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Antibacterial soaps: Should we use them?Jan 27 '09 (Updated Jan 29 '09) Write an essay on this topic.
Popular Products in Personal Care
The Bottom Line Short answer: No. Long answer: No, and stop being a sucker. Read on.
Henry_thoreau has a review for Ajax antibacterial hand/dish soap which piqued my peeve for antibacterial products. What could be bad about something that is antibacterial, you might ask? Why wouldn't you want to get rid of bacteria like the soap says it will do? Well, read on, and you'll understand why the soap industry created these products, why these products aren't significantly better than regular soap at getting rid of bacteria, and why you should go back to conventional soaps. First, let's look at the genesis of antibacterial products in general. When the health community discovered that bacteria in hospitals were a major source of infections acquired by patients while in their care, something had to be done. Products like Lysol spray were developed to combat surface-dwelling bacteria. Pine-Sol and similar pine-based products were found to have anti-bacterial properties and were used to clean hospital floors. Meanwhile, doctors had to clean their hands for two purposes: surgery and general doctor-patient contact. For surgery, a surgical scrub was developed using a general antiseptic called chlorhexadine gluconate, which kills gram-positive and most gram-negative bacteria. CG was also found to be useful as an injection and preoperative surgical site cleanser. For general contact, alcohol-based hand cleansers like Purell have been developed for and adopted at most major hospitals as the primary means of preventing the spread of bacterial infection within the hospital. Alcohol denatures proteins, which means the bacteria will be torn apart at the cellular level. It does not cause death; it destroys the chemical structure of the DNA and any other proteins in the cell. As such, it is impossible to develop a resistance to alcohol. And, since use of such products is easy and inexpensive, it helps reduce infection. Which leads us to triclosan and trichlocarban. Triclosan and trichlocarban are used in hospitals, at concentrations far higher than consumer products contain, for the purposes of cleaning skin for surgery. At high concentrations, it is extremely effective at killing bacteria. And, even at lower concentrations, it does kill a wide spectrum of bacteria. Now that we know where they came from, why aren't these any better than regular soaps? The folks at the University of Michigan School of Public Health asked the same question. Their study, found in the August, 2007 edition of Clinical Infectious Diseases (Consumer Antibacterial Soaps: Effective or Just Risky) examines the results of 27 studies from 1980-2006. They "found that soaps containing triclosan within the range of concentrations commonly used in the community setting (0.1 to 0.45 percent wt/vol) were no more effective than plain soaps" (http://www.physorg.com/news106418144.html) when it came to preventing infectious illness or removing bacteria. Regular soap works by combining hydrophobic and hydrophilic qualities in the same product. To say it simply, it creates an environment where water can wrap itself around oily substances and wash them away. Dirt, oil, and bacteria all become wrapped up in water and carried off the skin. Antibacterial soap is the same product with triclosan added. Antibacterial soap makers will not tell you that regular soap is ineffective at eliminating bacteria from the skin. In fact, they often won't even tell you anything about regular soap, because that would distract you from their message: buy antibacterial soaps because they kill bacteria. For instance, in a statement by Brian T. Sansoni on behalf of the Soap and Detergent Association, an industry group, he said, "[w]e believe that the benefit of reducing harmful germs on the skin is apparent," and that they are concerned that consumers' access to these products might be limited in some way." (http://www.webmd.com/news/20051020/fda-panel-no-advantage-to-antibacterial-soap) We all know that getting rid of germs on the skin is good, but did he say that antibacterial products do the job any better than regular soap? No. The only message is that antibacterial products work, and people should have full access to them. His argument is as valid as "for the children" or "because of 9/11." It offers no data about superiority, it just creates a sort of cloud of feeling, and a vague connection between eliminating bacteria and antibacterial soaps. Anyone who's seen the movie "Thank You For Smoking" recognizes this tactic. Finally, why should we stop using these antibacterial soaps and go back to conventional soaps? I mean, so what if it doesn't work any better? It is clear that it doesn't work any worse. The answer to this question is simple: mutation. Triclosan and trichlocarban are chemicals formed from oxides of benzene, among other ways to manufacture it. They attack particular sites on bacteria and cause bacterial death. "Triclosan works by targeting a biochemical pathway in the bacteria that allows the bacteria to keep its cell wall intact. Because of the way triclosan kills the bacteria, mutations can happen at the targeted site" (http://www.physorg.com/news106418144.html). Exposure to these chemicals will kill most of the bacteria that the drug targets, but there are almost always a couple stragglers that linger after treatment. Usually, our body can either do away with them naturally with white blood cells if the bacteria are inside, but when the bacteria are on the outside, things are different. Most people do not wash their hands adequately. The average person's hand-washing routine lasts for approximately 5 seconds, which is about 15-20 seconds too short. By exposing bacteria to triclo-products for short periods, those most susceptible to triclo-products will die quickly, leaving behind the most resistant strains along with those strains that would have been killed had exposure lasted longer. Add to this the fact that triclo-products remain on the skin for far longer than just the hand washing, but in far lower concentrations, and those bacteria that were in the middle for resistance have the potential to increase their tolerance, or resistance, to the antibacterial drugs. Now, instead of having a tiny contingent of inherently resistant bacteria that would have been inconsequential health-wise, we have that contingent plus a growing population of bacteria that are being conditioned to tolerate higher and higher concentrations of anti-bacterial products via repeated short exposures and chronic low exposures. You might wonder, "wouldn't this be taken care of if we just wash our hands longer?" No, it wouldn't. Life has a wonderful way of doggedly making itself continue despite the best attempts to end it. Longer hand washing would eliminate more of the bacteria that are susceptible, but because triclo-products remain on the skin long after we've finished washing our hands, the bacteria that arrive later will find an environment with an extremely low concentration of triclosan/trichlocarban, and those with a moderate resistance will have the chance to replicate their resistance and mutate to tolerate higher concentrations the longer they remain in that low concentration environment. (Mind you, this all refers to the POTENTIAL for mutation, and the POTENTIAL for so-called "superbugs." While they have not yet formed on their own as a result of triclosan use, the potential exists.) Does regular soap allow for mutation? Nope. Until cells stop using fats for their cell membranes, they will be susceptible to soap's cleansing abilities. At that point, though, life would be far different than we now know it. Every animal life form, with the exception of viruses, use fats to surround its cells. A completely new system of cellular structure is unlikely in our mostly contained environment, which means soap should, for the foreseeable future, work. So, why are antibacterial soaps on the market when regular soap is just as effective at preventing infectious illness, eliminating bacteria, and getting your hands clean in general? Because people are willing to spend money on it. When triclosan started getting added to hand/dish soaps, manufacturers saw their sales skyrocket, while sales of regular soaps started to decrease. These companies prey on the average person's lack of savvy and awareness when it comes to how soap works, how triclosan works, and whether there is any significant advantage to using one over the other (not to mention potential long-term consequences). People are afraid of getting sick, and if they're told that a product kills bacteria (the FDA does not regulate soap, so regular soaps can't legitimately claim to kill bacteria, and because triclosan on its own does kill bacteria, and the FDA acknowledges this fact, the FDA currently does nothing to regulate a product that does exactly what it says it does), they'll buy it. Yes, I'm saying the American consumer is a sucker. A yellow, chicken, fraidy-cat, ignorant sucker. And I'm also saying that the American consumer's fears are the grist for the antibacterial mill. I know, I know, you're not a dummy. Never said you were. There's plenty of smart people who are suckers, though. Think the two are mutually exclusive characteristics? Check out this story about a county treasurer in Michigan who fell for the Nigerian scam: http://www.theregister.co.uk/2007/01/25/treasurer_accused/. As the story states, even a neuroscientist and a Harvard professor have fallen for this scam. Were they smart? Surely. Were they suckers? Heck yeah. And so is the vast majority of America. And it's that suckerocity...suckerdom...suckeriness...whatever, that soap makers bank on (literally). The fact is, if you wash your hands with regular soap and warm water for 20-30 seconds, you do just as much to protect yourself from infectious illness and bacteria as you do with a triclosan-laced product, but without opening the door for potential health problems down the road from drug-resistant bacteria. The CDC agrees. So does the FDA. When the CDC and FDA (usually a great friend of drug-pushing manufacturers) are telling you you DON'T have to take a drug, and that not using a drug may actually be better for you, maybe, just maybe, you should listen. So, after all of that, my point is this: stop using antibacterial soaps. You're not doing yourself any favors, you're falling for fear tactics and letting your ignorance and emotions dictate your choices, and you're potentially creating a superbug. Use regular soap and water or alcohol-based hand sanitizers if soap and water are not available.  |
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