Primary Care Corner with Geoffrey Modest MD: Antibacterial soaps may be hazardous to your health

There was an important editorial in the NY Times on governmental ineffectiveness in regulating industrial chemicals. The potential effects are profound and not significantly different from data I saw in the early 1970s.

–There are 84,000 chemical compounds in commercial use, with 500-1000 new ones introduced annually

–In an analysis of 143,000 peer-reviewed research papers, it takes an average of 14 years from the time safety issues are raised and action taken (while the chemicals remain in the market)

–The case in point in the article is the use of triclosan and triclocarban, ubiquitous environmental contaminants used in anti-bacterial soaps, cosmetics and other consumer products for the past 40 years.

soap

–These chemicals are from the same class as “persistent, bioaccumulative and toxic compounds known as organohalogens”, such as DDT, and are known to interfere with the human endocrine system and may be related to the development of bacterial resistance

–Dozens of organohalogens have been detected in mothers and babies, with altered hormone levels, lower birth weights, reduced head circumferences

–And, to boot, the addition of these antibacterials is no better than using regular soap: the CDC has published: “Researchers found that incidence of disease did not differ significantly between households given plain soap versus antibacterial soap” (CDC, 2005).

So, my recollection from the 1970s (when regulation was probably more robust than today) was that the government was able to do a thorough review of about 5 new industrial chemicals/year through NIOSH (the research arm of OSHA), which was dwarfed by the large number of new chemicals introduced annually into industry and the environment. My concern is obvious (and iterated repeatedly in prior blogs): We are seeing lots of potential long-term consequences of carcinogens, for example, yet so much of our approach is early detection. Mammography has marginal benefit in preventing breast cancer deaths, though 12% of all US women develop invasive breast cancer. Colonoscopy is probably more effective than mammography, yet the number of untested food additives is shocking….

Geoff

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