Plain soap and water

mom and son washing hands

Cropped image. Cade Martin and Dawn Arlott, PIXNIO. CC license.

How many times a day do doctors wash their hands? Dozens, perhaps. And they encourage us to follow effective hand-washing techniques as well.

“But, the conversation shouldn’t end there”, according to Dr. Paula Kim, M.D. with Beaumont Health, clinical professor at Wayne State University’s School of Medicine, and associate professor at Oakland University William Beaumont School of Medicine. She says, “The next questions are: What type of soap is used at home? Is it an antibacterial? Or is it plain soap and water?”

The Centers for Disease Control, American Medical Association, U.S. Food and Drug Administration, and others overwhelmingly encourage people to use non-antibacterial (plain) soap and warm water, and to rub hands together for a minimum of 20 to 30 seconds.

Why plain soap? Isn’t an antibacterial product more effective? Surprisingly, no. In 2013 the FDA challenged manufacturers of over-the-counter antibacterial hand and body soaps to prove that their products are more effective at killing germs than plain soap and water. And they couldn’t do it.

“There’s no data demonstrating that these drugs provide additional protection from diseases and infections. Using these products might give people a false sense of security,” says Theresa M. Michele, M.D., of the FDA’s Division of Nonprescription Drug Products.

Due to health risks, including bacterial resistance, the FDA banned manufacturers from using almost all antibacterial chemicals, including the widely used triclosan. Manufacturers of hand and body soaps (soaps intended to be used with water) have until September 2017 to switch their formulations. The new rule affects most of the liquid hand soaps and bar soaps currently on the market. It does not affect hand sanitizers or hand wipes.

Health risks

The FDA is heeding the warning of research showing that the use of triclosan can lead to bacteria that are resistant to antibiotics, making them ineffective. The agency also expressed concern over triclosan’s potential hormonal effects. According to the FDA, “…recent studies have demonstrated that triclosan showed effects on the thyroid, estrogen, and testosterone systems in several animal species, including mammals, the implications of which on human health, especially for children, are still not well understood.”

Other organizations, such as the Canadian Environmental Law Association (CELA), have found — in addition to concerns about endocrine activity — triclosan carries risks for the reproductive system and brain development.


We likely use at least one product every day that contains triclosan. Antibacterial chemicals are added to thousands of products, including household cleaners, cosmetics (including deodorant, toothpaste and mouthwash), clothing, furniture, lunchboxes, backpacks, food packaging, kitchen utensils, children’s toys and more. But the chemical doesn’t simply stay in those products. Researchers found triclosan in household dust, in streams and other waterways, in wildlife, in human plasma and breast milk, and in drinking water.

Indeed the multitude of exposure paths was a driving factor behind the FDA’s original inquiry. According to a September 2016 FDA Consumer Update factsheet, Antibacterials? You Can Skip It – Use Plain Soap and Water, “…people’s long-term exposure to triclosan is higher than previously thought, raising concerns about the potential risks associated with the use of this ingredient over a lifetime.”


Many people use antibacterial soaps without knowing they are using an OTC drug. Shoppers should watch out for the word “antibacterial” or the phrase “kills germs”. Generally, we find these words and phrases reassuring. But remember that it isn’t necessary to kill all the germs, but to simply remove them with plain soap and water. Then wash them down the drain. A drug facts label on a soap or body wash is a sign a product contains antibacterial ingredients. As Dr. Kim always encourages her patients, “Read the label on anything you buy. Read what’s in it!”

More information

You don’t have to settle for toxic triclosan in your household cleaners either. Dr. Kim suggests her patients to “use natural things if possible, such as vinegar and water.” White vinegar is a food-grade anti-microbial that can kill germs on surfaces. Or look for Clean Well brand soaps and sanitizers, which use thyme oil as the active ingredient to kill germs. Some of the Seventh Generation brand cleaning products include the Clean Well technology also.

– Melissa Sargent, Environmental Health Educator with LocalMotionGreen at Ecology Center. For more information, you can email her at or visit

Research Says Older Grandfathers Equal Higher Autism Risk in Grandchildren

grandpaAs we noted in an earlier post, we’re highlighting some recent autism-related research findings this month.

You may already know that autism has been linked to increased maternal and paternal age, but a very interesting Swedish study was just published in the Journal of the American Medical Association, climbing even further back in the family tree.

As it turns out, the age of a child’s grandfather also contributes to a child’s relative risk of developing autism. Men who were over 50 when their children were born were more likely to have a grandchild with autism. Older men with daughters were 1.79 times more likely to have a grandchild with autism, and men who had sons when they were 50 or older were 1.67 times more likely to have a grandchild with autism.

The mechanism appears to be related to the fact that cellular mutations in the reproductive cells increase with age. For example, the male germ cells of a 20-year-old man have undergone 200 divisions, and by 40, they’ve divided 660 times. That’s a lot of opportunity for what scientists call “copy errors”. As an analogy, imagine making a copy on a piece of paper, then copying that copy, then copying the third copy, etc. Now do it 660 times. The later copies don’t quite like the original, do they? Obviously, our bodies do a much better job of copying our genetic information than a copy machine, but nonetheless, the risk of genetic mutations rises with age.

No one investigated whether the grandfathers themselves had been diagnosed with autism or other related disorders. The researchers noted that it is possible that men with psychiatric disorders may be more likely to become fathers at an older age. However, other research has controlled for the effects of mental illness and still found the link to paternal age. This suggests that the real key is in the reproductive cells, and all that copying.

The highest risk, as you can imagine, was for children born to older parents, who themselves had older parents. However, the contribution of grandpaternal age was independent of the age of the child’s parents.

Does this mean that older parents should not have children? Of course not! Many factors contribute to the risk of developing autism, most of which are not yet fully understood. The study’s authors state, “Older men should not be discouraged to have children based on these findings, but the results may be important in understanding the mechanism behind childhood autism and other psychiatric and neurodevelopmental disorders” (Frans, et al., 2013).

Remember, please help spread autism awareness this month, and throughout the year! The more you know, the more you can help.

—Lori J. Warner, Ph.D., LP, BCBA-D, Director, HOPE Center

Are Autism Rates Rising?

autism statsThis month, we’re highlighting the fact that April is Autism Awareness month. Here at Beaumont’s Center for Human Development, we focus on diagnostic assessment, and our HOPE Center provides treatment services. Although we are not part of the group of scientists researching the potential causes of autism, we follow the literature carefully so we will know the latest findings. To that end, we’ll discuss some recent research each week this month.

You may have seen news coverage recently regarding the newest CDC survey results that were released stating that autism prevalence may have risen from 1:88 to 1:50. It can become confusing. What’s the “real” number? What is making the numbers rise or fall? Whenever a new survey comes out, it’s important to know what goes into the data. We want to compare apples to apples, so to speak. Comparing the 1:88 number to the 1:50 number is more like comparing apples to oranges.

  1. Type of Survey. The previous survey that found 1:88 children had been diagnosed with autism was a different type of CDC survey, that asked parents to provide information and then double checked responses against medical records. That gives us a very solid idea of what prevalence is, and if other surveys find similar numbers, we have even more confidence. The newest survey, finding 1:50 children had autism was based upon parent telephone survey alone. This means that there was no independent verification of the answers parents gave. These responses may have been quite accurate, but we don’t know that until we verify with some other type of survey or medical information.
  2. Age of Target Child. The 1:88 data referred only to children who were 8 years old at the time of the survey. The 1:50 data referred to children aged 6-17 years at the time of the survey. So we are looking at a broader age range in the newer survey.

However, there are some indicators that despite the differences in how the data were collected, the autism diagnosis rates may have actually risen. This same type of survey (parent report only), when last conducted in 2007, found about 1:86 children had been diagnosed with autism. That’s very similar to the 1:88 found in the other CDC survey based on 2008 data, which was verified through medical records.

The authors of the latest survey note that the increase was found mainly for boys (girls’ autism rates did not change significantly) and for older children, who were diagnosed after 2008. So those later diagnoses would not have been captured in the earlier data, but those children did actually have autism. When children are diagnosed at later ages, it’s almost always the case that they are more mildly affected by their autism. More severely affected children are typically diagnosed at a young age.

Taken together, these data suggest that autism rates may truly be on the rise, again. I don’t know about you, but I was already appalled at the 1:88 number! This is a public health crisis, and we need to find out what’s causing this disorder. We know that parents, medical professionals, and educators are all more aware of the signs of autism. We know that many communities now have better access to diagnosis and treatment services. Undoubtedly, that explains some of the increase we’ve seen over the last few decades. Nonetheless, these numbers are higher than just a few years ago, when these factors should not have been dramatically different.

It’s heartbreaking and frustrating to those of us touched by autism to see these numbers increasing, and we are hopeful each day that there will be a breakthrough to stop the rising tide of autism diagnoses. We love working with our children and their families, and they are all heroes to us, but we wish that they didn’t have to struggle with all the challenges autism brings.

Stay tuned for more autism news, and help spread autism awareness this month, and throughout the year! The more you know, the more you can help.

—Lori J. Warner, Ph.D., LP, BCBA-D, Director, HOPE Center