Germs and the Rise of Antibacterial Products

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Headline-making deadly bacteria such as E. coli, salmonella, and staphylococcus have lately been putting the fear of dirt in consumers’ hearts. Over the past few years, commercial soap-makers have met this fear with a host of antibacterial products that range from soaps and detergents to gels and lotions. Some children’s toys and a number of kitchen items, including cutting boards and sponges, have been impregnated with an antibacterial agent. There is even antibacterial toothpaste on the market.

But are antibacterial products–which generally fetch a premium price–actually effective? Are the antibacterial agents themselves safe? And perhaps most im­portantly, do these products promote the proliferation of drug-resistant bacteria? Experts disagree on these basic questions.

What Makes a Product Antibacterial?

Adding an agent designed to kill or reduce the growth of bacteria allows a manufacturer to label a product “antibacterial.” These agents are actually antibiotics, and are sometimes referred to as disinfectants or antiseptics. The active ingredient in most antibacterial soaps is triclosan, in use for over thirty years. When used in soaps, triclosan is considered an over-the-counter drug by the Food and Drug Administration. Other antibacterial agents added to consumer products include triclocarbon and benalkonium chloride. All these compounds were originally used in hospital-grade soaps and surgical clothes to inhibit the spread of infections.

Microban, a pesticide registered with the EPA, incorporates triclosan to protect plastic from bacterial growth. Microban has been added to some Hasbro toys and in 3M O-Cel-O sponges. In April 1997, however, the EPA ruled that Microban had not been approved or registered to protect public health; therefore neither company can claim that Microban-treated products kill harmful germs.

Benefits of Antibacterial Products

There is no doubt that antibacterial products are a boon to soap makers and other consumer-product companies. Antibacterial soaps, which are sold at a premium, make up 30 percent of the cleanser market, and more than 650 antibacterial products were introduced to the consumer market between 1992 and 1998.

In hospitals, where a germ-free environment is necessary, antibacterial washes help provide a measure of sterilization. But hospitals–with both an overabundance of disease-carrying germs and liberal use of anti­biotics–are, ironically, locations where tough strains of bacteria thrive. Such conditions do not exist in the typical home, so antibacterial products are ­usually not called for there. This is fortunate since many antibacterial products require minutes, even hours, of application to work effectively, and most of us aren’t prepared to do such intensive cleaning. Nonetheless, household use of antibac­terial soaps can be appropriate under special circumstances–for instance, when a friend or family member with a weakened immune system is visiting or when a family member returns home from a hospital stay.

Antibacterial Alerts

While the FDA allows the use of triclosan in consumer products, the agency is still studying the ingredient for safety. It’s certain, though, that compounds created to kill or impede the growth of bacteria are too toxic to be taken internally, and children who accidentally ingest soaps that contain triclosan can experience nausea, vomiting, and diarrhea. Making matters worse are cleansers that contain scents such as bubblegum, watermelon, and other “flavors” that children may be tempted to swallow.

In rare cases, topical use of antibacterial compounds can cause serious allergies. So if anyone in your family is prone to allergies, or if you’re concerned about increasing your chemical-exposure load in general, keep clear of antibacterial products.

Another concern is that consumers who buy antibacterial products may overestimate manufacturers’ claims. Thus some people won’t use antibacterial soaps as thoroughly as standard soaps. And those who purchase products such as toys or cutting boards infused with antibacterial agents may not wash them adequately. If you do use antibacterial products, keep in mind that they are not magic ­bullets for fighting germs.

Does Antibacterial Equal Eco-Friendly?

There is a good deal of debate over whether antibacterial products harm our environment by promoting the development of drug-resistant bacteria. On the one hand, a 1998 FDA advisory panel found that antibacterial washes containing triclosan do not threaten public health by encouraging antibiotic resistance. Soap-makers and other manufacturers who use triclosan in their products are quick to point to this ruling.

Federal figures show that each of the six most frequently occurring bacteria in hospitals is resistant to at least one antibiotic, and some experts believe that triclosan should be regulated by the FDA like antibiotics. Among studies that indicate cause for concern over bacterial resistance to triclosan is one being done by Tufts University researchers who are considering whether antibacterial household products are contributing to a decrease in the number of medicines that are proven to eradicate dangerous bacteria. And researchers at St. Jude’s Children’s Research Hospital in Memphis published a paper in April 1999 stating that the use of antibacterial products may encourage the growth of drug-resistant strains of bacteria. Both research teams are studying how triclosan kills bacteria. Conventional wisdom holds that the compound kills bacteria indiscriminately, much like a bomb, and that it’s unlikely that bacteria can find a way to resist triclosan. Newer studies show that triclosan may interfere with a particular biochemical process within bacteria and thus may leave room for some bacteria to mutate into resistant strains. Further, if triclosan does not wipe out all bacteria, its use may allow relatively weaker strains of bacteria that once had competition from other microbes to thrive.

Cleaning Safely

Experts agree that good old soap and water really do the job! Soap works by reducing the surface tension of water and allowing action from your hands, washcloth, sponge, or rag to loosen and carry away dirt and bacteria. Friction is the key here, so the longer and more vigorously you rub a surface–including your skin–the cleaner you’ll make it. For items that must be disinfected–such as utensils used to prepare raw meat–try a chemical that evaporates rapidly, like alcohol, ammonia, bleach, or hydrogen peroxide. These products can remove potentially harmful bacteria, and they don’t leave residues that stick around and kill benign bacteria or promote resistance in dangerous strains.

While most consumer products very proudly announce their antibacterial potential on the label, a few keep it relatively quiet. If you want to avoid antibacterial agents, don’t assume that shopping at a health-food store or from a natural-products catalog means your soap won’t contain triclosan. If the soap does contain an antibacterial compound, it must be listed as an active ingredient. If you do keep antibacterial products in your home, try to save them for critical situations. nNH

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