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Aug 19, 2014, 2:12pm PDT UPDATED: Aug 19, 2014, 3:40pm PDT
UCSF study: Hand-wringing over hospital handwashing
Chris Rauber, Reporter-San Francisco Business Times
Handwashing using antibacterial soap may expose doctors, nurses and other hospital staffers to “significant and potentially unsafe levels of triclosan,” a commonly used chemical that’s under review by theU.S. Food and Drug Administration, according to a clinical study led by researchers at UC San Francisco.
Triclosan, described by UCSF as a “synthetic antibacterial agent,” is also found in thousands of consumer products, researchers said, including soaps, cosmetics, acne creams and some brands of toothpaste. A quick Google search found that Colgate’s Total toothpaste is one of them, and that Colgate has posted material defending the safety of the material.
UCSF said the FDA is reviewing triclosan’s safety based on research showing it can “interfere with the action of hormones, potentially causing developmental problems in fetuses and newborns, among other health concerns.”
A failure to properly wash hands is known to pose serious health risks. Many tens of thousands of deaths in U.S. hospitals each year are attributed to sepsis and other hospital-acquired infections, and many of those result from a failure to keep hands, clothes and equipment antiseptic. The Business Times reported on some of those risks in June.
The current study, published in the August issue of the Journal of Occupational and Environmental Medicine, compared urine samples from two groups of 38 doctors and nurses, at facilities identified only as Hospital 1 and Hospital 2. Staffers at Hospital 1 used an antibacterial soap containing 0.3 percent triclosan, while those at Hospital 2 uses plain soap and water.
The result, researchers said, was the staffers at the first hospital had “significantly” higher levels of the chemical in their urine than their counterparts at Hospital 2.
“Antimicrobial soaps can carry unknown risks, and triclosan is of particular concern,” Paul Blanc, M.D., a professor of medicine at UCSF and an expert in occupational and environmental medicine, said in UCSF’s Tuesday statement. He recommended using soaps and other products that don’t include the chemical, on the principle that “if you don’t know for certain that something is safe, it’s better to err on the side of caution.”
He also opined that the FDA has a duty “to carry out a review of this chemical and, if indicated, get it off the market.”
In a brief late afternoon telephone interview, Blanc said that the FDA currently has triclosan classified as a substance where there is “insufficient evidence” to determine its safety and efficacy — hardly a ringing endorsement from an agency that’s supposed to be protecting us from dangerous foods and drugs.
He also noted that many products are grandfathered in by the agency, and are “assumed to be safe” because they’ve been around for a long time.
Co-authors of the study included other doctors and researchers at UCSF, the Natural Resources Defense Council and Kaiser Permanente’s San Francisco Medical Center.
The August 2014 journal article, titled “Health Care Worker Exposures to the Antibacterial Agent Triclosan,” identified triclosan as a “potential endocrine disruptor.”
Colgate, in its online material, said its Total toothpaste uses a 0.3 percent triclosan formula “to fight harmful plaque germs,” and describing the chemical as having been deemed safe for such use by the FDA, the American Dental Association and other unnamed government agencies and other independent sources.
The Centers for Disease Control and Prevention, meanwhile, requires the use of antimicrobial soap both before and after certain types of “invasive activities,” such as caring for an IV or a urinary catheter, according to a fact sheet on UCSF Medical Center’s web site.
Chris Rauber’s beats include health care, insurance, nonprofits and the wine industry for the San Francisco Business Times.