Antibacterial products: helpful or harmful?
We uncover the pros and cons
Antibacterial products are meant to protect us, but are they putting us at risk in more ways than we realise? Louise Wedgewood uncovers the pros and cons, and the alternatives.
It’s hard to imagine life before antibiotics, when a dirty splinter could lead to illness, and common troubles like bladder infections and mastitis were not just painful but often deadly. Antibiotics are the miracle drugs we’ve come to rely on, but as bacteria become increasingly resistant to them, the Australasian College for Infection Prevention and Control has put out a drastic warning: “Prepare for a world without antibiotics.”
We tend to think of antibiotics as a limitless resource, like bandages, say, or light bulbs; we assume if we just keep manufacturing them then we can’t run out. Unfortunately, the more we use antibiotic and antibacterial products, the more resistant bacteria become. The antibiotics we have may eventually be useless and there aren’t any others in the pipeline. According to the July 2013 paper from the Office of the Chief Scientist: ‘Only one antibiotic that works in a novel way has been discovered and developed for use in humans in the last 50 years.’
There are two main ways we create resistant bacteria, says Professor Peter Collignon of the Australian National University Medical School. One is by needlessly giving antibiotics to livestock (because it promotes their growth) and the other is by giving them to people who have viral infections such as colds and flu. The Australian Medical and Veterinary Associations both recognise the problem and promote the responsible use of medicine. Yet millions of prescriptions are wasted each year in ‘treating’ patients with viruses, partly because some patients don’t realise antibiotics won’t help a cold.
Are we too clean?
A lesser-known contributor to resistant ‘superbugs’ is the antibacterial products proliferating in our homes – from soaps to sandwich bags; shaving gels to chopping boards. No one wants to get sick and when marketers try to scare us with the thought of germs growing everywhere, who could blame us for believing we need their products to stay safe? Gold Coast woman Donna Webeck relies on antibacterials to keep her family well. “I see them as a form of protection against the unseen...I am often swayed by a product which claims to have antibacterial qualities.” She uses antibacterial soap and dishwashing detergent, and uses antibacterial wipes on her daughter’s highchair to clean up the mess of each meal.
Alarmingly, it seems the more we use products like these to keep us safe, the more vulnerable we’re gradually becoming. Collignon explains that antibacterial products increase the resistance of bacteria either by altering the outside of them to become impervious to antibiotics or by changing their genetic code, which can happen very quickly. “Bacteria divide every 15 minutes, so they’re very good at evolution,” he says.
The downsides of using antibacterial products at home go beyond creating antibiotic resistance: they can disrupt our endocrine system, throw out our body’s balance of good and bad bacteria, impede the development of our children’s immune systems, and pollute our environment.
Triclosan
One of those risky chemicals is triclosan, and it’s the main antibacterial we’re overusing. It’s been used since the 1970s and you’ve probably seen it listed on hand soap and face wash, but when you look you’ll find it everywhere – toothpaste to rubbish bags, laundry detergent to deodorant, and even socks and underwear designed to resist getting smelly. Aside from its contribution to antibacterial resistance, triclosan is a suspected endocrine-disrupting chemical.
Another unintended consequence of all antibacterials is that they indiscriminately do away with both helpful bacteria and harmful ones. After taking a course of antibiotics, you might have experienced what can happen without enough beneficial bacteria in our bodies. For example, thrush can get out of control and our digestion can be impaired.
Children’s development can also be hindered if they’re not exposed to enough germs. Heather Ellson, Brisbane mum to twin girls, is one believer that exposure to bacteria is vital in developing a healthy immune system. “I don’t mean licking the rubbish bin,” she says, “we just don’t need to be squeaky clean.”
Research from the Johns Hopkins Children’s Center found evidence that backs up Ellson’s mother’s intuition. A 2012 study concluded that exposure to antibacterials…“may make children more prone to a wide range of food and environmental allergies.” When poorly developed immune systems do come into contact with allergens and bugs, they can overact and produce allergies and asthma.
The effects of antibacterial products don’t end when we wash them away or throw them in the bin. Collignon warns: “The more of these products you use, the more is going down the drain and into the environment, and then it comes back to you.” Once they’re in the environment, they continue to interact with bacteria that learn to become more resistant.
The feeling of safety that antibacterial products try to give us can actually discourage more effective action. For example, we might start to think that using antibacterial soap means thorough hand washing is not as important.
“I’ve seen some ridiculous products such as (antibacterial) garbage bags – how is that going to prevent infection? And in sandwich bags! It lulls us into a false sense of security because it’s not going to prevent food poisoning, which actually comes from leaving food out of the fridge, etc. We’re getting misleading messages from advertisers that say: ‘Use these products and you’ll be OK,’” says Collignon.
People who want nothing more than their nearest and dearest to ‘be OK’ may feel torn between the longer-term risks of antibacterial products and the short-term dangers of getting sick, not to mention the time away from work and other commitments that few of us can afford. This need to stay well motivates Webeck to choose antibacterial products. “I am a germ-phobe – basically because I have a low tolerance for getting sick!”
Fortunately our mothers and grandmothers were right all along about the best ways to avoid getting sick – it means washing your hands before meals and after the toilet, keeping raw and fresh food separate, and rinsing fruit and vegetables. Plain soap and water has been demonstrated to reduce bacterial load just as effectively as antibacterial soap does; but if you can’t wash your hands, gels are a good option.
Checking the label
Webeck admits to being a “huge fan” of hand sanitiser. “I’ve two in the house, one in my handbag and one in the nappy bag. I feel it’s a great go-to option when you’re out and about and (the kids) touch a bin, public toilet seat or tap.”
Collignon agrees they’re a good idea in these circumstances and other high-risk situations such as visiting or working in a hospital or caring for someone who’s very ill or has open wounds. “We recommend using alcohol gel on your hands...because it evaporates off and doesn’t have the residual effect,” he says. It’s this residual effect of chemicals like triclosan that really gives bacteria the chance to adapt and become resistant.
Ellson follows the old-fashioned rules and has avoided antibacterial products for 11 years. “Even if these (chemicals) are only present in tiny amounts in a product, I don’t want anything with such potential health implications anywhere near me or my children.” Her traditional approach covers her whole home: “I use environmentally friendly cleaning cloths all over the house and also use the classic DIY cleaning products of lemon, bi-carb and vinegar.” She’s satisfied with the level of hygiene these methods create. “I’m very confident that we are safe – both from bacteria and from chemicals. The proof is in the pudding. My children rarely, if ever, get sick and I can’t remember the last time there was a tummy upset for anyone.”
If you too want to avoid antibacterials entirely, check the label when you’re buying things like hand soap, detergent and toothpaste. If you prefer to use antibacterial products, find out whether the active ingredient is triclosan or something else, like alcohol and hydrogen peroxide, which are also effective but don’t have the residual effect.
Even while research into the consequences of antibacterials continues, for Professor Collignon the bottom line is clear. “Some antibacterial products do have a benefit...but we should reserve them for high-risk situations. We know they are contributing to antibacterial resistance and we’re using more than we need.”
