Scientists Discover That Antimicrobial Wipes and Soaps May Be Making You (and Society) Sick
Scientists discover that antimicrobial wipes and soaps may be making you (and society) sick
A few weeks ago as I was walking out of a Harris Teeter grocery store in Raleigh, North Carolina, I saw a man face a moment of crisis. You could see it in the acrobatic contortions of his face. He had pulled a cart out of the area where carts congregate, only to find that its handle was sticky with an unidentifiable substance. He paused and looked at the handle, as if to imagine the nature of the offense. Gum? Meat juice? Chewed marshmallows? So many vulgar possibilities. Forlorn, he reached for an antibiotic wipe conveniently placed by the door. He scrubbed his hands VERY diligently and then pushed the cart back for someone else to rediscover.
Scenarios like this one are playing out all over America. There is an epidemic of sticky, dirty and otherwise gross handles on shopping carts. But it isn't just carts. Disgusting doorknobs have also been found, as have cryptically damp table-tops in restaurants and even, sad as it is, slimy back rests on the weight machines in gyms! Increasingly, the world seems to be rife with contamination. Fortunately, all of the main companies producing hygiene products have offered a solution--sanitary, antibacterial, antimicrobial, antibiotic, wipes, and soaps to kill anything that dares to creep into our wholesome lives. These salves will cure us of the demons that dare to grow near us.
The really intriguing news--a kind of breakthrough--is that the main compounds in antibiotic wipes, creams and soaps, triclosan and/or the chemically similar triclocarban, have also been sprinkled around our lives more generally. A recent study notes that triclosan is now used to "impregnate surfaces and has been added to chopping boards, refrigerators, plastic lunchboxes, mattresses as well as being used in industrial settings, such as food processing plants where walls, floors and exposed machinery have all been treated with triclosan in order to reduce microbial load." You can now go home, wipe your world down and live a happier life, surrounded by an antibiotic force field. Be especially sure to wipe your children down. Children are just about the grimiest thing in the world.
Yet, although I hesitate to digress or cause trouble, the devil on my shoulder, that voice of so-called reason, is urging me to avail myself of more than the vague suspicion that everything around me is contaminated. Maybe, the devil says, we should glance, just for a second, at what scientists like to call--in their nasally ivory-tower voices--"the evidence." I do not mean anything too fancy… Let's just take a moment to look at a study here and there that might be relevant as we go about coating our lives--from underpants to kitchen pans--in antibiotic wonder.
For example, what if we just considered whether people who wipe down the world around them with antibiotic soap or wipes are less likely to be sick. Of course, they must be. The world is gross and they are, God bless them, clean, but let's just check.
OK, we shouldn't have checked. There are some problems. One is the actual evidence, or just as often, lack thereof. Case in point: along with her colleagues, Allison Aiello, a professor at the University of Michigan, recently surveyed all of the experimental or quasi-experimental studies published in English between 1980 and 2006 on the effectiveness of different hand washing strategies [2]. Aiello focused on studies that compared different strategies, for example the use of normal soap versus the use of antibiotic soap, in terms of their effect on the probability of developing gastrointestinal or respiratory illness. Our intuition is that antibiotic soaps and wipes should make everyone healthier. Aiello's results were something else entirely.
Aiello's first result was fine enough, but it set the stage for the trouble to come. She found "the use of nonantibacterial soap with hand hygiene education interventions is efficacious for preventing both gastrointestinal and respiratory illnesses." In other words, if you wash your hands with soap (and are educated about washing your hands with soap) you are less likely to get sick. Score one for intuition and grandma's admonitions. But then things went terribly wrong.
Aiello next considered the antibiotic soaps and wipes now used, in one form or another, by 75% of American households. Odds are that you use them. Go check your labels. Sadly, Aiello and colleagues found that antibiotic soaps and wipes with triclosan were no more likely than good old-fashioned soap to prevent gastrointestinal or respiratory illness. In Aiello's words, "There was little evidence for an additional impact of new products, such as alcohol-based hand sanitizers or antibacterial soaps compared with nonantibacterial soaps, for reducing either gastrointestinal or respiratory infectious illness symptoms."
For example, in a study Aiello reviewed that was conducted in Pakistan, gastrointestinal illnesses were reduced by half when people washed their hands with soap and by a little less than half when they washed their hands with antibiotic soap [3]. What is worse, perhaps the most comprehensive study of the effectiveness of antibiotic and non-antibiotic soaps in the U.S., led by Elaine Larson at Columbia University (with Aiello as a coauthor), found that while for healthy hand washers there was no difference between the effects of the two, for chronically sick patients (those with asthma and diabetes, for example) antibiotic soaps were actually associated with increases in the frequencies of fevers, runny noses and coughs [4]. In other words, antibiotic soaps appeared to have made those patients sicker. Let me say that again: Most people who use antibiotic soap are no healthier than those who use normal soap. AND those individuals who are chronically sick and use antibiotic soap appear to get SICKER.
Here, then, is the evidence we need, evidence very clearly at odds with our intuition to scrub and scrub. Yet hardly anyone has followed up on Larson's study and no one has reexamined what happens with chronically sick patients and antibiotic soaps. The truth is that few biologists are studying what antibiotic soaps do to us. Still, the evidence indicates that when confronted with a dirty grocery store cart handle, we should just wash with soap and water like our great grandmothers would have done (if they had had grocery carts). At the very least, antibiotic wipes do not appear to help us and, it may be that they are actually hurting us.
The devil on my shoulder suggests we need to take the radical step of actually thinking for a second about what happens when you wash your hands, or whatever other part. This is a step almost never taken in the study of illness. Our skin (just like Lady Gaga's skin) is covered in bacteria species. More than a hundred species of bacteria (not to mention fungi and other kinds of organisms) can be found on a single hand of any given adult [5] or for that matter belly button, forehead or other part, at any given moment (Image of some of the more abundant bacteria in the author's belly button:http://www.wildlifeofyourbody.org/?page_id=8 ). It appears that those species include two main groups. There are the "native" species, our own bodily citizens that have evolved to live in peace on our skin and, in doing so, benefit us by acting as a kind of defensive layer. Then there are the tourists. It is these tourists that cause us harm, the tourists who bear chemical knives.
When you wash your hands, the goal is not to kill all the microbes. As Larson and a group of colleagues put it in a 2003 paper "Handwashing with a non-antimicrobial soap does little to modify the natural [citizen] flora. In fact, such an effect would be undesirable." What is desirable is, instead, to kill the tourists who have just turned up but not yet established, or at least the dangerous among those newly arrived species. Kill the tourists is a reasonable hand washing motto (although the truth is we still know surprisingly little about the citizens; they are the neglected serfs of our bodies). Soap is thought to be effective at killing the tourists, not always, but at least often, although this hypothesis has never been directly tested.
Source:Scientific American
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