Text: Hilary Venables. Article from the May 2014 issue of Noseweek Magazine.
In spite of growing concerns about over-use of potent antibacterials in the home, some manufacturers are determined to keep shoving these chemicals down our throats.
At the New York headquarters of Colgate-Palmolive there has been much trumpeting of the results of a recent study into the effectiveness of its antibacterial toothpaste, Colgate Total.
Colgate Total contains a not-inconsiderable 0,3% ( 1) of the antimicrobial chemical triclosan which, along with triclocarban, has come under belated scrutiny by the US Food and Drug Administration. (see nose 173).
Inexplicably, the FDA ruling compelling manufacturers to remove triclosan and triclocarban from their soaps unless they could prove they were safe and effective, targets only soaps. Other products containing these toxins, including toothpastes and mouthwashes, are to be left unexamined.
Colgate-Palmolive, which was granted a licence to peddle triclosan-laced toothpaste back in 1997 (*2), is therefore not obliged to present the latest evidence for either the safety or effectiveness of its antibacterial dentifrice.
But of course it’s only too happy to share when there is anything positive to say. In this case, however, the findings are less convincing than the manufacturer would have us believe. The study is by the Cochrane Oral Health Group, a US company which does no primary research, but reviews existing literature. It looked at 30 previous studies of varying quality. After six-to-seven months of use, Colgate Total was reported to have reduced the incidence of plaque by 22% and gum bleeds by 48%. After six-to-nine months of use, gum inflammation was reported to have decreased by 22%.
There was no evidence of a reduction in periodontitis and only a slight reduction in caries after 24 months-and-more of use.
In summary, the report says there was “moderate-quality evidence showing that toothpastes containing triclosan/copolymer, in addition to fluoride, reduced plaque, gingival inflammation and gingival bleeding when compared with fluoride toothpastes without triclosan/copolymer. The reductions may or may not be clinically important…”
Not exactly a ringing endorsement. And while the authors report that no ill-effects were recorded, the research under review wasn’t looking for effects on general health. The longest of the studies lasted just 36 months, so long-term effects were not considered. And these – as doctors and microbiologists have been arguing for decades and even the FDA has now acknowledged – could be nasty (*3).
Both triclosan and triclocarban (sometimes referred to by its full name, trichlorocarbanilide) are endocrine disrupters, proven to affect thyroid and testosterone expression in frogs and rodents. Triclosan has also been shown to have a “dramatic effect” on the functioning of heart and skeletal muscle in animal studies and in invitro tests on isolated human muscle cells. It has proved “highly toxic” to small aquatic animals and plants.
Both chemicals are fat soluble, rapidly absorbed by the skin, persist in the environment, accumulate in living tissue and are magnified as they move up the food chain.
Some studies indicate that the routine use of antibacterials is making people more prone to infection as their natural immune response is weakened through lack of use.
Most worrying is that laboratory experiments and new field studies indicate that triclosan can fuel the development of microbes resistant not only to triclosan, but to other antibacterials and even antibiotics – a particular concern in South Africa where multiple-drug-resistant TB is a growing threat.
Whatever its effectiveness for oral hygiene, there is no evidence that the use of triclosan (or triclocarban) for comment on the effectiveness or safety of triclosan, which is still included in Palmolive antibacterial liquid soap, Ajax antibacterial dishwashing liquid and Colgate Total toothpaste.
Unilever’s Unathi Mgobozi is quoted as saying: “Triclosan is an effective antibacterial ingredient which we use in a limited number of products where it has a clear role in maintaining health and hygiene”.
The company, which counts among its brands Sunlight antibacterial dishwashing liquid (triclosan) and Lifebuoy soap (triclocarban), has recently launched a cheap multi-purpose antibacterial bar soap called Germiguard (triclocarban) for “low-cost earners”.
Reckitt Benckiser claimed to have started removing triclosan from its products in 2009, but still uses triclohand-washing is any improvement on ordinary soap, so how do the manufacturers defend their continued inclusion in everyday toiletries?
Experiments indicate that triclosan can fuel the development of microbes resistant to antibiotics
Noseweek approached the most prominent culprits, Colgate-Palmolive, Unilever and Reckitt Benckiser asking for a list of all their locally-marketed antibacterial products, specifying how much triclosan or triclocarban each contained (none of this information is available on their websites). They were also asked whether they intended discontinuing the use of these chemicals, considering the rising tide of scientific and regulatory opposition.
After more than two weeks, none of them had replied, so we are forced to rely on secondary sources for the corporate spin.
In a piece on Bizcommunity.co.za in January — attributed to the Sunday Times — Colgate-Palmolive spokes-person Del Levin is reported to have insisted that their Protex soap containing triclocarban was “safe and had clinically proven antibacterial efficacy”. He was not asked, apparently, to carban in its Dettol hygiene soap.
Johnson & Johnson, makers of Savlon (triclosan) pledged to replace the chemical by the end of this year, but did not specify with what.
Without a complete list, the advice given in nose 173 stands: get out your magnifying glass and read the labels if you want to know what you are putting into your mouth or on your skin.
*1. This amounts to 3 million parts per billion. Triclosan, at concentrations of 0.15 parts per billion, was enough to disrupt hormone signalling in frogs. The percentage of triclosan in antibacterial soaps is commonly 0.1% to 0.45% weight/volume or between 1-and-4.5 million parts per billion (before you add water, of course).
*2. Environmental organisation, the Natural Resources Defence Council, is suing the FDA in the Manhattan Federal Court to try to force the release of the full record of its decision to approve Colgate Total. The NRDC was instrumental in compelling the FDA to issue its latest ruling on triclosan and triclocarban.
*3. There are comprehensive reference lists at http:l /en.wikipedia.orgIwiki/Triclosan and http://en.wikipedia.org/wiki/Triclocarban.
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