Just Washing Your Hands Is What Makes The Difference
People are fighting a war on germs.
With more and more reported cases of E. coli, salmonella and staphylococcus, it seems you can’t watch television or go to the grocery store without being bombarded by messages for antibacterial products.
These days you can clean your bathroom with them, wash your hands in them and give your kids toys that are coated in them. A company in Japan is even working on an antibacterial steering wheel.
Antibacterial products make up 30 percent of the $2.1-billion hand-, dish- and bath-soap market, according to the ACNielsen Co.
But, experts warn, people should not be too quick to jump on the antibacterial bandwagon.
“They’re probably safe, and they’re probably not helpful,” says James Todd, M.D., director of clinical microbiology and epidemiology at Children’s Hospital and a professor of pediatrics and microbiology at the University of Colorado Health Sciences Center.
“It depends on the product. Generally, what I can say about these things is that they make intuitive sense. ‘Gee, if I add antibacterial things to these soaps or these children’s toys, everything is going to work out fine.’ But it turns out that the most important thing about soaps is that you’re actually washing your hands.”
Regular vs. antibacterial
The difference between regular and antibacterial products is that the latter actually kill a certain percentage of germs as opposed to just washing them away.
“(Regular soaps) lower the surface tension of water and allow it to get down around the follicle and down into crevices of the hand,” says Lumpkins. And, Todd says, regular soaps do take care of about 99 percent of the unwanted bacteria.
Antibacterial products are basically a great marketing technique, says Tyler Curiel, M.D., co-chairman of Infection Control for the University of Colorado’s Health Sciences Center. “There are clearly viruses and bacteria that these products can kill that soap will not be able to.”
For example, say you’re at the gym, and you cut yourself and get blood on the weight machines. Antibacterial cleaners probably would do a good job of cleaning up the potentially dangerous bacteria, but Curiel says Clorox and alcohol will do the job just as well if not better.
“I do, however, also think that good old warm water and soap is good for most activities,” says Curiel. “They (antibacterial products) are not dangerous. They’re just more product, and there’s more of a chance to get an allergic reaction or a dermatitis reaction.”
Are they safe?
Ingredients in antibacterial products go through an over-the-counter drug review with the Food and Drug Administration. That process involves proving that the product is effective and safe.
The jury is still out on antibacterial products, says Debbie Lumpkins, a microbiologist with the Food and Drug Administration’s Division of Over-the-Counter Drug Products. There just isn’t enough data to show that they are effective and safe.
But Rita Niemeyer of Boulder, Colo., knows more than she’d like to about antibacterial products.
In February of 1996, Niemeyer started experiencing what seemed like neurological problems. And she was scared. Her hands felt shaky, she had pains in her arms and legs, and she no longer could take walks with her husband. She worried that she was showing early signs of multiple sclerosis.
So she went to see her internist, who diagnosed her with hypothyroid, gave her some medication, and told her she should feel better soon.
The problems didn’t get better. They got worse.
In March, she saw an opthamologist because her vision was blurred. She was diagnosed with migraines.
In April, she began seeing an acupuncturist who told her that she was deficient in vitamins and minerals, so she began taking Chinese medicinal herbs - to no avail.
She also saw a nutritionist and a neurologist, each of whom had their own diagnosis.
By this time, Niemeyer had become obsessed with her health, keeping track of what she was eating, various products she was using, her routine.
“I don’t drink coffee, alcohol or pop,” she says. “I eat a very low-fat diet, and I exercise every day and have for the past 20 years. At one point, I felt so terrible that I think I had a panic attack. I thought I was going to die.”
It wasn’t until September, during a 2-1/2-week trip to Boston, that Niemeyer finally made the connection between all the antibacterial products she was using at home - dish and hand soap, sponges and kitchen cleaners - and her illness. She felt fine while in Boston, where she wasn’t exposed to any of these.
Lumpkins says it’s likely that Niemeyer had an allergic reaction to the products. Curiel says it’s even possible she had absorbed enough of the product into her system to give her a toxic reaction.
“As with any over-the-counter product,” Lumpkins says, “there’s going to be some segment of the population that has the potential to react to the product.”
Niemeyer has since thrown out all of her products that claim to be antibacterial. And all but about 5 percent of her symptoms are gone. She even has heard from several people who are having the same kind of symptoms she did.
“I never would have dreamed that soap could make me feel that bad.”
Do they work?
Antibacterial soaps are popular at many day-care centers.
But, “It’s been well shown in day-care settings that if you just wash your hands after changing a diaper and before you prepare food, you could reduce illness,” says Todd. “It doesn’t say anything about what you use. E. Coli is in every child’s stool. So you’ve got E. Coli all over your hands. All you need to do is wash your hands with regular soap and water. That’s what mothers have been doing for hundreds of years.”
And even if you do use antibacterial hand soap, you won’t be able to kill all the germs on your skin.
Besides, says Todd, “The antibacterial substance may take many minutes to hours to work. You can’t kill bacteria instantaneously with the stuff you can put in soap. The only thing that can kill bacteria instantly is fire. The best thing to use is iodine in alcohol. That used to be called Tincture of Iodine, and the reason we don’t use it anymore is that it not only kills the bug, but it also kills the skin.”
Which brings up a concern about toys that claim they have antibacterial qualities. Most of these toys, Todd says, come with assurances that the ingredients won’t rub off in a child’s mouth.
“For the substance to kill the bacteria, they have to be soluble,” Todd says. They have to be able to attach to the bacteria to kill them. “If they won’t leach out and hurt your kids, they’re not going to leach out and hurt the bacteria.”
Triclosan is one ingredient that many of these products - including some of the toys - contain. It can kill bacteria such as staphylococcus, E. Coli and salmonella. But it can’t kill all infectious bacteria. And the FDA hasn’t finished its review of triclosan yet, Lumpkins says, because it hasn’t been able to prove that it is safe or effective.
The FDA’s Nonprescription Drugs Advisory Committee and the Anti-infective Drugs Advisory Committee are working together to try and keep tabs on these products.
Could they pose a threat?
The combined advisory committee is also trying to figure out a way to keep track of whether problems with bacterial resistance arise from use of these products.
“The committee said it didn’t see there was a cause for concern,” Lumpkins says. “But knowing the history of antibiotic resistance, the committee (decided it) should set up something for surveillance of the products.”
Todd says the idea that these products might add to the problem of bacterial resistance is not far-fetched.
“There is some reason to worry about that,” says Todd. “Whenever you kill bacteria with certain substances, they can develop a resistance to that substance.”
Todd’s advice at this point is to stick with regular soaps and cleaners. Theoretically, bacterial resistance could occur, he says. “But we don’t know for sure. I would say to somebody, ‘Prove to me that your product really reduces illness in children, if that’s what people are worried about…. Don’t tell me how they kill germs in laboratory tests because my kid isn’t a laboratory. You prove to me that if you take 100 kids, they’ll have 50 percent less illness.’
xxxx THERE REALLY IS A RIGHT WAY TO WASH HANDS Knight-Ridder We all know that washing our hands can help stop the spread of germs. But do you know how to wash your hands? It sounds like a silly question. But to do a good job, there are a couple of things you need to keep in mind: The key is to wash frequently. That means after you go the bathroom, change a diaper, sneeze, cough or blow your nose, take care of someone who’s sick, or play with a pet, and before you prepare or eat food. Make sure you are particularly meticulous during cold and flu season and try to keep your hands away from your mouth and face. Use soap and lather thoroughly (between 30 and 60 seconds) making sure you scrub all surfaces including the backs of your hands, wrists, between fingers and under fingernails. Then it’s important to rinse your hands in warm water, which helps produce a better lather. While the water is still running, dry your hands and use a dry area of the paper towel or towel to turn the water off so you don’t recontaminate your hands.