In the Media...
Articles about toxic ingredients in personal care products and related issues
Chemical Good Looks
Safe In The Shower?
Are Foam and Bubbles Worth Bad Health?
Do You Use These Products?
Common Disinfectant Could Breed Superbugs
Wash Your Hands!
ABC's 20/20 Report
Lethal Strain of Germ May Cause Threat to Public Health
CHEMICAL GOOD LOOKS
BY Emily Yoffe, U.S. NEWS & WORLD REPORT, November 10, 1997, pp. 86, 91
Each day American women reach for shampoo and conditioner, deodorant, moisturizer, and dusting powder. We apply blusher, eye shadow, mascara, and lipstick, then maybe dab on a nail polish and perfume. We look good, we smell good, and we have just exposed ourselves to 200 different chemicals. As American consumers we have every confidence that someone in a lab coat in a big government building has checked out these substances. Right? Not exactly. "You know more about the ingredients in your dogs collar than you know about the toxicity of whatever youre putting on your skin.", argues David Wallinga, a senior scientist with the Natural Resources Defense Council in Washington, D.C. It turns out that cosmeticsa group of products that includes makeup, skin creams, hair-care products and dyes, baby lotions, and deodorants, on which Americans spend about $22 billion a yearcomes to us almost un-examined by the Federal Government. And, as recent events on Capitol Hill indicate, the situation is not about to change.
To get a prescription or even an over-the-counter drug on the market, a manufacturer must first prove the drugs safety and effectiveness to the Food and Drug Administration. The burden of proof rests on industry. Thats not the case for cosmetics, although the FDA regulates them, as well. Except for a handful of banned chemicals, manufacturers can add almost any ingredients to those revitalizing eye creams, vitamin-stuffed conditioners, and kiss-resistant lipsticks, and if questions about the safety of products arise, the burden is on the government to prove the product is unsafe. With a budget of about $5.5 millionless than one per cent of the FDA totaland around 30 employees, the cosmetics division is rarely up to that challenge, say critics.
The law governing cosmetics says that they may not contain "harmful substances". But how the tests for harmful or unsafe substances will be conducted is left up to the companies themselves. The FDA doesnt accept standards for proper safety testingand doesnt require companies to do any testing at all. If the company does tests, the FDA has no authority to review the records. Companies test cosmetics for their tendency to cause allergic reactions and irritate skin (protests over using animals for these tests have led many companies to do them in test tubes and on human subjects). But as for possible long-term effects of exposure to cosmetic ingredients, says John Bailey, Director of FDAs Office of Cosmetics and Colors, "those kind of issues are not addressed very well".
State muscle. This summer, the cosmetics industry almost won an even laxer regulatory set-up from Congress. Republican Sen. Judd Gregg introduced an amendment to the FDA reform bill that would have prohibited states from requiring warning labels on products containing suspect chemicals, or otherwise filling the vacuum in the federal rules. Democratic Senator Edward Kennedy, with the support of the Clinton administration, managed to defeat the proposal. "The reason preserving the states ability to act is so important is that FDAs regulation has been so weak.". Kennedy says.
Ironically, the law that created the modern FDA in 1938 is itself partly the product of public concern over cosmetics-caused injuries. An eyelash-dyeing product called Lash Lure was damaging the eyesight of many women, and after one woman died and another was blinded, Lash Lure became the first product seized under the new FDA authority. Since then, the rules governing the manufacture and distribution of foods and drugs have been endlessly revised. But the cosmetics rules havent been changed much, despite a revolution in the way scientists think about the skin.
In the 1930s, skin was thought to be essentially an impermeable barrier, a more attractive version of armadillo plate. But since at least the 1960s, it has been widely known that the barrier can be breached, partly as a result of demonstrations that some pesticides could enter the body through the skin. In the 1980s, in particular, molecular biologists began piecing together a new understanding of the skin as a reactive, dynamic organ. This view led to the development of transdermal patches, which deliver drugs into the body through the skin.
Not all chemicals can pass through the skin, however. Many ingredients in cosmetic creams are designed to sit on the surface, helping to keep the skin moist by holding in water, says Jim Riviere, Director of the Cutaneous Pharmacology and Toxicology Center at North Carolina State University in Raleigh. Many ingredients in these products, such as fatty acids, are identical to chemicals that occur naturally in the human body. "Most ingredients Ive come across in cosmetics are fairly benign compounds.", Riviere says.
But there is a controversial class of chemicals in cosmetics that may be absorbed through the skin. These are the color additives, derived from petroleum, known as coal tars. Coal tar colors (they are also found in foods, like M&Ms) are the single group of ingredients in cosmetics required to be tested for safety.
In 1960, there were about 200 on the market. But because so many have been found to be carcinogenic, such as Red No. 2, which was banned in 1976, today the list of approved colors numbers about 45.
Hair dyes derived from coal tars are mostly exempt from federal rules. Women who use dark dye for many years might increase their risk of dying from cancer. The FDAs Bailey says these remaining dyes have been so widely tested that he has "very high confidence that theyre safe". Not everyone is so sure. Dr. Andrew Weil, the natural health maven, advises avoiding the color additives whenever possible. "[Many] are energetic molecules that can interact with DNA, potentially causing mutations that lead to cancer", he writes.
There is an extraordinary loophole in the FDA regulations regarding testing and approval of colors. In 1938, the industry managed to win an exemption so that hair dyes derived from coal tars dont have to meet the standard that products not be harmful under normal use. As the FDAs own publication on hair dye points out, "Compounds suspected of causing cancer are found in temporary, semi permanent, and permanent dyes."
Bad hair daze. Does that mean hair dyes cause cancer in people who use them? The epidemiological studies are mostly reassuring. In 1994, a large survey found that dye users had a slightly lower rate of fatal cancers than women who didnt color their hair. But there is one exception: Women who used dark hair dye for two decades or more had a four times greater risk of dying from two cancers of the immune system, non-Hodgkins Lymphoma and multiple myeloma.
The FDA itself is looking into Alpha Hydroxy Acids (AHA), which are added to skin creams to help smooth out fine wrinkles. "Weve demonstrated that the use of AHAs increases sensitivity to sunlight", says Bailey. He speculates that the chemicals may also make skin more susceptible to skin cancer and perversely to even more wrinkling from sun damage.
Of course the question arises, how much do we really want to know about the safety of our cosmetics? We face so many dangers in life, do we have to live in fear of our moisturizers, too? As an experiment, I cross-checked the ingredients in my Anti-Aging face cream with A Consumers Dictionary of Cosmetic Ingredients. Most seemed fairly harmless. Until I got to zinc sulfate, about which the dictionary noted that "injection under the skin of 2.5 milligrams per kilogram of body weight caused tumors in rabbits." Thats when I began to wonder if the Anti-Aging moniker was a macabre joke. Is the idea that if I use it, I wont live long enough to get my full complement of wrinkles? But Ive already paid good money for it, and Im still using it.
In 1978, the General Accounting Office, the investigative arm of Congress, did an analysis of how the laws should be changed to improve cosmetics safety. The office suggested reforms like establishing industry-wide standards for safety testing and reviewing data from countries that have banned particular ingredients to see whether similar actions should be taken here. Those are just the kinds of reforms industry critics are seeking todayand will be seeking for a long time to come.
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SAFE IN THE SHOWER? (The Unbelievable Story of Propylene Glycol)
Fasten your seat belts folks, you wont believe what you are about to read:
Bob Folsom, a Field Hydrographer in the High Sierra Nevada mountains, has to work with propylene glycol on his job. Even though the PG is used in a solution of about 80% water, 20% PG and 1% mineral oil, there are rigid rules about how it must be disposed of, because it is considered so hazardous.
The Environmental Protection Agency (EPA) issues "Material Safety Data Sheets" that must accompany all hazardous chemicals. The data sheet for propylene glycol warns of severe health consequences and reactions, because PG has systemic consequences such as brain, liver, and kidney abnormalities.
(1) If the solution makes contact with the skin, immediate action must be taken, and the incident should be reported to the supervisor.
(2) If the solution spills on the ground, it must be contained and the contaminated earth dug up and hauled to a toxic waste dump.
When Bob is finished using the solution, he is required to empty it into a 55-gallon drum labeled "Hazardous Waste." While doing so, he must wear rubber gloves, goggles, and protective clothing. When the barrel is full, it must be transported to a special collection site, and the driver of the truck is required to maintain a commercial drivers license with a "hazardous material endorsement." Improper paperwork or mishandling of this toxic solution can result in severe fines and even imprisonment. It costs between $500-$1,000 to get rid of each 55-gallon drum.
Yet when Bob gets off work and goes home, he is free to shower with soaps and shampoos and then use a stick deodorant containing much higher concentrations of propylene glycol than the toxic solution he just shipped to the dump. If it was so hazardous at work, why is it "safe" at home?
Used as a solvent, propylene glycol is probably THE most common ingredient found in personal-care items, such as make-up, hair products, lotions, after-shave, deodorants, mouthwashes, and toothpaste. (Check the labels of your favorite products!!) It is also the active component in antifreeze; and there is no difference between whats used in industry and what you apply to your skin! Industry uses it to break down protein and cellular structure (what the skin is made of); its so strong that it can take barnacles off the bottom of boats.
But because it is so inexpensive, it is widely used in very high concentrations in most personal care formulationseven ones from "natural food" stores.
You CAN choose healthful alternatives:
Dare To Care What Touches Your Skin And Hair
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ARE FOAM AND BUBBLES WORTH BAD HEALTH?
The Truth about Sodium Lauryl Sulfate
Do you enjoy a shampoo with a rich lather? A shaving cream that really foams? How about relaxing in a tub full of bubbles? These may seem like some of lifes simple, innocent pleasures
until you look at WHAT is causing all that foam and lather. Once you find out, you may decide its not so simple or pleasurable after all.
Check the labels of your shampoo, soap, facial cleanser, shaving cream, body wash, or shower gel: Do you see either Sodium Lauryl Sulfate (SLS) or Sodium Laureth Sulfate (SLES) listed? Or one of their cousins: Ammonium Lauryl Sulfate, Sodium Myreth Sulfate, etc.? Most manufacturers use these anionic detergents because they produce a lot of foam very inexpensively. But SLS is so strong that its also used to scrub garage floors. Worse, it has been proven to cause cancer in the long run. And the American College of Toxicology says SLS stays in the body up to five days. Other studies show it easily penetrates the skin and enters and maintains residual levels in the heart, liver, the lungs, and the brain. Yet SLS is found in most cleansing, foaming productseven in some toothpastes! (Note: SLS may be disguised in pseudo-natural cosmetics with the parenthetical explanation "comes from coconut." Let's save the coconut from defamation of character!)
One woman who examined labels found that all the shampoos she checked had SLSeven health food store brands. Many listed Sodium Laureth Sulfate as the first ingredient on the label, meaning its the single most prevalent ingredient. So this lady called one company to complain that their product contains a substance that will cause people to have cancer. Their response was, "Yeah, we knew about it, but theres nothing we can do about it because we need that substance to produce foam."
Try contacting some manufacturers yourself: The typical responses might be:
(1) Denial: "Its completely safe."
(2) Avoidance: "You'll have to talk to someone else" or "We can't talk
(3) Ignorance: "I've never heard about that."
Most people selling products with this and other harmful ingredients really just don't know. The FDA has a GRAS list (Generally Regarded As Safe), and almost everything is on there, so most people selling these products just focus on the marketing hype and what the product is supposed to do for skin (clean it, make it feel soft, etc.). Sadly, of the 7000 ingredients used on the skin, only 5-6 have been tested for LONG-TERM safety, and none have been tested TOGETHER. Currently, 125 are strongly suspected carcinogens, 20 cause adverse nervous system reactions, and 25 are connected to birth defects.
So why exactly is SLS so bad?
Here are what tests show about Sodium Lauryl Sulfate:
(1) SLS PENETRATES EYES AND TISSUES. Tests show that SLS can penetrate into the eyes as well as systemic tissues (brain, heart, liver, etc.) and shows long-term retention in those tissues. Especially when used in soaps and shampoos, there is an immediate concern relating to the penetration of SLS into the eyes and other tissues. This is especially important in infants, where considerable growth is occurring, because a much greater uptake occurs by tissues of younger eyes, and SLS changes the amounts of some proteins in cells from eye tissues. Tissues of young eyes may be more susceptible to alteration by SLS
(2) SLS FORMS NITRATES: When SLS is used in shampoos and cleansers containing nitrogen-based ingredients, it can form carcinogenic nitrates that can enter the blood stream in large numbers. They can cause eye irritations, skin rashes, hair loss, scalp scurf similar to dandruff, and allergic reactions.
(3) SLS PRODUCES NITROSAMINES (potent carcinogens that cause the body to absorb nitrates at higher levels than eating nitrate-contaminated food like hot dogs or lunch meat): Dr. David H. Fine, the chemist who uncovered NDELA contamination in cosmetics, estimates that a person would be applying 50 to 100 micrograms of nitrosamine to the skin each time he or she used a nitrosamine-contaminated cosmetic. By comparison, a person consuming sodium nitrate-preserved bacon is exposed to less than one microgram of nitrosamine. 
(4) SLS STRIPS MOISTURE AND OIL FROM THE SKIN. According to the Journal of Investigative Dermatology, SLS produced skin and hair damage, including cracking and severe inflammation of the derma-epidermal tissue. Skin layers may separate and inflame due to its protein-denaturing properties.
(5) SLS IRRITATES SCALP AND MAY PROMOTE HAIR LOSS
(6) SLS CAN DAMAGE DNA IN CELLSaccording to Japanese studies.
SLS and all its cousins are very harsh detergents that strip the skin's moisture barrier (which is linked to immunity and skin health) and causes serious health problems during testing on animals. It is linked to harming children's eyes, denaturing protein (thereby possibly contributing to hair loss or thinning), and combines with DEA, MEA and TEA (often found in the same shampoo) to form nitrosamines, a potent carcinogen. Since it is only included in products because of its potent foaming action, the question you must consider is:
Whats more important: the foam or your health?
You CAN choose healthful alternatives:
Dare To Care What Touches Your Skin and Hair!
References for above information:
 Green, Dr. Keith. Detergent Penetration into Young and Adult Eyes. Department of Ophthalmology Medical College of GA, Augusta GA
 Hampton, Aubrey. Dictionary of Cosmetic Ingredients. Organica Press Metarasso, or Hampton, Aubrey. Natural Organic Hair and Skin Care. Organica Press, Tampa FL
 Journal of Invest. Dermatology, 32-581, 1959 "Denaturation of Epidermal Keratin by Surface Active Agents"
Wright, Camille S. Shampoo Report. Images International, Inc. 1989
Vance, Judi. Beauty to Die For. Promotion Publishing, San Diego, CA 1998. Page 23.
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DO YOU USE THESE PRODUCTS
By David Steinman, Natural Health Magazine, September/October, 1997 pp. 54 - 56
"If so, you may want to rethink how much you use them. Studies point to their possible dangers."
"Ron Owens parents never imagined what would happen to their son after they sent him to summer camp in 1972. Ron was like every other teenager at this mountain camp in California: He swam, played sports, slept in a cabin with other campers. Unlike the other boys, though, Ron slept a few feet from a no-pest strip. Night after night, he was exposed to dichlorvos (DDVP), a toxic pesticide. Not long after camp ended, the boy died of a fatal blood diseaseaplastic anemiathat the familys attorneys argued was caused by the boys exposure to chemicals in the no-pest strip. (The manufacturer admitted no wrongdoing, but did give the Owens family a small settlement.) Today, twenty five years after Rons death, you can still buy no-pest strips containing the chemicals suspected of having caused the boys death.
As a consumer advocate who has investigated the safety of thousands of products over the past fifteen years, Ive heard too many accounts of people, often children, felled by dangerous products. Every day we use products that we think are safewe assume the product has been tested and any dangerous ingredients labeled. The truth is, products are not always safe and manufacturers dont have to tell us so. (The warning statement on the no-pest strip makes no mention of these health risks: bone marrow damage and aplastic anemia, as reported in 1980 in Clinical Research; immune system suppression, as determined by the World Health Organization in 1986; and cancer and birth defects, as reported by Shirley A. Briggs and the Rachel Carson Council in Basic Guide to Pesticides [Hemisphere, 1992].)
Cosmetic products are notorious. Hair dyes with suspected cancer-causing ingredients are not required to carry warning labels. Products often list fragrances, which can contain up to 600 different compounds, many carcinogenic or otherwise toxic, but the label only says they contain a "fragrance". And while cosmetic makers are required to list ingredients, they are not required to conduct pre-market safety tests.
"Even if the [Food and Drug Administration] suspects that serious adverse health effects are caused by a cosmetic product, they cant require the manufacturer to provide test data to prove the product safety", says Oregon Senator Ron Wyden.
It should be said that products with even very toxic ingredients are not likely to kill youor even cause illnesswith one-time or short-term use. But when so many different products on the market contain toxic ingredients, come claim that they may endanger the health of immunologically vulnerable people who use them regularly. If you or your children frequently use such products, the risks climb. Guarding yourself is simple: the less you breathe, eat, or absorb a toxic chemical, the less chance there is that it can harm your health. I recommend that people act on the side of safety and simply not useor radically reduce their use ofproducts whose ingredients are proven to be dangerous, or even suspected of being dangerous based on the available research.
In 1995, with the help of consumer advocate Ralph Nader and Samuel Epstein, M.D., the coauthor of my book The Safe Shoppers Bible (Macmillan, 1995), I compiled a list of those products that I personally choose to avoid or use sparingly.
Personal Hygiene Products
1. CREST toothpaste lists saccharin and FD&C Blue No. 1 on its label. A clear-cut bladder carcinogen in animal studies (with some evidence from human studies), saccharin has been rated carcinogenic by the International Agency for Research on Cancer (IARC) for a decade. (Cancer warnings for saccharin are required on artificial sweeteners.) Children and adults absorb the saccharin by swallowing or through the tissue in their mouths. FD&C Blue No. 1 has also caused tumors in experimental animals. Crest should not be singled out. Many other brands, including Colgate, also contain these two toxic substances.
2. The main ingredient in JOHNSONS BABY POWDER is talc. In 1982, Daniel Cramer, M.D., an obstetrician and gynecologist, found that women who used talc for feminine hygiene had a three-fold increase in their risk of ovarian cancer. Additional reports in Lancet (1979), Cancer (1982), and Obstetrics & Gynecology (1992) confirm the risk associated with frequent and prolonged use of talcum powder in the genital area. In 1994 the Cancer Prevention Coalition in Chicago petitioned the Food and Drug Administration (FDA) to require a label warning on this product. The FDA has not acted on this matter.
3. ORTHO WEED-B-GON LAWN WEED KILLER contains 2,4-D Agricultural studies by National Cancer Institute (NCI) researchers strongly link exposure to this chemical with high cancer rates. Another NCI study found that dogs whose owners use 2,4-D weed killers have higher rates of cancer.
4. LYSOL DISINFECTANT SPRAY may contain ortho-phenylphenol. This germ killer is carcinogenic, according to both the Environmental Protection Agency (EPA) and IARC. Lysons manufacturer stopped using this ingredient in 1995, but I still see cans of Lysol containing ortho-phenylphenol on store shelves. Be sure to read the label when buying this product. The older formula of Lysol, which does contain this chemical, is particularly troubling because as a spray it can be inhaled deeply into the lungs.
5. BONNE BELL GRAPE LIP SMACKER FLAVORED LIP GLOSS, which is marketed to teenagers, contains saccharin and FD&C Blue No. 1 (both of which are discussed on page 56). Although this product is not directly ingested, these ingredients can be absorbed through the skin on the lips, or through the mucous membrane in the mouth. This lip gloss also contains fragrances and propylene glycol, two of the leading causes of contact dermatitis, an allergic skin reaction.
6. COVER GIRL REPLENISHING NATURAL FINISH MAKE-UP contains several potentially toxic ingredients, but no warnings. The first is butylated hydroxyanisole (BHA), which is carcinogenic, according to IARC. The second, triethanolamine, which keeps the makeup moist, can combine with nitrite contaminants to form carcinogenic nitrosamines. An FDA report done in 1988 found 30 percent of cosmetic products contained these carcinogens. A third ingredient, lanolin, is perfectly safe by itself; however, it may be contaminated with pesticides. According to a 1993 report from the National Research Council, some 16 pesticides were identified in lanolin; diazinon [sic], a neurotoxin, was found in 21 of 25 samples.
7. CLAIROL NICE N EASY hair dye contains par-phenylenediamine, a dye that was recently shown to induce breast cancer in animals. It also contains quaternium 15, a preservative that often causes allergic reactions. One-fifth of cases of non-Hodgkins lymphoma among women are linked to hair-dye use. Indeed, more than a dozen studies link hair dyes with cancer, yet the FDA requires no warning of this hazard on product labels. Clairol is not the only hair dye to pose these risks. Many other brands, including LOreal, and Revlon, contain similar chemicals.
8. GRECIAN FORMULA for men contains lead acetate. Lead damages the nervous, circulatory, and reproductive systems. And this particular form of lead can penetrate skin. Recently, researchers at Xavier University found that large amounts of lead are left on the fingers of adults and children who rub their hands through the hair of men using lead-based anti-gray products. The FDA has suggested it will "study" the situation, according to a February 5, 1997 Associated Press report. While they do that, Karen Filkins, M.D., director of reproductive genetics at West Penn Hospital in Pittsburgh, says, "Avoid products that could contain lead, especially if you are pregnant. And prevent exposure to young children".
9. ZODIAC CAT & DOG FLEA COLLAR contains propoxur. This chemical is a carcinogen, according to a 1989 report done by researchers at Cornell University, University of California, and Michigan and Oregon State Universities. It may also cause learning disabilities, according to Basic Guide to Pesticides.
David Steinman, a former representative of the public interest at the National Academy of Sciences, is co-author of the forthcoming Breast Cancer Prevention Program (Macmillan, 1997). He is author of Diet for a Poisoned Planet (Ballantine, 1992), and co-author of The Safe Shoppers Bible (Macmillan, 1995) and Living Healthy in a Toxic World (Perigee, 1996)."
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by M. Angela McGehee, Ph.D., Biology and Marine Sciences
Triclosan, a chemical used for its antibacterial properties, is an ingredient in many detergents, dish-washing liquids, soaps, deodorants, cosmetics, lotions, antimicrobial creams, at least one brand of toothpaste, and an additive in various plastics and textiles. However, the safety of triclosan has been questioned in regard to environmental and human health. While the companies that manufacture products containing this chemical claim that it is safe, the United States Environmental Protection Agency (EPA) has registered it as a pesticide. The chemical formulation and molecular structure of this compound are similar to some of the most toxic chemicals on earth, relating it to dioxins and PCBs. The EPA gives triclosan high scores both as a human health risk and as an environmental risk.
Triclosan is a chlorophenol, a class of chemicals which is suspected of causing cancer in humans. Externally, phenol can cause a variety of skin irritations, but since it can temporarily deactivate sensory nerve endings, contact with it may cause little or no pain. Taken internally, even in small amounts, phenol can lead to cold sweats, circulatory collapse, convulsions, coma and death. Additionally, chlorinated hydrocarbon pesticides can be stored in body fat, sometimes accumulating to toxic levels. Long term exposure to repeated use of many pesticide products can damage the liver, kidneys, heart and lungs, suppress the immune system, and cause hormonal disruption, paralysis, sterility and brain hemorrhages.
Dioxins, PCBs, chlorophenols and many pesticides are categorized as persistent organic pollutants. In other words, they persist in the environment and accumulate to higher and higher concentrations with each step up the food chain. Virtually, every creature on earth has a measured amount of these pollutants in its body fat. Once absorbed into the fat cells, it is nearly impossible to eliminate these compounds. Triclosan is among this class of chemicals, and humans are among the animals at the top of the food chain. The health risks are considerable.
Employing a strong antibiotic agent such as triclosan for everyday use is of questionable value. Many antimicrobial treatments are toxic and take a shotgun approach to killing all microscopic organisms to which they are applied. However, this approach includes the risk of toxicity to host organisms, that is, the plants or animals (including humans) exposed to treatment for microbial infections. Toxic exposure to living creatures can also occur when food items and objects such as utensils or hard surfaces are treated with disinfectants for microbial contamination. Additionally, the shotgun approach destroys the beneficial bacteria which occur naturally in the environment and in our bodies. These so-called friendly bacteria cause no harm and often produce beneficial effects such as aiding metabolism and inhibiting the invasion of harmful pathogens. Antimicrobials and disinfectants can also cause genetic mutations resulting in drug-resistant bacterial and mutant viruses, producing new strains of harmful microbes for which the human immune system has no defense.
Triclosan has not been completely tested and analyzed for all health and environmental risks, but since it occurs in the category of the chemicals which are known to have the detrimental effects described here, do you want it added to products you use every day?
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COMMON DISINFECTANT COULD BREED SUPERBUGS
By Maggie Fox, Health and Science Correspondent, Reuters
WASHINGTON (Reuters) -
It sounds like a good idea -- put a germ-killing disinfectant in toothpaste and soap to keep kids and adults safe from infection -- right? Wrong, Boston-based microbiologist Laura McMurry and colleagues at the Tufts University School of Medicine say.
McMurry said triclosan, a disinfectant widely used in products as diverse as kitchen sponges, soap, fabrics and plastics, is capable of forcing the emergence of ``superbugs'' that it cannot kill. And experiments have shown that it may not be the all-out germ-killer scientists once thought it was. Changing just one gene in the E. coli bacterium allowed it to resist triclosan's effects, McMurry said in a telephone interview. ``We were able to get resistance by simply changing an amino acid in the target.''
Triclosan is used so widely because it is what is known as a nonspecific biocide -- it kills all microbes. Like bleach and alcohol it was believed to interrupt so many cell processes there was no way any organism could develop resistance to it. ``It was just kind of thought it dissolved the membranes. If it does, then you are probably not going to get resistance. You would have to have a totally different membrane that would be resistant,'' McMurry said.
Most drugs used as antibiotics work on just a single process. For instance, penicillin stops many bacteria from building a strong cell wall by acting against one component, known as a mucopeptide. But this specific action means many bacteria, including the very common staphylococcus, can resist penicillin. That is why new generations of antibiotics have had to be developed.
MORE USE MEANS MORE CHANCE OF RESISTANCE The more a drug is used, the more chances bacteria have to evolve resistance. Unless all the bacteria in an infection are killed, the ones that survive exposure to a drug will be those that resist it in some way, while the weaker ones die first. Thus, a species of bacteria can evolve resistance, especially if this happens over and over again. Antibiotic-resistant bacteria are becoming a bigger and bigger problem. They range from penicillin-resistant gonorrhea to super-strains of staphylococcus that cannot be killed by vancomycin, the strongest antibiotic available.
For this reason, doctors are now being warned to cut back on frequent prescriptions of antibiotics except for people who really need them, and patients are being reminded to take their full course of drugs to make sure no resistant bacteria survive to breed more resistant bacteria. But no one had thought this evolutionary process was a problem with triclosan because it was thought to kill all bacteria. Then McMurry and her colleagues put this to the test, breeding bacteria that had various genetic mutations to see if they would resist triclosan. Writing in the most recent edition of the journal Nature, they said they had found one. It was a gene called fab1, which is involved in the creation of fatty acids in cells. McMurry said this could mean that bacteria could evolve resistance to triclosan, but she stressed that there is no evidence so far that this has happened in nature.
DAILY USE OF TRICLOSAN MAY BE UNWISE We did find those triclosan-resistant mutants in the lab; we have not looked for them out in the real world. But the point is not that we've proved that it's really happened out there in the real world but that there is the potential.''
Considering this, she said, using triclosan daily in the home -- in products ranging from children's soaps to toothpaste to ``germ-free'' cutting boards -- may be unwise. "As I understand it, washing hands with soap, the goal of it is to wash off the bacteria. I think that unless it's in a setting where you are in a hospital or you are in a home with a really sick person, I think it is overkill,'' she said. "That's my suspicion. It's putting a chemical in there that I'm not sure is necessary.''
McMurry has not tested her mutant bacteria to see if they would resist triclosan in a real-life setting. "The amounts of triclosan employed in many of the hand soaps are quite high,'' she said. "I can't say with those high amounts that even my mutant would survive.'' But there is more than one way to fight off a drug. Sometimes bacteria evolve their own resistance, but they also have a habit of meeting and exchanging genes with one another. This means resistance to triclosan could be acquired, and not simply evolved.
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WASH YOUR HANDS!!
Excerpts from an article in The New York Times, August 20, 1999:
There could be serious consequences if you dont wash your hands with an effective BGSE cleanser. As the article below states, "take common-sense precautions like cleaning out infected cuts, washing hands frequently
And ABCs 20/20 said, "Hand washing may be the single most important thing you can do to protect your health and it may even be the difference between life and death!
.is the third leading killer of Americans, and at least 1/3 of these deaths are preventable simply by washing hands."
Any micro-tear in the skin, even a hangnail, is an entry point for infection from mutated microbes. A gentle BGSE cleanser can be applied as a "liquid bandaid" and left on all cuts, scratches, bites, blemishes, etc.
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ABC's 20/20 Report
Monday, July 12, 1999 Transcript from ABC 20/20 news segments
(This is an unedited, uncorrected transcript.)
CHARLES GIBSON This may surprise you-washing your hands may be the single most important thing you can do to protect your health. And it may even be the difference between life and death. Dr Timothy Johnsons story is as urgent a health warning today as it was two and one-half years ago when we first presented it. But think about this-almost everything you touch has been touched by someone before you. And who knows where those hands have been?
DR TIMOTHY JOHNSON, ABC NEWS MEDICAL EDITOR (VO) Our hands are our most intimate companions-scratching us when we itch, bringing us nourishment, comforting us when were sick and literally opening doors for us. But because our hands are so actively involved in the world, they come into contact with many things, including messes of one kind or another. And because theyre soft and moist with all kinds of crevices, our hands also have a tendency to pick up things we cant see, like germs, which can cause us to get sick if we forget to do one simple thing. Thats right-good old-fashioned hand washing, just like our mothers always told us to do. But many experts are now saying its a lesson too many of us have long since forgotten, and the results have been alarming.
Today, infectious diseases are growing with a vengeance. In just 12 years, they increased by 58 percent, rising from the fifth to the third leading killer of Americans. (on camera) And one of their favorite stomping grounds is hospitals. Every year some two million hospital patients come down with an infection that they didnt have when they came in, and each year those infections contribute to as many as 80,000 deaths. And heres the reason were telling you all this. Experts estimate that as many as a third of these infections are preventable, many, if not most of them, through better hand washing.
DR TRISH PEARL, JOHNS HOPKINS HOSPITAL It has been shown since the 1800s to be the single most important thing that we can do to reduce infections and even reduce mortality.
DR TIMOTHY JOHNSON (VO) Dr Trish Pearl is in charge of infection control at Johns Hopkins Hospital. (on camera) You will put hand washing, good old-fashioned hand washing in a modern hospital right at the top of the list?
DR TRISH PEARL I would put that number one.
DR TIMOTHY JOHNSON (VO) And yet, study after study shows that health care workers simply arent doing enough of it.
BRUCE CRANENDONK (PH) At one point, a nurse came in and started to change the bandages. She did not wash her hands in his room. And when I questioned her about it, she just basically snapped at me, "Are you a doctor? If not, leave me alone.
"DR TIMOTHY JOHNSON (VO) Bruce Cranendonks father, Charles, was admitted to Scottsdale Memorial Hospital North in April of 1995 to remove a cancerous growth in his lung.
ALEDA REILLY They expected full recovery. In fact, the surgeon indicated that my father had had a textbook surgery and a textbook recovery.
DR TIMOTHY JOHNSON (VO) And yet, Charles died within 10 days of his successful surgery. It wasnt the cancer that killed him, it was the staph aureus infection he caught in the hospital. His family is convinced the infection was the result of poor hygiene on the part of the nursing staff.
ALEDA REILLY My two sisters were there, my mother was there, I was there. None of us ever witnessed any nurse washing her hands or using any latex gloves.
DR TIMOTHY JOHNSON (VO) Scottsdale Memorial North declined our request for an interview, saying in a statement that hospital-acquired infections are "not necessarily caused by the hospitalization" and the nursing staff follows extensive hand washing protocols.
"BRUCE CRANENDONK These kind of things are what lead to needless death and-and we dont need this. Theres no reason for this.
DR TIMOTHY JOHNSON (VO) Surprisingly enough, the lowest rates of hand washing take place in intensive care units, which have the patients most susceptible to infection. Studies show that ICU hand washing rates can be as low as 20 to 50 percent and that doctors tend to be the worst offenders. (on camera) The issue of hand washing is considered so serious that the American Medical Association recently passed this resolution reminding physicians that "They have a professional obligation to wash their hands."
DR TRISH PEARL They should wash their hands before they see patients. They should wash their hands after they see patients.
DR TIMOTHY JOHNSON What kind of monitoring do you do in the hospital to see if people are complying?
DR TRISH PEARL What we like to do is we prepare little baggies-we put culture media in the baggies, and then we just walk up to somebody and we say& I was wondering if we could culture your hands?
HOSPITAL WORKER Oh, sure. That would be fine.
DR TRISH PEARL Just, if you will, put your hands in the bag and squeeze them together for about 30 seconds. And we have them put their hands in this solution, and then we go downstairs and take it to the microbiology lab. Hi, Dianne.
DR TRISH PEARL I have two hand cultures for you.
DR TIMOTHY JOHNSON What do you typically find that you come back and show them or tell them?
DR TRISH PEARL We find some things that are-everyone has on their skin. But then we will find other things that are more unusual. We can find staph aureus. We can find candida or yeast. And we can find gram negative rod.
DR TIMOTHY JOHNSON (VO) All of these, if not washed off, can lead to wound infections, urinary tract infections, pneumonia, even bloodstream infections. In the case of this nurse, nothing unusual was found. But hospitals are only one of many places where germ-laden hands can put people at risk. Take, for example, the hands that prepare our food. In restaurants all across the country, there have been increasing outbreaks of food-borne illnesses like hepatitis A, shigellosis and e. Coli, all of which can be carried on the hands of food preparers.
1ST DINER I started shaking from fever chills, I guess.
DR TIMOTHY JOHNSON (VO) These four are among some 95 patrons of this Salt Lake City Taco Bell who are now suing the company, claiming they came down with hepatitis A after eating food contaminated by a sick employee.
1ST DINER If I get my body heat elevated, I get sick. If I mow my lawn, I get sick.
DR Ilene Risk (PH), Epidemiologist To decrease hepatitis A is as simple as washing your hands. It breaks the chain of infection.
DR TIMOTHY JOHNSON (VO) Dr Ilene Risk is chief epidemiologist for Salt Lake Countys health department. She says one of the main reasons for the spread of food-borne illness is unwashed hands preparing ready-to-eat foods. In response to the outbreak, Salt Lakes health department has launched a hand washing campaign using the slogan "Utahs Health Is In Your Hands."
All of this made us wonder what other types of germs are lurking about in our everyday environment. So we asked these microbiology students from Wagner College in Staten Island to do a survey for us. We asked them to take microscopic samples from a pay telephone, from a commonly shared computer keyboard, from a bathroom door. We also sent them to two restaurants where they took samples from cutlery, salt and pepper shakers, even a napkin dispenser. All the samples were then cultured onto agar plates and the germs identified with the help of their professor, Dr Kathleen Bobbit (ph). (on camera) So this was taken from the pepper shaker in a restaurant?1ST STUDENT Yes.
DR TIMOTHY JOHNSON And all those little dots we see are ...
1ST STUDENT Staph.
DR TIMOTHY JOHNSON & colonies of staph?
1ST STUDENT Yes. Exactly.
DR TIMOTHY JOHNSON Thats a pretty good growth, isnt it?
1ST STUDENT A very heavy growth.
DR TIMOTHY JOHNSON (VO) Many of the germs found were not dangerous, but in several places-the telephone mouthpiece and keypad, the computer terminal, the bathroom door and on paper money-they did find disease-producing forms of staph, which can cause anything from food poisoning to acne to boils. We also asked the students to take on one more assignment. We sent them here to Newark Airport. Their mission? Spend one hour in the public restrooms observing hand washing.
2ND STUDENT OK, we surveyed 261 people, and after they used the restrooms, 68 percent washed their hands and 32 percent did not.
DR TIMOTHY JOHNSON (VO) Broken down by gender, it wasnt even close. Women washed their hands 83 percent of the time while men only 54 percent, and our standards were not that strict.
3RD STUDENT As long as they rinsed, wed throw them in there with the people who washed.
DR TIMOTHY JOHNSON But in fairness, a lot of that 54 percent didnt do a very good job?
3RD STUDENT I would say about half of that.
DR TIMOTHY JOHNSON So were now down to three quarters who really didnt do the right thing?
3RD STUDENT Men are pigs, I guess. I dont know about the rest of you, but I cant wait to wash my hands.
4TH STUDENT I know. Im thinking the same thing.
DR TIMOTHY JOHNSON (VO) And thats precisely what these children do each day at Salt Lake Citys Learning Tree Day Care Center, where attention to hand washing has successfully fended off a shigellosis outbreak thats devastated other centers. Maybe our stressed out health care workers and food handlers can take a moment to observe Elijah, an expert at infection control.
ELIJAH You turn on the water. You get the soap, rub it all around your hands, and you get a paper towel. Dry your hands. Turn the water off and then throw the paper towel in the trash.
CONNIE CHUNG Now, theres an expert. Since we first brought you this report, Utahs campaign to raise awareness about the importance of hand washing has paid off. The state has reduced the number of infectious disease outbreaks by 20-fold to less than half the national average. And just one last legal update-that lawsuit brought against Taco Bell after a hepatitis A outbreak has since been settled out of court.
Lethal Strain of Germ May Pose Threat to Public Health
by Sheryl Gay Stolberg
"More than 200 people in Minnesota and North Dakota have become sick and four children have died over the past two years after becoming infected with a drug-resistant germ that until recently had been confined to hospitals and nursing homes, said Federal health officials said."
"Staph germs exist in the nostrils and skin and can be passed through hand to hand contact, but are typically harmless unless they enter the body through a cut or a scrape, which enables them to travel through the bloodstream and attack a variety of organs."
"Dr. [Tim] Naimi, [a medical epidemiologist for the Centers for Disease Control and Prevention, in Atlanta], said that parents should not be alarmed but should take common precautions like cleaning out infected cuts, washing hands frequently, and seeking medical care if their children appear sick.
[these] deaths are the tip of the iceberg
and at least 200 other people, most of them children and healthy young adults, had also been infected
. For the past decade, experts have been warning that misuse of antibiotics is creating a wave of drug-resistant bacteria, or "superbugs".
Are antibacterial cleansers causing the same problem? Scientists have already found that anti-bacterials such as triclosan can also cause the mutation of "superbugs".
.Dr. Levy of Tufts University said some experts refused to believe [these] reports. He gave a talk about the recent infections at a conference of microbiologists in May
. he said Some people denied that it exists..
insisting that the infected patients must have passed through a hospital at some point."
"None of the children who died in Minnesota and North Dakota had visited a hospital or nursing home, Dr. Naimi said, nor were they exposed to anyone who did. He said the lethal bacterial appear to be a slightly different strain from those typically found in hospitals, suggesting that the staph bugs did not escape from the hospital, but rather mutated in the environment. We dont know how it happened, he said."
SAN JUAN, Puerto Rico (AP) (from the World Wide Web)
Tuberculosis, cholera and other diseases once thought almost eradicated in the Americas have developed drug-resistant strains and again threaten millions, a leading health official said Monday
.Another unexpected development is the return of diseases once thought manageable, in part due to the mutating nature of carriers, Alleyne said.
"Drug-resistant strains of microbes are having a deadly impact on the fight against tuberculosis, malaria, cholera, diarrhea and pneumonia [which] together kill more than 10 million people worldwide each year
.This is happening at a time when too few new drugs are being developed to replace those that have lost their effectiveness". [Dr. George A.O. Alleyne, Director-General of the Pan-American Health Organization]
He singled out the mosquito that carries dengue the highly debilitating and untreatable disease some call "breakbone fever" that infected 770,000 people in the Americas last year, and killed dozens. "There was a time when a lot of this region was free of this mosquito, but now we find virtually the whole region reinfected". Alleyne said. He blamed excessive reliance on Chemical insecticides, which the mosquitos have become resistant to, and inadequate sanitation that provides an environment for mosquitos to breed.
Tuberculosis, affecting 400,000 a year in the region, was another concern. "We thought we had the magic bullets to treat it. Now we see it coming back
and killing 137 people every day", Alleyne said.
Other diseases identified as re-emerging in the last decade:
--Cholera, reintroduced to Central and South America following an absence of nearly a century.
--Bubonic Plague, which has returned to Peru since 1992.
--Hantavirus, a rat-borne disease that was discovered again in the U..S. state of New Mexico
--Drug-resistant malaria has infected a great swath of the South American Amazon, attacking entire villages in Guyana.