Crossover Control Study of the Effect of Personal Care Products Containing Triclosan on the Microbiome

Poole, Angela C.; Pischel, Lauren; Ley, Catherine; Suh, Gina A.; Goodrich, Julia K.; Haggerty, Thomas D.; Ley, Ruth E.; Parsonnet, Julie

doi:10.1128/msphere.00056-15

Cited by 58 publications

(68 citation statements)

References 48 publications

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“…There was no evidence of an association in any of the analyses. Similarly, the cross-over trial by Poole et al (2016) found no evidence that TCS exposure affects serum levels of free or total testosterone.…”

Section: Puberty Endpoints In Girlsmentioning

confidence: 99%

“…One of the methodologically strongest studies in this category was the double-blind, randomized, crossover trial assessing the effect of TCS on human microbiome (Poole et al 2016). In that study, participants were randomly assigned to receive TCS-containing or TCS non-containing household and personal care products for 4 months and then switched exposure arms for an additional 4 months.…”

Section: Methodsmentioning

confidence: 99%

“…Of the 43 studies, 24 were conducted in North America (Wolff et al , 2010(Wolff et al , 2015Clayton et al 2011;You et al 2011;Buttke et al 2012;Savage et al 2012Savage et al , 2014Koeppe et al 2013;Lankester et al 2013;Buser et al 2014;Spanier et al 2014;Adgent and Rogan 2015;Li et al 2015;Ihde et al 2015;Shiue 2015aShiue , 2015bVelez et al 2015;Ashley-Martin et al 2016;Buckley et al 2016;Poole et al 2016;Scinicariello and Buser 2016;Smarr et al 2017;Geer et al 2017), two studies in the Caribbean (Watkins et al 2015;Aker et al 2016), 10 studies in Europe (Allmyr et al 2009;Chevrier et al 2012;Philippat et al 2012Philippat et al , 2014Bertelsen et al 2013;Buhl et al 2014;Den Hond et al 2013, 2015Geens et al 2015;Lassen et al 2016), four in Asia (Chen et al 2013;Wang et al 2015;Xue et al 2015;Zhu et al 2016), and three in Australia (Cullinan et al 2012(Cullinan et al , 2015a…”

Section: Overview Of Studiesmentioning

confidence: 99%

“…In the previously cited double-blind, randomized, crossover trial assessing the effect of TCS on human microbiome (Poole et al 2016), the authors also examined whether the participants demonstrated any weight gain during the TCS vs. non-TCS intervals (each interval was 4 months duration). Six subjects gained weight (defined as increase of at least 0.6%) in the TCS phase but lost weight or stayed at the same weight in the non-TCS phase; however this result was not statistically significant (p ¼ 0.22).…”

Section: Measures Of Overweight and Obesitymentioning

confidence: 99%

“…Allmyr et al (2009) conducted an experimental study comparing health biomarker levels before and after intentional TCS administration and observed significantly higher plasma TCS levels following the 14-day study intervention (0.009-0.81 ng/g and 26-296 ng/g: ranges before and after exposure, respectively). Poole et al (2016) used a cross-over experimental study design and included measurements of TCS in five urine samples for each study period with clear evidence of increased exposure during the intervention phase. Smarr et al (2017) used one sample in a study of reduced fecundity but explored the extent of error by conducting a separate analysis restricted to couples with a shorter time to pregnancy.…”

Section: Exposure Assessmentmentioning

confidence: 99%

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Systematic review of the literature on triclosan and health outcomes in humans

Goodman

Naiman

LaKind

2017

Critical Reviews in Toxicology

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The ability of epidemiologic evidence to inform regulatory decisions is largely dependent on the coherence and quality of the published literature. This systematic review examines the quality and consistency of studies assessing health outcomes associated with exposure to triclosan (TCS), an antimicrobial chemical with a short physiologic half-life. We used elements of the Biomonitoring, Environmental Epidemiology, and Short-Lived Chemicals instrument to evaluate aspects of study quality. Each methodological domain -overall design, exposure assessment, and data analysis -was categorized according to three tiers where Tier 1 indicated the highest quality. We also examined consistency of methods, results and reporting as considerations for weight of evidence (WOE) assessment. Studies were considered sufficiently comparable if they addressed the same or similar research questions. Forty-two studies met the criteria for inclusion. Only one randomized cross-over clinical trial of TCS was assigned to Tier 1 for all three domains. Most other studies were assigned to Tier 3 for at least one domain. Although the available literature examined more than 100 different health endpoints and reported hundreds of different measures of association, few studies were considered comparable. For reported measures of association, most were not significantly different from the null; the few statistically significant results represented isolated findings without a discernable across-or within-study pattern. We conclude that the current body of epidemiologic literature does not allow a meaningful WOE assessment due to methodological limitations of individual studies and lack of inter-study consistency. On the other hand, methodologically stronger studies may be used to inform future research. ARTICLE HISTORY

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Section: Puberty Endpoints In Girlsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Overview Of Studiesmentioning

confidence: 99%

Section: Measures Of Overweight and Obesitymentioning

confidence: 99%

Section: Exposure Assessmentmentioning

confidence: 99%

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Systematic review of the literature on triclosan and health outcomes in humans

Goodman

Naiman

LaKind

2017

Critical Reviews in Toxicology

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Temporal dynamics of gut microbiota in triclocarban-exposed weaned rats

Kennedy

Fling

Robeson

et al. 2018

Environ Sci Pollut Res

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Widely used as an antimicrobial in antibacterial bar soaps, triclocarban (3,4,4'-trichlorocarbanilide; TCC) is effective against Gram-positive bacteria but shows little efficacy against Gram-negative strains, potentially altering the composition of indigenous microflora within and on the human body. To date, the consequence of continuous or previous nonprescription antimicrobial exposure from compounds in personal care products on commensal microflora is still elusive. Previous research has shown that TCC exposure during gestation and lactation induced dysbiosis of gut microbial communities among exposed dams and neonates. However, the impact of antimicrobial exposure specifically after discontinuation of the use of TCC on the gut microbiota has not been investigated. In this study, weaned Sprague Dawley rats (postnatal day, PND 22) were provided ad lib access to TCC-supplemented diet (0.2% w/w or 0.5% w/w) for 4 weeks (phase I) followed by a 4-week washout period (phase II) to determine gut microflora changes both during continuous exposure to TCC and to determine the potential rebound following TCC withdrawal. Fecal samples were collected at baseline (PND 22) prior to TCC exposure and throughout phase I and phase II. The V4 region of 16S rDNA was sequenced from extracted total fecal DNA with the MiSeq platform. Exposure to both 0.2% w/w and 0.5% w/w TCC was sufficient to alter diversity of microbiota during phase I of treatment. This effect was further prolonged into phase II, even when TCC exposure was discontinued. Collectively, these data highlight the impact of both continuous and prior TCC exposure on gut microbial ecology and shed light onto the potential long-term health risk of daily nonprescription antimicrobial personal care product use.

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