Townsend Letter for Doctors and Patients Triclosan--a controversial…

Townsend Letter for Doctors and Patients

Triclosan--a controversial antibacterial

May 2006 by Rose Marie Williams

Triclosan is a chlorinated aromatic compound with antibacterial properties, as well as antifungal and
antiviral properties. It goes by the trade name, Microban[R], when used in plastics and clothing, and as
Biofresh[R] when used in acrylic fibers. The companies that manufacture and use triclosan claim it is
safe. However, it is registered as a pesticide with the United States Environmental Protection Agency
(EPA). Pesticides are chemicals designed to kill some life form. The EPA considers triclosan a high
risk for human health and the environment. When introduced in 1972, triclosan was confined to health
care settings in a surgical scrub. (1-4)

Triclosan may not be a familiar term to most consumers, though it is now ubiquitous in most American
households, masquerading under the unassuming term, "antimicrobial." In the United States,
"antimicrobial" has become synonymous with cleanliness and good health. The chemical industry has
fostered a fear of germs among American consumers and developed a lucrative market selling products
designed to protect us from germs. The EPA estimates sales of antimicrobial products now constitute a
billion dollar per year industry. (5)

As an antibacterial, triclosan is added to numerous consumer goods. It is commonly found in
detergents, dishwashing liquids, kitchen sponges, soaps, deodorants, cosmetics, lotions, antimicrobial
creams, acne medications, skin cleansers, toothpaste, mouthwashes, various plastics including
children's toys, paint, wallpaper, flooring, textiles, curtains, sandal foot beds, public railings, keyboards,
countertops, faucets, even dog bowls. It is being added to an increased number of consumer products
including kitchen utensils, cutting boards, socks, and trash bags. (1,3,5-8)

Linens are now being targeted for the antimicrobial treatment. "Consumers are really demanding it,"
claims Billy Henry, president of Microban International of Charlotte, North Carolina. While the EPA
prevents manufacturers from making health-related claims about killing germs, it does allow the word,
microbes, to be used in advertising. Consumers would certainly enjoy the benefit of preventing mildew
odor on damp towels, but might not be so easily seduced if fully cognizant of the health risks associated
with exposure to the controversial chemical. (5)

Health Risks

Triclosan is a chlorophenol, a class of chemicals suspected of causing cancer in humans. A variety of
skin irritations can result from phenol exposure, but since phenols are capable of deactivating sensory
nerve endings, the normal warning signs from pain may not be present. There have been reports of
individuals developing contact dermatitis (skin irritation). There has been some evidence also that
triclosan can cause photoallergic contact dermatitis (PACD), which occurs when skin exposed to
triclosan has also been exposed to sunlight. A rash may result on the face, neck, back of hands, or sun-
exposed areas of the arms. Will health providers be advised to ask patients with these symptoms if they
are using antimicrobial treated linens? Probably not. (2,3)

Triclosan can interfere with the body's thyroid hormone metabolism, lowering body temperature and
causing a "nonspecific depressant effect on the central nervous system" of mice. (2)

Symptoms of internal exposure, even in small amounts, may include cold sweats, circulatory collapse,
convulsions, coma, and death. Long-term and repeated exposure to many pesticide products can
damage the liver, kidneys, heart, and lungs and cause paralysis, sterility, brain hemorrhages, hormonal
disruption, and immune suppression. (3,4)

The chemical structure of triclosan resembles certain estrogens. One study on a species of Japanese fish
did not indicate any estrogenic effects, but found androgenic effects resulting in changes in fin length
and sex ratios. (2)
Triclosan is lipophilic, attaching to fatty tissue. It can accumulate in the liver, lungs, and kidneys,
reaching toxic levels. As a chlorophenol, it is categorized as a persistent organic pollutant, along with
dioxins and PCBs. These chemicals persist in the environment and bioaccumulate up the food chain.
Being at the top of the food chain, humans harbor the most concentrated amounts of these toxic
chemicals. (2-4)

Triclosan's use is already so widespread it has made its way into the human body. Studies show
triclosan residues in the umbilical cord blood of infants and in the breast milk of nursing mothers. (9)
Triclosan has not been thoroughly tested nor evaluated for potential risks to human health and the
environment though it is in a category of very toxic and carcinogenic chemicals. It is chemically similar
to Agent Orange. (3,4)

Not All Germs are Bad

Multiple exposures from daily encounters with a strong antibiotic agent such as triclosan is being
questioned by many health proponents. Antimicrobials kill off the good bacteria along with the bad,
while increasing health risks to host organisms, including plants, animals, and humans. We are finally
recognizing the important role of friendly bacteria. Such bacteria are needed for their beneficial effects
of aiding metabolism to protect against harmful pathogens. (3)

Wide use of antimicrobials and disinfectants can lead to genetic mutations, creating drug-resistant
bacteria and mutant viruses for which the human immune system remains defenseless. Studies indicate
that people exposed to a variety of microbes develop stronger immune systems, while individuals who
grow up in more sterile environments are more susceptible to respiratory allergies, asthma, and eczema.
(2,3)

A half-century after penicillin was introduced as the greatest wonder drug to kill infectious bacteria, we
are now witnessing the emergence of super bugs that are not only resistant to penicillin, but are also
resistant to the newer and stronger antibiotics, such as vancomycin. (6)

Antibiotics' ability to save lives is unquestioned. However, the pervasive use of these drugs is creating
heretofore unanticipated problems of mutant strains of drug resistant bacteria faster than modern
technology is able to contain them. Widespread exposure to antibiotics from multiple prescriptions
beginning in early childhood and from a steady diet in the food supply has done little to fortify our
immune systems. Antibiotics are routinely added to animal feed to accelerate growth and to combat
rampant disease from overcrowded factory farm conditions.

Because triclosan was originally thought to kill all bacteria, the possibility of it contributing to bacteria
resistance was not considered. Triclosan soon became the perfect germ-killer, added to soaps and
toothpaste for adults and children to protect against infection. As a germ-fearing culture, we embraced
this concept wholeheartedly. History may be repeating itself as we begin to learn about new risks
associated with triclosan.

Microbiologist, Laura McMurray, PhD, and colleagues at Tufts University School of Medicine in
Boston, now believe triclosan may not be so great after all. In lab experiments, they were able to breed
mutant strains of bacteria, which could develop resistance to triclosan. Writing in the journal Nature,
McMurray indicated the possible emergence of triclosan-resistant bacteria, but stressed there is no
current evidence that this has already happened. No research has yet "looked for them out in the real
world," but she stressed, "there is the potential." McMurray discouraged using triclosan germ-killing
products in the home and encouraged fighting germs with ordinary soap and water instead. (6)

Safer alternatives to using antimicrobial soaps include the following:

* frequent and thorough hand washing with regular soap and water, and thorough rinsing,

* washing children's hands and toys frequently,
* using clean towels for drying, and

* frequently washing surfaces that come in contact with food.

Mother Nature has provided some very good antimicrobial products that pose less threat to humans and
the environment. Among them are Australian tea tree oil, pine oil, and grapefruit seed extract. (2)

Dioxin Contamination

The molecular structure of triclosan is similar to dioxins and PCBs, some of the most toxic substances
on earth. Its production creates small amounts of residual polychlorinated dioxins and polychlorinated
furans, which are contained in small amounts in the products to which triclosan has been added. (1,2)
Besides being highly carcinogenic, dioxins can weaken the immune system, decrease fertility, alter sex
hormones, and cause birth defects and miscarriage. Dioxins are formed when triclosan is manufactured
and probably when it is incinerated. (2)

Additionally, small amounts of dioxins and furans are also produced when triclosan reacts with chlorine
in tap water. Dioxins are extremely toxic and potent endocrine disruptors that bioaccumulate to
dangerous levels and persist in the environment for long periods of time. (1) According to EPA
spokesperson, Enesta Jones, the agency is investigating the possible impact of dioxin-like byproducts as
part of its review process scheduled for completion in 2007. (5)

Triclosan + Water = A Bad Mix

Nearly all dish liquids now contain triclosan. Consumers who use antibacterial dish liquids believe they
are helping themselves and their families stay healthy. It seems this controversial germ-killing agent
reacts with chlorinated tap water to form hazardous chloroform as dishes are being washed, according
to research conducted at Virginia Polytech Institute and State University. Chloroform is classified as a
"probable" carcinogen. (8)

Erick D. Olsen, senior attorney for the Natural Resources Defense Council, believes "there is a very
real likelihood that washing dishes with triclosan-containing liquid could cause additional and troubling
significant exposure through inhalation and potentially through dermal absorption." Consumers with
chlorinated tap water who use triclosan-containing dishwashing products are advised to wear rubber
gloves to reduce skin contact, but no one has yet suggested wearing facemasks to reduce inhalation
exposure, nor have suggestions been made on how to avoid mucosal absorption from toothpaste use. As
in all things, caveat emptor, let the buyer beware. If product labels are unclear about contents,
consumers may wish to contact manufacturers to clarify chemical ingredients, or they might simply
choose alternative brands. Consumers without access to a health food store, or with insufficient choices
in their supermarket, can obtain safer household and personal care products from N.E.E.D.S. (800-634-
1380, www.NEEDS.com).

Environmental Risks

Over 95% of triclosan in consumer products is washed down the drain. Wastewater treatment plants do
not remove triclosan from the water. The chemical is highly stable for long periods of time,
contaminating our waterways. Triclosan has become one of the most frequently detected compounds in
US streams, and in lakes and rivers in Switzerland. (2)

Triclosan effluents have a negative impact on stream ecosystems, with especially high risks occurring
downstream from water treatment facilities. Triclosan's lipophilic nature and resistance to degradation
make it readily available for absorbtion by and bioaccumulation in aquatic organisms. Methyl triclosan,
a breakdown product, is actually more lipophilic than the parent compound and, therefore, more
bioaccumulative. (2)
It is likely that triclosan in water exposed to sunlight can also produce dioxins. Consequently, another
concern is the potential for dioxin creation when triclosan-tainted chlorinated water is exposed to
sunlight at water treatment plants. (2)

US Regulation is Lax

The US Environmental Protection Agency regulates all pesticidal use of triclosan, including its use as a
preservative, fungicide, or biocide, as is the case with Microban[R] used in plastics. When used in
soaps, deodorants, creams, and acne medications, triclosan comes under the jurisdiction of the US Food
and Drug Administration. (2)

Hasbro Inc. manufactures Playskool toys made with Microban plastic containing triclosan. In 1997, the
company was stopped from making false claims about protecting children from microbial infection, but
was allowed to continue using the antimicrobial chemical. In 2000, Denmark issued a warning against
the routine use of antibacterial household and personal care products, emphasizing they "are extremely
persistent and highly toxic in the marine environment." Finland also urged consumers to avoid certain
antibacterial chemicals. Germany's environmental minister referred to household antimicrobials as,
"superfluous and risky." Subsequently, soap and detergent manufacturers in Europe agreed to a ban on
any increase in use above 1998 levels. In the United Kingdom, four major grocery chains have banned
triclosan from their products. (2,7)

Cecil Fox PhD, retired National Institutes of Health (NIH) senior microbiologist and immunologist,
expressed frustration saying, "I am troubled that governmental review of triclosan has failed to
scrutinize the development of resistant microorganisms (and the byproduct, antibiotic resistant
microbial populations) and transport and accumulation of triclosan residues through skin and mucosal
absorption. FDA's failure is a national scandal." (9)

In 2005, a federal advisory panel to the FDA voted 11 to one to declare that antibacterial soaps and
washes offer no greater protection than regular soap and water. The panel of independent experts
acknowledged the chemical germ-killers could actually contribute to the growth of antibiotic-resistant
bacteria. Dr. Alastair Wood, chairman of the Nonprescription Drugs Advisory Committee, said, "There
is no evidence they are a good value." (10)

A coalition of health and environmental groups led by Beyond Pesticides petitioned the FDA on
October 25, 2005 to pull the controversial chemical from the market. Jay Feldman, executive director
of Beyond Pesticides, expressed the group's concern by stating, "The failure to regulate triclosan as the
law requires puts millions of people and the environment at unnecessary risk to toxic effects and
elevated risk to other bacterial diseases." (10)

Dr. Stuart Levy, president of the Alliance for Prudent Use of Antibiotics, advocates restricting
antibacterial products from consumer goods and leaving them where they are most needed, in hospitals
and in the homes of very sick people. It will take years before our regulatory agencies move to ban
triclosan, and even more years will pass during which those same agencies will allow manufacturers to
sell off existing products. As consumers, we don't have to wait that long. We can choose to ban these
products from our homes with our very next purchases. Dr. Levy reminds us that, "Bacteria are not
going to be destroyed. They've seen dinosaurs come and go. They will be happy to see us come and go.
Any attempt to sterilize our home is fraught with failure." (10)

Rose Marie Williams

156 Sparkling Ridge Road

New Paltz, New York 12561 USA

845-255-0836 / Fax 845-255-5101
References

1. Triclosan. Available at: http://en.wikipedia.org/wiki/Triclosan. Accessed February 18, 2006.

2. Glazer, A. The ubiquitous triclosan, a common antibacterial agent exposed. Pesticides and You. Vol.
24, No. 3, 2004. Available at: www.beyondpesticides.org/pesticides/factsheets.

3. McGehee, A, PhD. Triclosan. Available at: http://www.lindachae.com/Triclosan_article.htm.
Accessed February 18, 2006.

4. Lark, S, MD. Triclosan. The Lark Letter (877-437-5275). June 2004; 11(6).

5. Baldwin, D. Mold? Mildew? Odors? New towels fight back. The New York Times. August 11, 2005.

6. Fox, M. Health & Science Corresp., Reuters. Common disinfectant could breed superbugs. Available
at: http://www.lindachae.com/common_disinfectant.htm. Accessed February 18, 2006.

7. Kepner, J. Triclosan hazards continued. Pesticides and You. Winter 2004/2005; 24(4).

8. Antibacterial dish liquids + chlorinated water = dangers in your dishwasher. FL Breast Cancer
Resource Network (800-696-8349). Summer 2005.

9. Groups ask FDA to ban antibacterial products containing triclosan. Technical Report. November
2005; 20(11). Beyond Pesticides. Available at: www.beyondpesticides.org.

10. Soap claims don't wash, panel says. Poughkeepsie Journal (NY). October 21, 2005.

by Rose Marie Williams, MA

jwill52739@aol.com

[ILLUSTRATION OMITTED]

COPYRIGHT 2006 The Townsend Letter Group
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