This Global Handwashing Day, say NO to antiseptic soaps!

by Dr. Merlin Franco

Global Handwashing Day (GHD), celebrated annually on 15 October, is an occasion promoted by the ‘Global Public-Private Partnership for Handwashing with Soap (PPPHW)’, which is a coalition of international stakeholders whose focus is handwashing and child health.

However, what most of us do not know is that the ‘stakeholders’ of this partnership include at least two major corporate organisations who own major brands of handwashes, particularly the ubiquitous antiseptic ones that assure us a germ-free life.

This article is not another article dealing with the much celebrated matrimony between corporations and global entities such as the World Health Organisation (WHO). Rather, it intends to question the need for antiseptic soaps in every home and the stigmatising of human-to-human contact.

How many times have we come across advertisements for handwashes claiming to kill 99.9% of germs? Have we ever wondered what happened to the remaining 0.1%? Personally, I find it perplexing that such advertisements mysteriously increased after the advent of the Global Handwashing Day. How effective are these antiseptic soaps?

Most of the antiseptic soaps or handwashes contain compounds such as triclosan and its chemical cousin triclocarbon. Triclosan was introduced in 1972 to control germs in hospitals and other high-risk settings. However, it gradually became a household name, becoming the principal component in toothpastes, anti-bacterial soaps and handwashes, toilet cleaners, floor cleaners, plastics and even children’s toys.
Various studies have shown that triclosan and triclocarbon can cause health problems such as skin irritation, endocrine ailments and bacterial antibiotic resistance.

A year-long study undertaken by Aiello et al. (2005) in 238 households of Colombia and published in the journal ‘Emerging Infectious Diseases’ shows that regular use of antibacterial soap with 0.2% triclosan provides no benefit over ordinary non-antiseptic soap in reducing infection-causing bacteria and infectious diseases in the normal household setting.

Another article led by the same author and published in the journal ‘Clinical Infectious Diseases’ in 2007 confirms the inefficacy of handwashes containing triclosan in preventing infections.

Likewise, a study by Luby et al. on the effect of hand washing on child health, published in the reputed journal ‘Lancet’ in 2005 demonstrates beyond a doubt that the antiseptic soaps with triclocarbon (1.2%) offer no advantages over non- antiseptic ones.

Their study involving 306 households in a suburb in Pakistan shows that washing hands with plain soaps (non-antiseptic) is enough to control infectious diseases such as pneumonia and diarrhoea and their efficacy is equivalent to that of antiseptic soaps containing triclocarbon.

A recent study led by Neilson (2013) published in ‘BMC Microbiology’ shows that Staphylococcus aureus, a bacterium that commonly causes respiratory tract infections and food poisoning develops resistance to triclosan after multiple exposures.

It should be noted here that the products containing triclosan do not claim to eradicate 100% germs. By partially eradicating germs in our skin, we are unknowingly ‘selecting’ the population that is more tolerant to germs.

A recent research led by Druri published in the journal ‘Environmental Science and Technology (2013)’ shows that triclosan that is dumped into streams can disrupt their microbial composition. In their experiment, triclosan caused a dramatic increase in the population of cyanobacteria while drastically reducing the population of algae.
The air we inhale contain millions of microbes and their spores which are generally ‘harmless’ to the average healthy human being. The same can be said about the human skin. The human body is an ecosystem in itself, as it is host to numerous microbes that constitute the ‘normal flora’ of the human body.

Some of the common bacteria living in human bodies include Staphylococcus epidermidis, Streptococcus mutans, Enterococcus faecalis, Streptococcus pneumoniae, E. coli, Bifidobacterium bifidum and Lactobacillus acidophilus. Of these, Bifidobacterium bifidum and Lactobacillus acidophilus are considered as friendly bacteria as both of them live in the intestines.

Bacteria other than the ‘friendly’ ones turn into potential pathogens when the host human being’s immune system becomes weak or when they get an opportunity to ‘invade’ localities where they are not commonly found. For instance, Streptococcus pneumoniae is normally found in the upper respiratory tract. Yet, it can cause pneumonia if it happens to invade the lower respiratory tract.

In addition to these bacteria, there are also numerous fungi whose population is ‘controlled’ by competing bacterial species. Removal of the bacterial species alone from the skin will escalate the fungal population leading to diseases such as Candidiasis.

The key to a healthy life is a healthy immune system which can be developed only if one comes into contact with the germ. Children who are exposed to different pathogens might develop resistance after multiple exposures while others do not. Emerging infectious diseases are mostly caused by viruses that are airborne and chances of encountering them do not depend on the ‘clean’ nature of our hands.

I have come across people who apply sanitisers to their hands every time they shake hands with a stranger or before having meals. Personally, I would prefer to have a few bacteria in my hands than these antiseptics which are either proven to be hazardous or simply waiting their turn. I wouldn’t dare to use a sanitiser unless I visit the infectious diseases ward of a hospital or a public toilet.

The floors of my home or toilets are not equivalent to my food plate and I do not require them to be germless and sparkling clean as I know that the toilet cleaners that I flush down the loo indiscriminately are harmful to the bacteria that live in human waste and decompose it.
‘Did you know? Infectious diseases can be transmitted through contact with people or surfaces.’ This is a famous marketing line used by a major handwash brand. Yes, diseases can be transmitted from people to people through contact but I doubt if these transmissions can be prevented by the use of antiseptic soaps and handwashes. What I know for sure is that love and goodwill can be transmitted through these handshakes and hugs and humankind desperately needs them more than any antiseptic soap.

This Global Handwashing Day, I will be renewing my pledge NOT to use antiseptic handwashes and soaps. How about you?

Dr. Merlin Franco is an ethnobiologist working with the Curtin Sarawak Research Institute (CSRI) at Curtin Sarawak. Prior to joining CSRI, Dr. Franco was working with Earthwatch Institute, a premier global research institute. At CSRI, his research focuses on the interrelationship between biodiversity, people and culture. In 2011, he received the Young Scientists for Rainforests Award from the Conservation Foundation, UK, for his PhD work. He can be contacted at +60 85 443 939 ext. 5039or by e-mail to mfranco@curtin.edu.my.