Impact of Triclosan on Health
Introduction
Antimicrobial or antibacterial agents are commonly used as ingredients in many of the household products. This trend has increased the concern of growing level of chemicals in the environment that ultimately bring negative impact on human as well as animal health. Triclosan is one among them. It is a synthetic, and an antibacterial agent having broad spectrum that has exploded in the consumer market in last few years. There has been tremendous debate on the safety, regulation of its use and effectiveness of triclosan (The European Consumer Organization, (2012).
Triclosan contains antibacterial properties along with antiviral and antifungal properties as well. This chemical is most commonly used to kill bacteria present in the skin and other parts of the body. It has also been used in consumer products for about 30 years or more, products like detergents, skin cleansers, soaps, lotions, deodorants, toothpastes, dishwashing liquids, and creams. This can also be added to other products like textile in order to make resistant against bacterial growth (The European Consumer Organization, 2012).
The use of Triclosan started in US in 1970s in soaps for the first time, but its use has been risen to an alarming height in past few years. Triclosan and other antibacterial agents are found in the environment like on water surfaces, fish tissues, soil along with human breast milk (Adolfsson-Eric et. al, 2002). Antibiotic resistance in the community is an emerging health issue. People and animals who get infected with antibiotic lack natural or traditional immunity and this has been reported in various studies.
Background
Triclosan has not been observed currently as hazardous to the environment, human, and animal health. It has a long history to be used as a preservative in cosmetic products. Though there are some concerns that even low concentration of this chemical in different products may provide resistance to bacterial resistance for antibiotics, and this has been a serious problem worldwide. The main reason for antibiotic resistance probably is due to the consistent use as well as misappropriation of the chemical. The safety concerns regarding the use of triclosan in different products has been assessed by EU Scientific Committee on consumer Products. The committee recommended its minimum use until the complete evaluation of the negative impact of triclosan. They emphasized the continuity of research to understand related antimicrobial chemical. This clearly shows that the use of triclosan has not been stopped or banned by the authorities as the solid results need to be presented with valid justifications.
Triclosan is also in use as an antiseptic or preservative in various household products ranging from kitchen items like dishwashing bar to detergents as well as cosmetic products and even in children's toys. This chemical also gets incorporated on the external surface of medical instruments, plastic products, kitchen utensils, and textile products. By this application, it may slowly seep into our body due to its longer duration of use in order to perform biocidal action. In cosmetics, its concentration has been observed at 0.3% and this much amount is safe for different products like deodorants, soaps, hand washes and so forth. Unlikely, the consistent use in cosmetics may be harmful. But almost every product has this much concentration of triclosan, and user gets exposed to almost every product in daily life in the form of soaps, hand washes, toothpastes, lotions, makeup and so forth. Hence, it increases the required concentration from 0.3%, and this is then harmful for the consumers (Johansson, Janmar & Backhaus, 2014).
The threat associated with Triclosan has even made conscious some of the consumer products manufacturers. Tom’s of Marine stated publically that their products don't contain triclosan (Glaser, 2004). The triclosan is marketed under the name Microban if it is used in garments or plastic products and as Biofresh if used in acrylic fibers. Though the antibacterial and antibiotics are similar as both oppose bacterial growth. But the purpose of antibiotics is to cure disease caused by bacteria and the purpose of antibacterial is to prevent the transmission of diseases caused by bacteria or other microorganisms (Glaser, 2004).
Triclosan has been in used for last 30 years, and the basic purpose of its use was mostly restricted to health care products. This was introduced in the health care industry for the first time in 1972 as surgical scrub. In the past few years, the application of triclosan has been transferred to many other products. A study conducted in 2000 showed that over 75% of liquid soaps and 30% of bar soaps contain some form of antibacterial agents (Glaser, 2004).
People get exposed to this chemical by purchasing these products. The use of these products makes an individual absorbs some amount of triclosan through mouth or skin. By now the low-level effects of triclosan on human health has been unknown. Though it has been said that skin products are having triclosan seldom or never causes, any irritation. But the research is further needed to be done to investigate the effects of triclosan on human health (Blanco-Munoz et al., 2010; Glaser, 2004).
Though there has been quite a lot of debate on the effective use of Triclosan. Contrarily, there is a serious debate that has already been started on the negative impact of Triclosan on human health. With the cases investigated where stances of antibacterial agents like Triclosan has been observed like in mother’s milk as well as water samples. This has been a hot issue in scientific circles.
Durbize et.al, (2003) reported that the constant exposure of chemicals may result in various diseases. Many such diseases may be attributed to the destruction of the immune system along with inflammatory malfunctioning. Immune system is considered as the basic system of every human body that needs to be concerned about. They pointed out that children having asthma may get develop lung's cancer later on in their lives. The people who are above 87, their immune deregulation can be attributed to another immune system problem known as dementia. So constant exposure to toxic chemicals may bring lifelong changes to respond the infectious agents typically in the immune system and overall physical along with mental health (Durbize et.al, 2003).
Chalubinski & Kowalski, (2006) found that a group of environmental toxic chemicals affecting the function of the immune system is known as Endocrine-Disrupting Compounds (EDCs) (Chalubinski & Kowalski, 2006). EDCs are those substances that are found in personal care products, food, pharmaceuticals. This has shown a negative effect on human health, metabolism, homeostasis and reproduction (Diamanti-Kandarakis, et al., 2009). Triclosan is also one of the forms of such EDC. The functioning of triclosan as an antibacterial agent opposes its countless accumulation in human fat tissues, human breast milk, umbilical cord blood and urine. The most common way of absorption of the chemical in the human body is through skin. Clayton et.al, (2011) conducted a study during 2003 to 2004 taking a sample of US general population having age greater than 6. In the study, it was shown that triclosan has been found as an unadjusted concentration of 2.4 to 3,790 μg/L in the urine of about 75% of Americans. Unfortunately, still the importance of this study has not been understood (Clayton et.al, 2011).
Though the initial data on safety shows starting tolerance of the human body to triclosan but more recent studies showed that it had some negative impact on the human nervous system. This chemical was first categorized under EDC in 2006 when a study pointed out that the triclosan decreases considerable body weight and accelerates thyroid hormone. This was also stated in the study that triclosan doesn't mimic thyroid hormone. It may affect their performance or function. It brings negative impact on body metabolism and development, not only in frogs but also all other species who depend on thyroid gland for signaling, and this also includes human. (Blanco-Munoz et al., 2010; Clayton et.al, 2011). The ability of triclosan to interfere the working of the endocrine system and its interaction with the immune system also suggests that the EDCs are largely targeting the immune functions. As per Recio et.al, (2005), such immunological changes caused by triclosan and other EDCs decreases the propagation of peripheral mononuclear blood cells along with the increased frequency of auto-antibodies. These changes have been observed in humans having job-related exposure to such chemicals (Recio et.al, 2005). There is no epidemiological data have yet been examined to verify that triclosan has an effect on the immune system.
Strachan, (1989) also showed that using triclosan as an antimicrobial agent may cause allergies in humans through hygiene hypothesis. This hypothesis has been completely evolved into a quite potential explanation. This also provided justification for the increasing number of allergy cases along with autoimmune diseases that have been observed in recent years especially in developed countries. This hypothesis has attributed the increase in the number of allergies to the more increasing clean and hygienic environments and reduced exposure to in particular infectious agents (Okada et.al, 2010). Exposure to any antimicrobial agent like triclosan means we are living in too hygienic environment. That may lead to the disturbance and disruption of the usual immune system development by changing or completely removing the commensal microbiota that help in shaping the immune system of human. (Levy, 2001). In a research study, it has been shown that triclosan may negatively affect immune function of humans. This was measured during the research by CMV antibody level along with hay fever or allergy diagnosis as well as differential results observed with age factors. (Clayton et.al, 2011).
Mechanism of Action of Triclosan
The mechanism action of triclosan block the most active sites of enoly-acyl reductase enzyme (ENR) which is considered an essential enzyme to synthesize fatty acids in bacteria (McMurry et.al, 1998). Triclosan stops these enzymes by blocking these active sites. Thus, the bacteria is prevented from synthesizing fatty acids that is a necessary factor for the building of the cell membrane that helps in permeability and reproduction (McMurry, Oethinger & Levy, 1998). Triclosan is considered as the most potential inhibitor of ENR. It binds to bacterial ENR encoded by the gene Fabl. This binding hence increases the affinity of enzymes for nicotinamide adenine dinucleotide (NAD+). As a result, a complicated but stable ENR-NAD+ triclosan is created, and only little concentration of it is required to inhibit bacterial growth. Humans doesn't produce this ENR enzyme. Thus, they don't get affected by this (Shaheed et.al, 2012).
Some researchers predicted that the triclosan having little concentration is not harmful to human health. Unlikely, other studies also suggest that the exposure to triclosan results in dermatitis and skin irritation. This happens in the case of increased dosages and higher concentration. Its contact with human skin in case of exposure to the sun of that particular part may cause photo allergic contact dermatitis (PACD). This results in eczematous rash on that particular area exposed to sunlight. Triclosan has also been observed regarding allergic reactions among children who get exposed to it in any form (Clayton et al., 2010). The triclosan retains its action after many hours of exposure so it means that washing hand with any hand wash or soap having triclosan; the human is at risk for many hours after its use. Queckenberg et.al, (2010) however believe that triclosan doesn’t have mutagenic, carcinogenic or teratogenic effects. On the contrary, there was research showing the increased levels of triclosan in human breast milk samples. This however showed that triclosan is absorbed in the body in high concentration (Adolfsson-Ericiet et. al., 2002). Similar results have been shown by the center for diseases control and prevention in 2011 stating that the presence of some concentration of triclosan in the urine doesn't mean that it will result in adverse effects on health. But bio-monitoring is need to be conducted in order to investigate and determine whether triclosan has reached toxic levels in the human body or not (Shaheed et.al, 2012).
Physicians for social responsibility (PSR) had conducted the first bio-monitoring evaluation of health care professionals in order to study the effect of triclosan on their health. In order to conduct this study, twelve doctors, and eight nurses agreed to be part of this study and be tested for the results. Their blood and urine were tested for six different chemicals including the triclosan. All those chemicals can be specifically identified as being the most dangerous or chemicals of concern. They are also known as endocrine disruptors and are reported by several studies to have played roles in causing different diseases in human bodies. The results of this study proved that each participant had 24 different chemicals at least in their bodies while two were having the highest number of toxic chemicals i.e. 39. Eighteen toxic chemicals were found in every individual that was tested. All participants had five out of six chemicals for which the team conducted this study, and thirteen participants had all six of them (Wilding, Curtis & Welker-Hood, 2009).
Regarding the consumer point of view, it has to be asked why the triclosan use is still allowed in different products like deodorants, blemish, face powder and so forth. Why these products cannot be preserved with alternative ways having lesser concerns? Human health affected by triclosan is not yet been completely justified by studies. But different recent studies do show that the exposure to triclosan do cause many problems along with disrupting immune system like muscle malfunctioning including the heart as well (Syed, 2014). US researchers have tried to expose mice and fishes to triclosan in order to study its effects on them and how it can then affect human health could be correlated. The chemical under study had shown adverse effects on the heart functioning along with other muscles in mice. Thus, researchers concluded that the exposure to triclosan can be worrying especially for the patients who suffer from cardiac problems (The European Consumer Organization, 2012).
Environment Ministry & the Environmental Protection Agency of Denmark recommended for its people to stop using products having triclosan due different negative impacts of triclosan on human health (The European Consumer Organization, 2012). This directive is in particular given to pregnant women. Though it has been observed equally that triclosan has been providing some benefits to the patients who are suffering from gingivitis. This is because it should be used in some quantity in oral products in strict limited concentration for a specified period. A report in consumer magazines on comparative product tests shows that there are products in the market available in different price ranges which don't have triclosan. Since those products are said to have higher prices, but this must not be that much an issue when health is concerned. The prices of all such products should be made lower by the governments so that consumers can enjoy a safe life using healthy products (The European Consumer Organization, 2012).
The need of the day is to work collaborated work to find out the most adverse effects of triclosan on human health in particular and the environment in general. Different studies by now have proved that triclosan does play a role in affecting human health negatively by targeting any of the major function or part of the body. This has been verified by experimenting its effect on animals. Now the strict measures need to be taken by concerned researchers and governments to make this message public and let people know what is beneficial to them and what is harmful to them. Through proper public service messages campaigns, that concern can be reached every individual who is using triclosan in some form. Farmers, beauticians, children, pregnant women, doctors and other health professionals and all should be aware of the negative effects of triclosan on them and the people around them. Further studies are needed to be conducted to explore this dangerous synthetic chemical. In this more comprehensive and valid results could be obtained. In addition, the chemical should be banned internationally to be used as preservative or antimicrobial agent.
Conclusion
In short, the complete investigation about the adverse effects of triclosan on human health needs to be investigated and determined in detail. The controlled and careful utilization of triclosan in hospitals as well as other institutions related to health or for the people having suppressed immune system is considered ideal. But any further use apart from this is not good and should be discouraged completely either it's not been in household products or cosmetics. Too much exposure to triclosan has both negative effects on human health along with the environment. The best way to eliminate the infection in human is use of warm water and ordinary soaps without triclosan for the cleaning and washing purposes. The soaps are having antimicrobial agents and should be discouraged at government levels. Consequently, the exposure to triclosan can be reduced to larger extent and human health along with the environment could be preserved. Researchers need to explore further impact of triclosan on health in order to formulate a strengthened opinion on adverse effects on human health. This will help in completely abandoning it to be used in different products. A large number of organizations including the national environment protection agencies, dentists associations, risk assessment associations, NGOs along with consumer organizations also recommend the consumers to remain away from the products that use triclosan. As a matter of fact, the mere informing or warning or recommending consumers may not work, and this may not equally be a appropriate step towards consumer protection from this toxic chemical. The more solemn steps need to be taken at higher levels like banning the use of triclosan in consumer products in industries and any such industry which uses this chemical should be banned. Only this is the mean to protect the environment to be get contaminated from toxic chemicals including both human and aquatic life.
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