More on Triclosan

I’ve written here before about triclosan, an antimicrobial agent used in soaps, toothpaste, deodorant, mouthwash, other cosmetic products, and household cleaning supplies.  There have been some suggestions that widespread use of triclosan  may contribute to the development of antibiotic resistant bacteria; the chemical is also suspected, based initially on data from animal experiments, of being an endocrine disruptor.  The FDA is currently reviewing the safety of triclosan; the results of the review were originally scheduled to be released in April of this  year, but have been delayed.

The New York Times recently published an article on the ongoing triclosan controversy.  As I mentioned earlier, it is present in a very wide range of products, and there is also evidence that exposure to it is growing.

It is so prevalent that a survey by the Centers for Disease Control and Prevention found the chemical present in the urine of 75 percent of Americans over the age of 5.

Triclosan does have one antibacterial application for which the FDA has given explicit approval: there is evidence that its use in toothpaste helps to prevent gingivitis.  The safety concerns are mainly focused on its broader uses, especially in anti-bacterial soaps.  These are advertised as being more effective, hygienically, than ordinary soap, but there is no real evidence that this is true.  The FDA has a fact sheet, Triclosan: What Consumers Should Know, which says:

At this time, FDA does not have evidence that triclosan added to antibacterial soaps and body washes provides extra health benefits over soap and water.

A study conducted at the University of Michigan School of Public Health also concluded that plain soap was just as effective.  Many people are, nonetheless, persuaded by the advertising; the “anti-bacterial” soaps account for about half of the $750 million market for liquid soaps in the US.  (Some of the success of the advertising may be rooted in history.  In the early 20th century, there was a theory that washing hands was effective because the combination of water and the emulsifying properties of soap somehow disrupted the cell wall of bacteria.   We now know that most of the hygienic benefit comes from the physical removal of bacteria from the skin.)

The industry claims that there is no “real” evidence that triclosan might be harmful.  Calling for more, or a different kind, of research, has become a standard tactic taken from the tobacco industry’s playbook.

Brian Sansoni, spokesman for the American Cleaning Institute, said the evidence against triclosan was hardly convincing and that the chemical had been used safely in consumer products and in hospitals for decades.  “You would think after heavy use in hospital settings over several decades it would have shown up by now,” Mr. Sansoni said.

This is one of those plausible-sounding arguments that is really fairly specious.  Triclosan has only been in general use since the early 1970s; unless the effect were enormous, which no one is claiming, it would not “show up” unless someone looked for it. The FDA, for its part, is now saying that it is unlikely to have results from its review before next year.

My own conclusion is that, since I have seen no evidence that these anti-bacterial products provide any benefit, and since there may be some risk, they are not worth using, especially since they cost more than plain old soap.  I suspect part of their appeal is due to a variety of magical thinking.  It took me a while, quite a few years ago, to develop the habit of carefully washing my hands whenever I came home, and before preparing food, for example.  Rather than doing the work required to develop the habit, many people may find it easier to buy something that has the miracle ingredient that will fix everything.

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