Myths and Facts of Disinfectants: Health and Environmental Effects of Common Disinfectants

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Myths and Facts of Disinfectants Health and
Environmental Effects of Common Disinfectants

• Womens Voices for the Earth
• February 4, 2009
• Ann Blake, Ph.D.

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Health Effects of Common Disinfectants General

• Skin, eye, respiratory irritation
• Asthma immune system hazards
• Endocrine disruption/ reproductive hazards
• Emerging subtle neural effects
• Disruption of neuronal cell-signaling systems
• Indoor air quality
• interactions with ambient air pollutants
• Unknown nano-silver

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Common Active Ingredients

• Triclosan
• Currently used in over 75 of liquid hand dish
  soaps (at 0.5-3.0)
• Registered pesticide 40 formulations approved
  for use by US EPA in 140 types of consumer
  products
• Triclocarban
• Used in over 30 of bar soaps
• Quaternary ammonium compounds (QACs, quats,
  ammonium chlorides)
• Consumer all-in-one surface care products
• Bleach
• Nano silver
• Usually embedded in products (fabric, clothes
  washers, baby bottles)

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Health Environmental Effects of Actives
Specific

• TCS/ TCC
• Endocrine disruptor of unusual type
• Enhances effects of testosterone and estrogen in
  vitro
• Concentrates in biosolids, breaks down to dioxins
  with UV exposure (such as from use in crop
  fertilizer)
• QACs
• Skin irritation contact dermatitis occupational
  asthmagen
• Immune adjuvant enhances immune response to
  irritants
• Reproductive hazard causes genetic damage to
  reproductive cells
• Bleach
• Corrosive, respiratory hazard, eye skin
  irritation
• Aerosols generally
• Respiratory irritation enhanced by small particle
  size
• Less effective in terms of disinfection

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Health and Environment Asthma

• Asthma
• Known occupational hazard in medical settings
  from disinfectants
• 2007 EU Respiratory study claims 1-in-7 cases of
  asthma can be attributed to use of household
  cleaning sprays and air fresheners asthma has
  tripled in Europe in the past 30 years
• Pediatric asthma has increased 4.3 per year from
  1980 to 1995
• Indoor Air Quality (Nazaroff, UC Berkeley, CA Air
  Resources Board)
• Cleaning agents and air fresheners contain
  chemicals that are Hazardous Air Pollutants
• Exposures measured, and higher than expected
• Terpenes pinenes,d-limonene, terpinene (pine
  oil) also aldehydes (e.g. citronellal, geranial
  in fragrances)
• Reactions with ambient ozone to create secondary
  hazards
• Hazards poisonings from mixing bleach ammonia
• Asthma, allergy, respiratory impacts from
  exposure to
  cleaning products, VOCs in home
• Glycol ethers, hydrocarbons

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Emerging Issues Nano

• Nano silver
• 235 products listed by Woodrow Wilson nano
  tracking list as having nano-Ag as embedded
  disinfectant
• also seen in liquid hand soap, toothpaste, pet
  shampoo, fabric softener, baby bottles,
  deodorizers, ATM buttons..
• Immune system effects reduce immune systems
  ability to respond to pathogens

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TCS/ TCC

• Widespread human exposure
• 2003-2004 NHANES found TCS in the urine of 75 of
  Americans (Calafat, CDC 2007)
• No differences due to race/ ethnicity or sex
• Concentration peaks at age 20-29 and in
  households with income 20K and gt 40K year
• In girls aged 6 to 8, found in 61 of urine
  samples (Mt. Sinai, 2007)
• In breast milk and urine, US and Sweden
• Linked to use of personal care products
• USGS 1 ppm in most surface waters
• Found in 58 of 85 streams studied
• Wastewater treatment plants are the biggest
  sources of TCS, TCC (2002 USGS study)

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In vitro Effects

• In human cell culture androgen/ estrogen activity
  assay (developed for PCBs and dioxin compounds)
  (UC Davis)
• TCC increased gene expression that is normally
  regulated by testosterone.
• In male rats fed TCC testosterone-dependent
  organs such as the prostate gland grew abnormally
  large female rats had higher uptake of water in
  the uterus
• More potent anti-inflammatory than Tylenol,
  NSAIDs, aspirin
• New endocrine disruption mechanism enhance
  effects of testosterone and estrogen
• All previous studies of endocrine disruptors show
  they generally act by blocking or decreasing
  hormone effects
• Neurotransmitter Receptor Assay
• At 100-1000 nanomolar concentration TCS, neurons
  fire randomly, then get desensitized to
  environmental stimuli
• Apparent mechanism disruption of calcium
  channels responsible for key cellular activity,
  including signaling, gene transcription, growth,
  migration, cardiac function.
• Response at lower levels than currently seen in
  human urine

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Environmental Impacts

• Already a hazard for microbes, algae, crustacea,
  fish at existing environmental concentrations
• Potential for thyroid hormone disruption
• TCS disrupts TH-mediated development in tadpoles
• At 10 micromolar concentration, impacts on liver
  enzyme (PXR) that breaks down TH
• Bioconcentration in earthworms
• 90 different anthropogenic waste indicators
  studied at Colorado State University, top three
  were
• TCS _at_ 10 ppm
• DEHP _at_ 20 ppm
• 1,7 dimethylxanthine, a coffee metabolite
• TCS had highest BCF at 10.8, and as high as 39.6
  in an Oregon hayfield with repeated land
  applications of biosolids

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Concerns

• Increased inclusion in consumer products, often
  unknown to the consumer
• Over 1 billion/ year spent on consumer products
  containing antibacterials/ antimicrobials
• Massive increase in wastewater and biosolids
• 9 ppb in influent, 10x reduction in effluent, 5
  orders of magnitude concentration in biosolids
  50- 68 ppm combined
• TCS 20 ppm median, TCC 10 ppm median
• 12 million tons/ year of biosolids generated, of
  which 50 are land-applied
• Accumulating in biosolids applied to food crops
• 10-25 ppm TCS/ TCC in biosolids land-applied to
  food crops
• Persistence under land-applied aerobic
  conditions,
• TCS lt I yr, TCC gt 10 yrs
• TCS contains dioxin contaminants, degrades into
  chloroform or dioxin upon exposure
  to UV

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Quaternary Ammonium Chlorides

• Traditionally used in medical settings
  increasingly added to consumer disinfecting
  cleaners
• Known occupational asthmagens
• Now found in every municipal water system at ppm
  concentrations
• Emerging data show immune adjuvant effects (pig
  farmers using disinfectants)
• Possible contributor to drastic rise in pediatric
  asthma
• Nature, June 2008 Patricia Hunt, who highlighted
  hazard of BPA leaching from plastic.found the
  same thing for ammonium chloride disinfectants
  used on her mouse cages

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Antibacterial Soaps

• Plain soap and water as effective in general use
  as antibacterial soaps
• AMA 2002 No data support the efficacy or
  necessity of antimicrobial agents in such
  products. Considering available data and the
  critical nature of the antibiotic-resistance
  problem, it is prudent to avoid the use of
  antimicrobial agents in consumer products."
• FDA 2005 "The data we saw said handwashing was
  pretty effective, plain handwashing, and there
  was no data that was very convincing that
  antiseptic handwashing was substantially more
  effective."
• FDA to study efficacy of use for food handlers,
  health care workers vs. general consumer public
• Resistance to one antimicrobial often associated
  with cross-resistance to other compounds
• Poison control stats show cleaning chemicals, Rx
  are highest poisoning causes

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Childhood Poisonings

• Cosmetics and personal care products accounted
  for over 13 of poisonings in children five years
  old or under, with household cleaners a close
  second at nearly 10 of poisonings in this same
  group. Antimicrobial compounds make up another 3
  of childhood poisonings in young children. Food
  poisoning and food products, by contrast, make up
  1.4 of poisonings. For all poisoning cases,
  regardless of age, analgesics exceed cosmetics,
  personal care products and household cleaners at
  12. Analgesics are the third most likely source
  of childhood poisonings1.
• 1 2006 Annual Report of the American
  Association of Poison Control Centers' National
  Poison Data System (NPDS) Alvin C. Bronstein
  Daniel A. Spyker Louis R. Cantilena Jr Jody
  Green Barry H. Rumack Stuart E. Heard, p. 18
  Tables 17A and 17B http//www.aapcc.org/archive/An
  nual20Reports/06Report/200620Annual20Report20F
  inal.pdf

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Antibacterial resistance
Antibiotics given to animals 'helping spread
superbugs' Over-use of antibiotics on livestock
is helping potentially lethal human infections
become more resistant to drugs, an expert has
warned.   By Joanna Corrigan Last Updated
720PM BST 10 Aug 2008 New strains of MRSA and
E.coli have already developed in animals and are
starting to transfer to humans, according to
Richard Young, policy adviser to the Soil
Association.
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Whats actually necessary?

• WASH YOUR HANDS REGULARLY
• CLEAN FIRST physically removes most
  disease-causing organisms
• http//www.cdc.gov/ncidod/op/_resources/OOP20Broc
  hure2012.20.05.pdf
• Safe food handling reduces biggest home-based
  illness sources
• Per USDA Clean, Separate, Cook, Chill
• Microwave sponges
• Disinfect if someone in your house is immune
  compromised (chemo, autoimmune, etc.) or
  currently sick
• CDC http//www.cdc.gov/Features/FightGerms/

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Additional Resources

• Antimicrobial presentations, October 2008 _at_ UC
  Davis http//www.epa.gov/region09/waste/organics/s
  ymposium/index.html
• Environmental Working Group http//www.ewg.org/rep
  orts/triclosan
• Beyond Pesticides
• http//www.beyondpesticides.org/pesticides/factshe
  ets/Triclosan20cited.pdf
• Antibiotic resistance http//www.cdc.gov/ncidod/e
  id/vol7no3_supp/levy.htm
• Manufacturers
• Ciba http//cibasc.com/index/ind-index/ind-per_ca
  r/ind-pc-ah/ind-pc-triclosan.htm

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• Environmental and Public Health Consulting
• 510-769-7008
• annblake_at_comcast.net
• www.annblake.net