Is Antibacterial Soap Safe?

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While many agree hand washing is crucial to avoid getting sick, the growing concern over the safety of antibacterial soaps adds even more suds to an already slippery situation. Triclosan, the main ingredient in most antibacterial soaps, has been linked to drug resistance, disrupted hormone levels, and increased allergies [1] [2] [3]. Plus, it’s showing up where it shouldn’t in our bodies and the environment [4] [5] [6]. Are these risks worth the benefits?

Antibacterial Soap

Suds Up! — Why It Matters

Regulated by the FDA, triclosan is found in toothpaste, body washes, furniture, toys, and even clothing and conveyor belts. While the FDA has been reviewing the available research on triclosan’s safety in consumer products, ironically, they have already recognized that antibacterial soaps do not provide any benefits over washing with plain soap and water. When antibacterial soap was first introduced onto the commercial market in the 80s, triclosan had only been used by doctors to soap up before surgical procedures. By 2001, 76 percent of liquid hand soaps contained triclosan, the primary antimicrobial ingredient most often used to kill bacteria on the skin and other surfaces.

Since 2004, levels of triclosan in humans have increased by an average of 50 percent. It is showing up in urine and cell plasma [7], and a whopping 97 percent of U.S. women have detectable traces of triclosan in breast milk. This chemical buildup may be interfering with normal hormone function, increasing testosterone levels, and putting people at risk for cancer, decreased fertility, birth defects, even neurological and behavioral changes [2] [7].

Too Clean? —  The Answer/Debate

According to two studies (ahem, both published by the Dial Corporation), the use of antibacterial soap may significantly reduce transmission of bacteria and may even reduce the rate of infection by 50 to 80 percent when compared to plain soap alone [10] [11]. But other studies (by slightly less “invested” sources) found that commercial antibacterial soaps were no more effective at killing bacteria on the hands or preventing infectious illnesses than good old soap and water [1] [13] [14]. In environments where antibacterial agents are used frequently, triclosan may be morphing regular bacteria into superbugs— bacteria resistant to certain disinfectants and antibiotics— which can be detrimental to health [1] [16].

Since most antibacterial consumer products end up down the drain (literally), some studies have found triclosan and triclocarban (another antibacterial agent added to soaps) are now present in nearly 60 percent of all rivers and streams, with levels also steadily increasing in lake sediment [5] [6]. And when triclosan gets together with it's chemical friends, this antibacterial agent may cause even more trouble. Combine it with the chlorine in tap water, and it has been known to produce chloroform, a human carcinogen that can be absorbed through the skin or inhaled and may damage the heart, kidneys, liver, and even affect the nervous system and reproductive health [19]. When exposed to sunlight, triclosan may produce dioxins, another family of toxic chemicals that can build up in body tissue, possibly increasing cancer risk [19].

Findings are beginning to indicate that— especially in children with developing immune systems— there really is such a thing as being too clean [3]. Living in overly hygienic environments limits exposure to common bacteria necessary for developing strong immune systems— the immune system is formed in response to everyday foreign substances such as dirt, pollen, and mold [22] [3].

Recently, the FDA announced that they will be investigating soaps and other products advertised as antibacterial or antimicrobial. From now on, companies that place these words on labels must prove that the antibacterial products are safe and more effective than regular old soap. If a product fails the test, companies will have to remove antibacterial ingredients and relabel the soaps.   

The Takeaway

Just because antibacterial soaps are safe for some people doesn't necessarily mean they're the safest choice. Learning to properly wash your hands (and often!) with regular old soap and water is just as beneficial, and eliminates the chemical risks that antibacterial soap carries.

Works Cited

  1. Consumer antibacterial soaps: effective or just risky?  Aiello, A.E., Larson, E.L., Levy, S.B. Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, Ann Arbor, MI 48104-2548, USA. Clinical Infectious Diseases, 2007 Sep 1;45 Suppl 2:S137-47.
  2. Triclocarban enhances testosterone action: a new type of endocrine disruptor? Chen, J., Ahn, K.C., Gee, N.A., et al. Center for Health and the Environment, University of California, Davis, California. Endocrinology, 2008 Mar;149(3):1173-9.
  3. Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood. McDade, T.W., Rutherford, J., Adair, L. Department of Anthropology, Institute for Policy Research, Northwestern University, Evanston, IL. Proceedings: Biological Sciences,  2010 Apr 7;277(1684):1129-37. Epub 2009 Dec 9.
  4. Fate of triclosan and evidence for reductive dechlorination of triclocarban in estuarine sediments. Miller, T.R., Heidler, J., Chillrud, S.N., et al. Center for Water and Health, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Environmental Science and Technology, 2008 Jun 15;42(12):4570-6.
  5. Occurrence and loss over three years of 72 pharmaceuticals and personal care products from biosolids-soil mixtures in outdoor mesocosms. Walters, E., McClellan, K., Halden, R.U. Center for Environmental Biotechnology, The Biodesign Institute at Arizona State University, 1001 S. McAllister Avenue, Tempe, AZ. Water Research, 2010 Dec;44(20):6011-20.
  6. Identification of wastewater bacteria involved in the degradation of triclocarban and its non-chlorinated congener. Miller, T.R., Colquhoun, D.R., Halden, R.U. Johns Hopkins University, Department of Environmental Health Sciences, Baltimore, MD 21205, United States. Journal of Hazardous Materials, 2010 Nov 15;183(1-3):766-72.
  7. Triclosan: environmental exposure, toxicity and mechanisms of action. Dann, A.B., Hontela, A. Department of Biological Sciences, Alberta Water and Environmental Science Bldg, 4401 University Dr. W., University of Lethbridge, Lethbridge, Alberta, Canada. Journal of Applied Toxicology, 2011 May;31(4):285-311.
  8. Triclocarban enhances testosterone action: a new type of endocrine disruptor? Chen, J., Ahn, K.C., Gee, N.A., et al. Center for Health and the Environment, University of California, Davis, California. Endocrinology, 2008 Mar;149(3):1173-9.
  9. Triclosan: environmental exposure, toxicity and mechanisms of action. Dann, A.B., Hontela, A. Department of Biological Sciences, Alberta Water and Environmental Science Bldg, 4401 University Dr. W., University of Lethbridge, Lethbridge, Alberta, Canada. Journal of Applied Toxicology, 2011 May;31(4):285-311.
  10. Effect of hand wash agents on controlling the transmission of pathogenic bacteria from hands to food. Fischler, G.E., Fuls, J.L., Dail, E.W. Dial Center for Innovation, Microbiology Department, The Dial Corporation, North Scottsdale Road, Scottsdale, Arizona. Journal of Food Protection, 2007 Dec;70(12):2873-7.
  11. Alternative hand contamination technique to compare the activities of antimicrobial and nonantimicrobial soaps under different test conditions. Fuls, J.L., Rodgers, N.D., Fischler, G.E. The Dial Corporation, Microbiology Department, 15101 N. Scottsdale Rd., Scottsdale, AZ.  Applied and Environmental Microbiology, 2008 Jun;74(12):3739-44.
  12. Consumer antibacterial soaps: effective or just risky?  Aiello, A.E., Larson, E.L., Levy, S.B. Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, Ann Arbor, MI 48104-2548, USA. Clinical Infectious Diseases, 2007 Sep 1;45 Suppl 2:S137-47.
  13. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Oughton, M.T., Loo, V.G., Dendukuri, N. Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada.  Infection Control and Hospital Epidemiology, 2009 Oct;30(10):939-44.
  14. The effect of handwashing with water or soap on bacterial contamination of hands. Burton, M., Cobb, E., Donachie, P. Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. International Journal of Environmental Research and Public Health, 2011 Jan;8(1):97-104.
  15. Consumer antibacterial soaps: effective or just risky?  Aiello, A.E., Larson, E.L., Levy, S.B. Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, Ann Arbor, MI 48104-2548, USA. Clinical Infectious Diseases, 2007 Sep 1;45 Suppl 2:S137-47.
  16. Can disinfectants contribute to antibiotic resistance? Heir, E., Langsrud, S., Sidhu, M.S., et al. Statens institutt for folkehelse Postboks, Nydalen, Oslo. Tidsskrift for den Norske Laegeforening, 2001 Nov 10;121(27):3201-6.
  17. Occurrence and loss over three years of 72 pharmaceuticals and personal care products from biosolids-soil mixtures in outdoor mesocosms. Walters, E., McClellan, K., Halden, R.U. Center for Environmental Biotechnology, The Biodesign Institute at Arizona State University, 1001 S. McAllister Avenue, Tempe, AZ. Water Research, 2010 Dec;44(20):6011-20.
  18. Identification of wastewater bacteria involved in the degradation of triclocarban and its non-chlorinated congener. Miller, T.R., Colquhoun, D.R., Halden, R.U. Johns Hopkins University, Department of Environmental Health Sciences, Baltimore, MD 21205, United States. Journal of Hazardous Materials, 2010 Nov 15;183(1-3):766-72.
  19. Formation of chloroform and other chlorinated byproducts by chlorination of triclosan-containing antibacterial products. Fiss, E.M., Rule, K.L., Vikesland, P.J. The Charles E. Via, Jr. Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia. Environmental Science and Technology, 2007 Apr 1;41(7):2387-94.
  20. Formation of chloroform and other chlorinated byproducts by chlorination of triclosan-containing antibacterial products. Fiss, E.M., Rule, K.L., Vikesland, P.J. The Charles E. Via, Jr. Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia. Environmental Science and Technology, 2007 Apr 1;41(7):2387-94.
  21. Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood. McDade, T.W., Rutherford, J., Adair, L. Department of Anthropology, Institute for Policy Research, Northwestern University, Evanston, IL. Proceedings: Biological Sciences,  2010 Apr 7;277(1684):1129-37. Epub 2009 Dec 9.
  22. The impact of bisphenol A and triclosan on immune parameters in the U.S,. population, NHANES 2003-2006. Clayton, E.M., Todd, M., Dowd, J.B., et al. Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor. Environmental Health Perspectives, 2011 Mar;119(3):390-6.
  23. Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood. McDade, T.W., Rutherford, J., Adair, L. Department of Anthropology, Institute for Policy Research, Northwestern University, Evanston, IL. Proceedings: Biological Sciences,  2010 Apr 7;277(1684):1129-37. Epub 2009 Dec 9.

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