Triclosan: The Biocide That Creates Super Bugs?

Triclosan: The Biocide that Creates Super Bugs?

By Bob Root, Keys Technologist

 

Chemical Warfare Chapter 12:  Biocides:  Indiscriminate killers that create super bugs?

For almost two years, I have been working on a book draft titled, “Chemical Warfare.”  It is a book focused on simplifying information about personal care and household products uses and concerns for public safety.  As I studied, I realized how much hearsay there was in the industry.  Taking a scientific approach, I turned to the research community for insights and facts…as best as they are.  Part of my dedication was and is to release information that is important in real-time.  Books, after all, are merely a snapshot in time and pale in comparison to real-time information gateways like our blog.

FACT vs FUD is a chapter in this book as well as an article on this blog.  In this overly inflammatory news based society of ours, my resistance is to publish anything that is not based in research.

Definition: Biocide – A biocide is a chemical substance capable of killing living organisms, usually in a selective way. Biocides are commonly used in medicine, agriculture, forestry, and in industry where they prevent the fouling of water and oil pipelines.

A Bit of History:

One of the inspirations for this book and this article was an experience I had while in a store outside of Dayton Ohio.  Not too far from the headquarters of Protor & Gamble (Cincinnati) I was delivering a speech about the Dirty Dozen at an annual event the store promotes.  Probably 200 in attendance, I went through the Dirty Dozen chemicals created by the Marin County Cancer Project.  At the end, I provided some chemicals of concern, so I went back through my “most feared” list.  In the book, I describe that some of the Dirty Dozen are much more damaging than other, but tend to be used in only discrete segments and in only some products.  Some ingredients like parabens are much more widely used often in multiple doses during the manufacturing process elevating their concentrations in products to well beyond the called for percentages by the chemical maker.  During my speech, I invited questions as we went along and there were plenty.

At the end, I voiced my concern that Triclosan was perhaps my greatest fear because it is so powerful a biocide.  As a bit of background, Triclosan is the main ingredient in hand sanitizers and antibacterial soaps.  A biocide, by design, kill gram positive and gram negative bacteria as well as most all bacteria.  My concern all along has been two very important concerns.

1. If it  indiscriminately kill all bacteria, then what does it do to the flora-probiotic on our skin?
2. Will the destruction of all bacteria on the skin create super-bugs that morph and become resistant to both the biocide and antibiotics?

As I always do, I try to connect with the eyes of people in my audience.  It is my way of trying to figure out if I am connecting with them.  In my corporate life, I received training on how to read an audience as well.  As I call it, Squirming Around is a big flag that I have touched a nerve.  You better believe that I experienced this at every shareholder meeting.  So, this day, I was thrust back to my corporate life by a gentleman that had asked no questions, been very polite and had friendly eyes.  When I lumped Triclosan in with parabens as my major concern, his hand shot skyward as to immediately interrupt me.  I obliged by stopping to acknowledge his question.

He asked, “Why would you add the main ingredient in hand sanitizers with that of preservatives used in almost every product made from personal care, to toothpaste, to food?”

First things first, I knew immediately that this person was from the industry because the question was one I would have expected in a meeting inside a research and development process.  Not being ever deterred by confrontation, I answered both technically and emotionally.  Here is my initial response.

“I am more concerned with Triclosan than a Methyl Paraben for four primary reasons.

1. Triclosan has been used in hospital and scientific environments for many years because it is the most effect biocide.
2. The concentration of Triclosan in a function specific product like antibacterial soaps is much higher and therefore of greater concern to me because it does a much more wide reaching job of killing all bacteria on the skin including the good bugs!
3. The destruction from Triclosan is so powerful and long lived compare to parabens that I have more than a subtle concern that what bacteria arrive back on the scene will be the worst kind like staph, eColi etc.
4. I also worry that these strains of bacteria will grow back with a vengeance and become resistant to both Triclosan and known antibiotics.

The man stood straight up as if to confront me.  I could also tell that I had just scared the hell out of the rest of the audience.  Before I could temper my comments with the Fact that this was my personal concern and that I had not gathered all the facts, he spoke.

He said, “I am a scientist that works down the road.  First, I am a parent and father.  I do not care that we have the best health insurance; I worry about what we expose our kids to.  We have had an outbreak of staph in the middle schools in this area and what you are saying is that because we require our kids to wash with antibacterial soap containing Triclosan that we are exposing them to the potential of transmitted staph infections like the ones we are experiencing now?”

My only answer had to be from the heart and not my corporate training to dodge the question.  I said, Yes!”

He shook his head and sat down.  Honestly, you could have heard a mouse burp in that room!  I tried to interject some humor and my time was up.  The people filed out of the room as the other speaker got set up.  The man approached as did the sponsors from the store.

She thanked me for the informative talk and quickly said, can you send me something about this.  She offered that she was a cancer survivor and had a more than passing concern.

The man also echoed by adding that he was privileged to be able to read many documents about uses of chemicals.  He said that what he always noticed is that most have warnings of irritation when used in high percentages and that antibacterial soap using Triclosan actually exceeded the minimum percentages.  I asked if he could provide me with percentage data and he said, “no! I am not allowed to do that!”  I got the message.  I walked back to my team that was exhibiting at the health fare and told them of the experience.  I shared, that I only wish I had a study to hand to everyone that at least echoed my fears.

Over the last two years, I have shared the story with colleagues.  This morning in July of 2010, I received an email with a copy of the attached Opinion from the EU Scientific Directorate!  Being a geek, I read all 56 pages and decided to sit down to finish this chapter of the book.

Remember this is an opinion and I would encourage you to read the entire document.  There must be additional testing.  We do know that bacteria exposed to destructive agents does morph into “super bugs” in many cases.  This opinion echoes much of that concern.  In one sense, I am pleased that this concern of mine and others has now taken another step up in the process of science.

My opinion!  For what it is worth, science generally follows an orderly path.  The Mandelbrot theory says that, if that what we see occurs in a large scale, it will occur in a small scale.  If we can kill bacteria…good and bad… with a large dose of a chemical, then small doses delivered more frequently and repeatedly will have the same effect.  The other scientific principle that comes to mind here is Occam’s Razor which is the principle that “entities must not be multiplied beyond necessity” or that the simplest explanation is usually the correct one.  So, to me it makes sense from a logical perspective that using a chemical like Triclosan everyday in large does will have a long term adverse effect on the flora of the skin.  Only the test of time and scientific studies will bring the concern to even higher levels.

What I can share is that I personally avoid anything on or in my body designed to kill something like germs, bacteria and microbes.  Like all of us, I have had to take antibiotics and we know from the warnings that sustained use can make them ineffective.  Following Occam’s Razor, I also believe that is true of these chemicals under various names that are designed to make my life more pure…Purity at the sake of what?

So, my mother may not have been right that eating dirt was all that bad for me J

Below is the executive summary from the study.  Attached is the pdf of the entire OPINION!

EU Triclosan Opinion: Verbatim

EXECUTIVE SUMMARY

Triclosan is a biocide used in many product categories, including cosmetics. The information on environmental concentrations of triclosan in the EU is limited and bioavailability of the triclosan to bacteria in the environment is not known.

Although the present mandate concerns the evaluation of a possible association between the use of triclosan in cosmetic products and the development of resistance by certain micro-organisms, the SCCS has taken into account all evidence available from all uses of triclosan to perform its assessment.

Triclosan is the most studied biocide with respect to bacterial resistance. Such a level of information, notably on its activity against bacteria, theidentification of mechanisms of microbial resistance including genomic and proteomic aspects, is commendable and should be extended to other biocides.

Low concentrations of triclosan can trigger the expression of resistance and cross-resistance mechanisms in bacteria in vitro. In view of the concentrations of triclosan reported to trigger resistance in vitro, some of the environmental concentrations found in a number of geographical distinct areas are high enough to suggest that bacterial resistance could be triggered. It is however difficult to predict whether microbial resistance would be triggered in these environments. The few in situ studies performed to date did not show any bacterial resistance emerging following triclosan exposure. In addition, the presence of other chemicals (e.g. antibiotics, surfactants, other biocides, etc.) in the environment, which may also affect microbial populations, would preclude assessing the effects of triclosan independently.

The emergence of resistance induced/selected by triclosan is related to the genetic control on the resistance gene(s) present on chromosomal and genetic mobile elements. This represents the origin for a hazard about selection and dissemination of cross-resistance with other anti-bacterial molecules including biocides and antibiotics.

Triclosan, like any other biocide, contributes to the selection of less susceptible bacteria in a complex microcosm in vitro. The impact of such a selection is unclear, as is the fitness of the “selected” bacterial species following triclosan exposure. The few in situ studies investigating long-term triclosan exposure (i.e. at least 6 months) did not indicate changes in the resistance susceptibility in the predominant bacteria selected for monitoring, but the changes in the entire flora were not evaluated. Thus additional in situ information is needed to provide a definitive opinion.

There are, so far, no epidemiological data linking outbreaks of antimicrobial resistant human and zoonotic pathogens to exposure to triclosan.

A number of scientific and technical data gaps about the occurrence and understanding of the resistance profile of triclosan have been identified and should be addressed. In particular, where biocides, including triclosan are used intensely, monitoring for emerging resistance in the microbial flora should be conducted. A more detailed research strategy for investigating the antimicrobial resistance effect of biocides is presented in a separate opinion from the SCENIHR (2010).

There is an apparent discrepancy between in situ information that suggests the absence of induction of bacterial resistance and cross-resistance triggered by triclosan, and in vitro studies describing the mechanistic and genetic aspect of triclosan-resistance in bacteria. A better translation of in vitro findings to in situ situations is needed, making full use of molecular tools and environmental conditions used in laboratory investigations. Standardized protocols and similar parameters should be applied to both in vitro and in situ investigations.

Although triclosan resistance was not observed in situ, this is not sufficient to conclude that there is no risk. Information is still lacking to provide a risk assessment on the use of triclosan in cosmetic products, including the genetic aspects of resistance, changes in environmental microcosm, maintenance and transfer of virulence and resistance determinants in situ.

Due to the limited number of in situ studies of resistance induced by triclosan to date, SCCS can only recommend the prudent use of triclosan, for example in applications where a health benefit can be demonstrated. However, conclusions from in vitro studies cannot be ignored, notably the role of triclosan (and other biocides) in triggering resistance and in the dissemination (horizontal or vertical transfer of) resistance determinants. Research focused on triggering mechanisms of resistance, maintenance of the gene pool and the transfer of resistance and virulence determinants, and improving the translational application of laboratory results to situations in situ are needed. Hence,the SCCS appreciates that research investment from the industry will be maintained to contribute to a better understanding of the potential risks associated with triclosan applications.

Complete Report:  EU Opinion: Triclosan Superbugs

Amended 7/19/2010

Just a few hours after publishing, a number of friends commented on the article adding some noteworthy points.  Below are some additions submitted by a few of my scientific buds:  Bob

• Triclosan:  The Biocide that keeps on giving!

• Most of the free world including the US require that Triclosan be listed somewhere on the label if it is used in a product.  But how about if it is used in product packaging or molded into materials.  Unregulated therefore no requirement for listing.  Herein is the fallacy of confusing consequence with sequence.

• Have you ever wondered why cheese seems to last longer than it used to?  Have you wondered how companies can claim that if you buy their storage products that food will last longer?  Have you wondered how a manufacture could claim that their running socks are antibacterial?

• We know that Triclosan is used in sanitizers and tooth paste as well as antibacterial soaps.  Did you ever wonder what chemical they use in making utensils, cooking equipment, cutting boards and even sport clothing to make them antibacterial.  You guessed it, Triclosan.  The white powdery substance can be molded into products to make virtually antibacterial.  Many food packages are molded with Triclosan to make them antibacterial to preserve the food longer.

• If there was any reason to buy organic and local at the farmers market, this is a dammed good one for me. Even if you are only half right.

• So, like Phthalates, Triclosan is not just in personal care.  They found phthalates in childrens toys and car dashboards.  Triclosan is in much more than antibacterial soap.  So here is a partial list of products that use Triclosan that I could find after a 10 minute Google search.

• • Sanitizers
  • Antibacterial soap (really a detergent)
  • Deodorant
  • Toothpaste
  • Shaving Cream
  • Mouthwash
  • Skin Care
  • Makeup
  • Acne Products
  • Antimicrobial Creams
  • Cleaning Supplies
  • Kitchen Utensils
  • Food Storage
  • Plastic Wrap
  • Trash Bags
  • Toys
  • Bedding
  • Socks
  • Sports Clothing
  • Child Car Seats

• Someone asked me if I could link a direct connection to MRSA (Methicillin Resistent Staphylococcus Aureus) and Triclosan.  I said, “honestly, I do not know!”  Do I believe that it is connected, Yes!  So you can imagine my surprise when I read an article in a medical journal prescribe sits baths for MRSA suffers in a solution of 2% Tricolsan!

• Reports have suggested that triclosan can combine with chlorine in tap water to form chloroform gas which the U.S. EPA classifies as a probable human carcinogen. As a result, triclosan was the target of a UK cancer alert, even though the study showed that the amount of chloroform generated was less than amounts often present in chlorinated drinking waters.

• Triclosan reacts with the free chlorine in tap water to also produce lesser amounts of other compounds, like 2,4-dichlorophenol.  Most of these intermediates convert into dioxins upon exposure to sun light (UVA)  Small amounts of dioxins are produced and there is more than subtle concern over this effect because dioxins are extremely toxic and endocrine disruptors. They are also chemically very stable, so that they are eliminated from the body very slowly, so they can bioaccumulate.  Therefore they persist in the environment for a very long time.

• Triclosan is chemically somewhat similar to the dioxin class of compounds. Triclosan production leads to small amounts of residual polychlorinated dioxins, and polychlorinated furans which are contained in small amounts, in the products that are using it.

• A 2006 triclosan study concluded that low doses of triclosan act as an endocrine disruptor in the North American bullfrog. The hypothesis proposed is that triclosan blocks the metabolism of thyroid hormone, because it chemically mimics thyroid hormone, and binds to the hormone receptor sites, blocking them, so that normal hormones cannot be utilized.

• Triclosan is used in many common household products including Clearasil Daily Face Wash, Dentyl mouthwash, the Colgate Total range, Pepsodent, Softsoap, Dial, Right Guard deodorant, Sensodyne Total Care, Old Spice and Mentadent.