What is the risk for the fetus if the mother uses triclosan containing products during pregnancy an

Fråga: What is the risk for the fetus if the mother uses triclosan containing products during pregnancy and what is known concerning triclosan and breast-feeding?

Sammanfattning: There is limited documentation concerning the safety of triclosan exposure during pregnancy and breast-feeding. Triclosan has been found in human breast milk, but possible effects on the breast-fed infant has not been evaluated. The concentration limit for triclosan in available products in Sweden is 0.3%.

Svar: Triclosan is a chlorinated phenoderivative used as an antiseptic agent, effective against gram positive, most gram-negative bacteria and fungi but with variable or poor activity against Pseudomonas spp (1). It is an over the counter preparation primarily used in soaps, creams, solutions for disinfection of the hands or skin and in oral hygiene products (1).

There is limited documentation in the literature concerning the safety of triclosan exposure during pregnancy and breast-feeding. This stated in a handbook that solutions of triclosan are considered relatively safe during pregnancy if not used in stronger concentrations than 2% and only on intact skin (2). However, this is not based on clinical data. A relevant absorption must be assumed with higher concentrations (2). No fetal deaths or increased malformations have been observed in animal studies using high doses (up to 400mg/kg) (3). Triclosan has been found at measurable concentrations only in three out of five randomly selected human breast milk samples (4). However, there is no documented outcome in the breastfed infants or at what extent the pregnant mothers were exposed to triclosan. It is not possible based on these data to evaluate whether infants exposed to suggested levels of triclosan through breast-milk can be at risk of untoward effects.

In the only long-term study published of 108 subjects using toothpaste during seven months, no adverse effects were observed (5). None of these individuals were pregnant. The main concern of triclosan is not if it exerts direct toxic effects in humans, but whether it can cause a major increase of the risk of resistant bacteria, which scarcely has been reported (1,4).

According to the Medical Products Agency only 0.3% triclosan is allowed in available products (eg toothpaste) in Sweden (6).