Soap, water are best for handwashing | Columns | tucsonlocalmedia.com

Mia Smitt is a longtime nurse practitioner. She writes a regular column for Tucson Local Media.

Studies show that plain soap and water are as effective for hand washing as antibacterial soap. However, the latter may contain harmful ingredients.

In 2016, the Food and Drug Administration (FDA) banned several chemicals found in antimicrobial soaps. The FDA then deferred a decision on three of these chemicals — benzalkonium chloride (BAC), benzethonium chloride (BZT) and chloroxylenol (PCMX) — for one year to allow more safety testing.

The deferment is still in effect. Environmental and health agencies continue to urge the FDA to ban these chemicals in household products. Their use has increased since the COVID-19 pandemic.

These chemicals are quaternary ammonium compounds (QACs), a class of chemicals used as antimicrobials, preservatives and antistatic agents and for other uses in cleaning, disinfecting, personal care products and durable consumer goods.

A study in Environmental Science and Technology (May 8, 2023) covered triclosan and triclocarban. They were banned (except in prescription preparations) because manufacturers could not prove that they were safe for daily use or more effective than plain soap and water in preventing the spread of illness.

The Toxic Use Reduction Institute at the University of Massachusetts has recommended that QACs be formally listed as toxic or hazardous substances. Nature Neuroscience, (March 25, 2024) published a report linking BAC, BZT and PCMX to reproductive, skin, respiratory and neurological harms by impairing the development of oligodendrocytes, those special cells that are critical for central nervous system development and functioning.

“Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water,” reported Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.

“In fact, some data suggest that antibacterial ingredients may do more harm than good over the long term,” she continued in a 2016 report after the initial ban. No evidence to the contrary has been presented since. Some are concerned that they contribute to worldwide bacterial resistance.

The Centers for Disease Control and Prevention (CDC) recommends good old-fashioned hand washing with soap and water .over antimicrobial products.

“Following simple hand washing practices is one of the most effective ways to prevent the spread of many types of infection at home, at school, and elsewhere,” said the FDA’s Dr. Theresa Michele. “We can’t advise this enough. It’s simple, and it works.”

Hand washing with soap and water effectively removes germs from hands. There is a formula that has been proven to work: using running water, wet hands, lather with soap and scrub, including between fingers, backs of hands, and under nails.

Germs from unwashed hands can get into our eyes, noses and mouths when we inadvertently touch our faces after touching something contaminated. Unwashed hands can also transfer germs directly to other people and indirectly from objects such as toys, tabletops and handrails.

Hand sanitizers are an acceptable second choice if soap and water are unavailable (such as after pumping gasoline into your car). Sanitizers must be at least 60% alcohol, and still, they are not as effective in removing some microbes, including norovirus and clostridium difficile (both can cause life-threatening diarrhea).

Mia Smitt is a longtime nurse practitioner. She writes a regular column for Tucson Local Media.

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