Antimicrobial resistant infections keep rising despite fall in GP prescriptionsBMJ 2020; 371 doi: (Published 18 November 2020) Cite this as: BMJ 2020;371:m4502
All rapid responses
Antimicrobial resistance may not be the only matter of concern.
The public have been exhorted to frequently wash their hands or apply hand sanitisers to the skin and many products are on the market. A recent television advertisement advised,”Use biocides with care”.
HSE states that, hand sanitisers, “are biocidal products and are regulated by the Health and Safety Executive (HSE)….Product manufacturers and suppliers are responsible for ensuring that their products are suitably effective, including meeting any necessary testing standards…..(and) are also responsible for providing information and instructions for the user on the product label”. (1)
A random selection of six hand sanitisers for sale online by a well-known retailer revealed that the ingredient triethanolamine (TEA) featured in 50% of them, concentration unspecified.
A published report on the Safety Assessment of Triethanolamine, concluded that, “TEA (is) safe for use in cosmetic formulations designed for discontinuous, brief use followed by thorough rinsing from the surface of the skin. In products intended for prolonged contact with the skin, the concentration of ethanolamines should not exceed 5%”. (2)
According to Cosmetic Ingredient Review, Association of Occupational and Environmental Clinics, and the U.S. National Library of Medicine, “there is strong evidence that Triethanolamine is a human skin, immune system and respiratory toxicant. One or more animal studies show sense organ effects at very low doses, especially when used around the mouth, eyes and lips, and one or more in vitro tests on mammalian cells show positive mutation results. It has been shown to cause bladder and liver cancer, as well as changes in testicles”. (3)
Where is the evidence that the frequent, transdermal absorption of biocides over a long period of time is safe? And may it potentially pose more of a health hazard than the one it is designed to avoid?
Competing interests: No competing interests