When Clean Isn’t Always So Clean:
The Case Against Antibacterial Soap
by Wendy Priesnitz

When you have just had a baby, you want to make sure she has the healthiest possible start in life. So you try to keep yourself, your baby and your home as clean as possible. One of the products you might be using is antibacterial soap. However, there is an increasing amount of evidence that the use of antibacterial soap in the normal household is unnecessary and causes far more harm than good, to both human health and the environment.

Since 2000, the American Medical Association (AMA) has been advising the U.S. Food and Drug Administration (FDA) to closely monitor and possibly regulate the home use of antimicrobials. At the AMA annual meeting in 2000, Myron Genel, chair of the AMA Council on Scientific Affairs and a Yale University pediatrician, said, “There’s no evidence that they do any good and there’s reason to suspect that they could contribute to a problem” by helping to create antibiotic-resistant bacteria. And more recently, the FDA has announced that it is considering restricting antibacterial soaps, which its panel of health experts overwhelmingly said have not been proven any more effective than regular soap in preventing infections among average consumers. Actions the FDA could take include changing product labels, restricting marketing claims or pulling the products off the market altogether.

At issue are antibacterial products that include chemicals such as triclosan, which is known for its bacteria-fighting properties. Triclosan is found in 75 percent of liquid soaps and 30 percent of bar soaps, as well as in toothpastes, acne creams, deodorants and lotions. It is also incorporated into a wide range of consumer products like toys, cutting boards, toothbrush handles, hot tubs and athletic clothing.

However, antibiotics kill more than the disease-causing bacteria to which they are directed. They kill any other susceptible bacteria. Once the ecosystem is cleared of susceptible bacteria, resistant bacteria can multiply and dominate the environment due to lack of competition, resulting in drug-resistant “superbugs”. The phenomenon can be likened to weeds that have overgrown a lawn where the grass has been completely destroyed by an overdose of herbicides.

The ubiquity of the antibacterials in soaps “is a worrying thing,” lead researcher Dr. Eli N. Perencevich of Beth Israel Deaconess Medical Center in Boston, Massachusetts, told the media at a meeting of the Infectious Diseases Society of America in New Orleans in 2000. He said at the level of usage of antibacterial soap in the typical home, bacteria could easily develop that would be resistant to both antibiotics and the antibacterial soaps themselves.

Microbiologist Dr. Stuart Levy of Tufts University told an International Conference on Emerging Infectious Diseases in Atlanta, Georgia in 2000 that strong antibacterial cleaners are needed only when someone in a household is seriously ill or has low immunity. He said that older cleansers such as soap and hot water, alcohol, chlorine bleach and hydrogen peroxide are sufficient for most purposes.

In fact, your use of antibacterial cleaners may be hurting your baby’s immune system rather than keeping her healthy. Dr. Levy, who has long been active with the Alliance for the Prudent Use of Antibiotics (APUA), spoke of an Italian study that found that exposure to bacteria is essential for development of an infant’s immune system. A baby, he said, must be exposed to germs during its first year in order to develop the antibodies needed to fight infection later in life. In 2006, the Canadian Paediatric Society called for parents to stop buying antibacterial products, and instead use soap and water to wash toys, hands or household items.

There are also environmental problems with the over-use of antibacterial agents, which may, in turn, lead to health problems. According to Peter Vikesland of the Virginia Polytechnic Institute and State University, in research published on Environmental Science & Technology’s Research ASAP website, he and his colleagues found that triclosan reacts with chlorinated water to produce unacceptably high levels of chloroform, which is known to be a probable human carcinogen. The research also suggests that the reaction of triclosan with chlorine could be producing highly chlorinated dioxins in the presence of sunlight.

In 2006, Caren Helbing, a molecular biologist at British Columbia’s University of Victoria, reported that while triclosan isn’t lethal in small quantities, it can potentially affect the human thyroid gland. The thyroid plays a role in development, body temperature and metabolism. Helbing’s research, published in the online journal Aquatic Toxicology, found triclosan to be harmful in the development of frogs and potentially humans. At the molecular level, the chemical compound is similar to vertebrates’ thyroid hormone. Helbing found triclosan at levels found in the environment disrupted a tadpole’s transition into a frog.

A 2008 study by researchers at the University California-Davis confirmed earlier research that added the antibacterial chemical triclocarban to the list of problematic components of antibacterial soaps. Using human and animal cell lines, researchers found that triclocarban disrupts reproductive hormone activity. Unlike classical endocrine disruptors that bind to cell receptors, triclocarban amplifies the response of naturally occurring sex hormones. Because of feedback loops in the body, amplification of these hormones could have the effect of depressing natural estrogen and androgen production, potentially impacting fertility and other hormone-dependent processes.

“Americans spend nearly one billion dollars a year on these products even though recent studies show that they are no better than regular soap and water at reducing the spread of illness. Now we have added evidence that, in some cases, the benefits may not be worth the risks,” says Dan Chang, professor emeritus of civil and environmental engineering at University of California. “Manufacturers of products containing triclosan and triclocarban should consider providing cautionary labels. There are new health-related data on these chemicals that consumers should know about, even if the research is in its early stages.”

The study was published online in Environmental Health Perspectives, a publication of the National Institute of Environmental Health Sciences.

“We decided to take a look at triclocarban and triclosan because these compounds appeared to be building up in the environment,” according to Bruce Hammock, a professor of entomology. Triclosan tends to bioaccumulate , or become more concentrated in the fatty tissues of humans and other animals. As a result, a number of studies since 2002 have detected it in human breast milk, and in blood samples as well.

Research in 2007 by the Centers for Disease Control on a broad cross-section of the American population detected triclosan in the urine of 75 percent of those studied. Higher levels were typically found in higher income participants. An earlier study spearheaded by the Mount Sinai School of Medicine found triclosan in the urine of 61 percent of 90 girls age six to eight.

Triclosan has also been found in house dust and is commonly used in everything from credit cards to children’s personal care products, children’s toys, baby bibs and blankets and other items that ensure exposure by children. However, regulations seem to ignore the possibility of harm to this vulnerable group.

That is of special concern to the Environmental Working Group (EWG), a Washington-based public health and environmental research and advocacy organization, and one of the topics in a lengthy letter sent to the U.S. Environmental Protection Agency (EPA) in mid-2008, during its review of health and safety data for triclosan. “Triclosan persists in the environment, breaks down into substances highly toxic to wildlife, pollutes the human body and poses health risks that are barely studied and poorly understood,” wrote Staff Scientist Rebecca Sutton and Vice President for Research Jane Houlihan. They note that the EPA’s draft risk assessment is “plagued with data gaps and inconsistencies” and “was crafted to support the status quo.”

That status quo is irresponsible, says EWG, “because triclosan has been proven ineffective, and EPA has failed to assess its safety for children.” So they asked for a ban on triclosan in personal care products and any other products used at home, in line with the conclusion of the American Medical Association that common antimicrobials for which resistance has been demonstrated should “be discontinued in consumer products unless data emerge that conclusively show that such resistance has no effect on public health and that such products are effective at preventing infection.” They also suggest that consumers avoid the use of triclosan-laden products whenever possible and that manufacturers voluntarily curtail its use in advance of mandatory restrictions.

Triclosan and triclocarban were first introduced for use by surgeons and other operating room personnel to prevent bacterial infections. Today they are inexpensive and readily available, in part because the patents on them have expired. “We are not concerned about limited use in settings with clearly evident high-value such as in surgical settings. It’s the widespread use that is of concern,” Hammock says.

Even though they’re exposing themselves to these harsh products, many consumers are not reaping the intended benefits. Triclosan and other antibacterial chemicals take time to work, needing to be left on a surface for up to two minutes. Since most people are not that knowledgeable, patient or conscientious, they end up rinsing off the antibacterial cleansing agent before it has time to work. On the other hand, regular soap gets rid of bacteria by attaching it to the soap’s fatty acids, which become encapsulated in droplets of water and washed away.

Industry representatives, such as the Soap and Detergent Association, contend that their antibacterial products are safe and that people should be able to clean themselves and their homes as effectively as hospitals. Another piece of the puzzle not mentioned by the soap industry in its marketing of expensive antibacterial agents to consumers is that many of the most common diseases are viral in nature and therefore not prevented by antibacterial products!

So take the advice of some of the world’s best microbiologists and medical doctors – including the Centers for Disease Control and Prevention – and wash your hands, your baby and your home thoroughly with ordinary soap and warm water or, in the case of your home, with natural cleaning agents like vinegar and baking soda. That way, you will be effectively, safely and inexpensively warding off infection while not destroying your family’s natural immunity, exposing yourselves to future health problems or polluting our water supply.

Wendy Priesnitz is the editor of Natural Child Magazine and others She is also the mother of two adult daughters and the author of thirteen books.