due in part to the very high risk of aquatic toxicity and its persistence in the environment. Once triclosan-laced wastewater is discharged into local waterways it reacts with sunlight to form dioxins, which can produce a spectrum of toxic health effects.

Consumers

Many people use antibacterial soaps without knowing they are using an OTC drug. Shoppers should watch out for the word “antibacterial” or the phrase “kills germs”. Generally, we find these words and phrases reassuring. But, remind patients that it is not necessary to kill all the germs, but to simply remove them with plain soap and water. Then wash them down the drain. A Drug Facts label on a soap or body wash is a sign a product contains antibacterial ingredients. As Dr. Kim always encourages her patients, “Read the label on anything you buy. Read what’s in it!”

More Information

You don’t have to settle for toxic triclosan in your household cleaners either. Dr. Kim suggests her patients to, “Use natural things if possible, such as vinegar and water.” White vinegar is a food-grade antimicrobial which can kill germs on surfaces. Or, look for Clean Well brand soaps and sanitizers, which use thyme oil as the active ingredient to kill germs. Some of the Seventh Generation brand cleaning products include the Clean Well technology also.

 

Published on January 30, 2017

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