Kiichiro Sato • Associated Press,
Counterpoint: Antimicrobial hucksters can't be trusted
- Article by: Michael T. Osterholm
- March 20, 2014 - 6:05 PM
In all my years in public health, I have to rank the counterpoint from the American Cleaning Institute (“Misinformation, confusion fuel fears about triclosan,” March 19), regarding legislative efforts to remove triclosan from soap in Minnesota, at the top of my smoke-and-mirrors list.
Triclosan, once designated a pesticide, is a chemical additive to some soap and cleaning products, promoted by manufacturers as a way to reduce infectious diseases by killing microbes that cause them. The problem is that no study has ever demonstrated disease reduction when triclosan-containing products are actually used in homes, restaurants, cruise ships or hospitals.
My public-health colleagues and I, who are being accused of distorting the facts about triclosan, have no financial conflicts of interest in telling the truth. But the ACI, an industry trade group, does have a conflict. Also, as an infectious-disease epidemiologist who has been warning about the loss of a growing number of our lifesaving antibiotics because of drug resistance, I welcome any product that can help us reduce the risk of infectious-disease transmission. We need all the help we can get.
But we also need to consider both the risk and benefit to society. We could lather ourselves up every day in a toxic bath of chemicals that would kill all the skin-related disease-causing microbes, but that same lather would also eventually kill us. This one is an easy call. In the case with triclosan, it’s clear that evidence of risk of its use to society is mounting — and this risk was not even mentioned in the ACI counterpoint.
Multiple groups of scientists have been studying the potential toxicological impact of products containing triclosan being absorbed through our skin or washed down the drain into our sewers — and ultimately into our lakes and streams. Recent groundbreaking research from the University of Minnesota led by Prof. Bill Arnold has shown that, as triclosan moves through the wastewater treatment process and into surface waters, it is exposed to sunlight and chlorine, which cause it to transform into a family of potentially dangerous dioxins.
The levels of these specific dioxins in the sediment of our waters parallel their presence in commercial soap products. Of note, in Minnesota lakes without a waste treatment plant, these dioxins were absent. We’re still waiting for the verdict regarding the impact that these dioxins will have on our kids’ and grandkids’ health. The ACI never talks about this issue.
Since I’m not a toxicologist, I too count on experts like Bill Arnold on this emerging dioxin issue. But I do know something about the prevention of infectious diseases, and can tell you that triclosan-containing soaps give no more protection against infectious disease than just using regular soap. Four well-conducted studies in Asia and the United States found no difference in any disease occurrence between those who used triclosan-containing soaps and those who used plain old soap. The ACI doesn’t mention those.
And don’t be confused when the ACI tries to lump triclosan-containing soaps with other antimicrobial soaps that have been found more effective than plain old hand-washing in places like hospitals. When you opt to use a triclosan-containing product, it means you are not using one found to be significantly more effective. That’s like making the choice to put your kid behind the wheel of a 1960s Corvair vs. a safety-loaded car from 2014.
In addition, alcohol-based hand rubs found in most every drug, grocery and department store have been shown to effectively reduce infectious diseases caused by contaminated hands. These conclusions are supported by every major public health or infectious-disease group that addresses this issue, including the World Health Organization and the U.S. Centers for Disease Control and Prevention. Does that sound like a few local public health professionals spreading misinformation?
Finally, if these triclosan-containing products are effective and safe, will the ACI please explain why a growing number of companies are removing triclosan from their products? For example, Procter & Gamble, one of the most respected science-based companies in the world and an ACI member, has not only removed triclosan from all its products but touts them as being “triclosan free.” The ACI never talks about that.
Minnesota should take a lead in protecting our kids and grandkids and removing triclosan-containing products from the market.
Michael T. Osterholm is a professor in the School of Public Health and Medical School at the University of Minnesota.
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