Organization calls on U.S. hospitals to phase out hand soaps containing problematic antimicrobials, adopt products that are safer for patients, staff, and environment

A scientific consensus statement published today in Environmental Health Perspectives concludes that commonly used chemicals meant to kill germs have concerning implications for human health and the environment.

Widely used in health care, two antimicrobials — triclosan and triclocarban — are also found in more than 2,000 types of products, including hand soaps, clothing, toothpaste, toys, carpets, plastics, and paint. Triclosan and triclocarban are endocrine disruptors, are associated with reproductive and developmental impacts in laboratory animal studies, and are likely to pose similar risks in people. Human epidemiology and animal studies also suggest triclosan exposure can increase sensitivity to allergens. Exposure in people is widespread: A CDC study showed triclosan was detectable in the urine of the majority of Americans.

Because of the ubiquity of their use, triclosan and triclocarban are also found widely in the environment, including in waterways. Both have been shown to have detrimental health impacts on aquatic organisms.

“In the last decade, we have questioned the use of these chemicals in hand soaps while at the same time, we’ve seen a rush to add them and other antimicrobials to many products in hospitals in response to the rise in health care associated infections without proven benefits,” said Ted Schettler, MD, statement co-author and Health Care Without Harm senior advisor. “While the evidence of adverse impacts in people merits further study, when taken together with the widespread exposure to these two chemicals and the evidence of harm to other species, their widespread use should be discontinued.”

The scientific consensus statement — called the “Florence Statement” — also includes an urgent call to only use antimicrobial chemicals, including triclosan and triclocarban, when they provide an evidence-based health benefit. Issued by the Green Science Policy Institute, the statement follows a 2014 recommendation by the Society for Healthcare Epidemiology of America against the use of triclosan-containing soap in health care facilities because of the lack of evidence of its superior clinical effectiveness compared to other products, concern about promoting antibiotic resistance, widespread human exposures, and potential adverse health effects.

Triclosan-containing soaps are no more effective at cleaning hands than regular soap and water in most circumstances, and safer alternatives do exist. Health Care Without Harm is working with leading hospitals and health systems that have already made the move to green-certified hand soap products manufactured without antimicrobial agents. In addition to the health benefits, these health systems and hospitals are finding that moving to green hand hygiene products is cost neutral or a cost savings.

“This comprehensive analysis from scientists across the globe leaves little room for doubt: We need to eliminate hand soaps containing triclosan and triclocarban from our health care facilities in order to protect people and the planet,” said Rachel Gibson, Health Care Without Harm’s Safer Chemicals program director.“We are already seeing hospitals step up and lead in removing these chemicals from hand soaps in their systems, and we urge others to follow their lead.”  

Practice Greenhealth, Health Care Without Harm’s membership organization, will launch a Hand Soaps Challenge in September, encouraging its more than 1,100 hospital members to take the health-protective step of eliminating hand soaps with these problematic chemicals. Suggested alternatives and steps for implementation will be provided.

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Click here for the full statement from the Green Science Policy Institute.

About Health Care Without Harm

Health Care Without Harm seeks to transform the health sector worldwide, without compromising patient safety or care, so that it becomes ecologically sustainable and a leading advocate for environmental health and justice. To learn more about Health Care Without Harm, visit www.noharm.org.

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