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“It’s ironic that the chemicals we’re deploying in vain for one health crisis are actually fueling another,” Erica Hartmann, a co-author of a new study examining the dangers of disinfectants and an associate professor of civil and environmental engineering at Northwestern University, said in a statement.
Hartmann and colleagues’ new study, published today in Environmental Science & Technology, examines quaternary ammonium compounds, or quats, which are used in disinfectants and personal care products. They reviewed the existing environmental and human health science on quats, which have been used much more since the pandemic began, and found that the compounds are linked to asthma, dermatitis, inflammation, infertility, birth defects and other problems. They can also harm aquatic life and cause antimicrobial resistance, which can make drug-resistant viruses and bacteria.
“Antimicrobial resistance was already contributing to millions of deaths per year before the pandemic, Hartmann said. “Overzealous disinfection, especially with products containing [quats], threaten to make it worse.”
Quat use and exposure
Quats can be found in disinfectants, baby wipes, eye drops, hair conditioners, fabric softeners and other products.
Credit: Claudio Schwarz/Unsplash
Quats can be found in disinfectants, baby wipes, eye drops, hair conditioners, fabric softeners and other products. There was a spike of disinfectant use when the COVID-19 pandemic began, increasing exposure, and researchers saw an associated spike in quats in people. People are mostly exposed via their skin and breathing quats in, but food and water could be other potential sources of exposure. Certain professions, including housekeepers, food or medical equipment preparation, dental assistants and nurses, are more highly exposed. Children and teachers may also have elevated exposure.
“Disinfectant wipes containing [quats] are often used on children’s school desks, hospital exam tables and in homes where they remain on these surfaces and in the air,” Courtney Carignan, a co-author and assistant professor at Michigan State University, said in a statement.
The most common quat is benzalkonium chloride, but if you see ingredients on labels that end in “ammonium chloride,” there are probably quats in the product. The authors point out that U.S. regulation varies — pesticides, for example, list quats, while paints do not. Most quats are unregulated, and so are not tested for health impacts. This makes it a challenge to tease out how much people are exposed or what the health impacts are.
While the feds haven’t tested the compound, academic researchers have linked the chemicals to multiple health problems, and the authors point out that there is evidence going back more than 70 years that the chemicals spur antimicrobial resistance.
“Antimicrobial resistance was already contributing to millions of deaths per year before the pandemic. Overzealous disinfection, especially with products containing [quats], threaten to make it worse,” Hartmann said.
Using safer cleaning products
Anastasia Swearingen, director of the Center for Biocide Chemistries, which is part of the American Chemistry Council, told EHN in an email that quats have been "rigorously evaluated for their human health and environmental safety and remain important chemistries used to protect public health."
Quats "also help preserve products and improve product sustainability. While disinfection is not always necessary, there are many important government guidelines, rules and disinfection protocols in place to reduce outbreaks of infectious diseases," she added.
However, the authors of the new study recommend not using quat-containing compounds when the chemicals are unnecessary. Soap and water usually do the trick — and if you need a disinfectant, University of Massachusetts Lowell has a guide to safer products.
Related: How to shop for cleaning products - while avoiding toxics
“Drastically reducing many uses of [quats] won’t spread COVID-19,” Carol Kwiatkowski, a co-author and scientist at the Green Science Policy Institute, said in a statement. “In fact, it will make our homes, classrooms, offices, and other shared spaces healthier.”
Read the full study at Environmental Science & Technology.
It’s been nearly eight years since the filing of the first US lawsuit alleging that Roundup weed killer and other herbicides made by Monsanto can cause non-Hodgkin lymphoma (NHL).
The lawsuit kicked off nationwide litigation that ultimately included more than 100,000 plaintiffs and unveiled long-hidden corporate secrets.
After plaintiffs won the first three trials, Bayer AG, which bought Monsanto in 2018 as the first Roundup trial was getting underway, agreed to pay more than $11 billion to try to settle the litigation, and pledged to withdraw Roundup and other glyphosate-based products from the US consumer market. Though most plaintiffs have now settled, many opted out of the settlement, and trials around the US are continuing.
Chadi Nabhan, MD, MBA, a lymphoma specialist formerly with the University of Chicago, has been a key expert witness in many of the plaintiffs’ cases, including those who won the first three trials.
In his new book, Toxic Exposure: The True Story behind the Monsanto Trials and the Search for Justice, Nabhan gives readers a behind-the-scenes look into how he and other experts working for the plaintiffs’ lawyers pieced together a complicated scientific puzzle made up of numerous studies to convince jurors of the company’s liability and the link between Roundup and NHL.
The book details what it was like for Nabhan to join the fight against Monsanto, explains how the trials affected his life’s trajectory, and highlights the struggles faced by plaintiffs suffering from cancer. Environmental Health News sat down with Nabhan to discuss the link between Roundup and NHL, his experiences at the trials, and what he thinks the public should know.
Q: Why was it important for you to share your experience with readers, and what do you hope they take away from your book?
A: When I went through these three trials, there was a lot of information that I learned through my own research, as well as through the legal proceedings, that I suspected the general public may not be aware of. I strongly feel that making people aware of the information about Roundup and its link to non-Hodgkin lymphoma is critical.
In February of 2019, I was being cross-examined by Monsanto’s attorney Brian Stekloff. And one of the things that he challenged me with was that I wasn’t going around the country and telling people about Roundup, its risks, and its association with cancer and lymphoma. And my answer was that I didn't know that I could, since the trials were ongoing. He told me, in front of the judge, “No, actually, you can.” The minute he said that, I started thinking about the best way to share this information with the public. Writing a book to the general public seemed to be the best way to disseminate the information broadly.
My hope is to raise more awareness about the scientific link between Roundup and non-Hodgkin lymphoma. I hope readers really understand how I came to the conclusion that Roundup is not safe, and that patients need to be aware of the risks. I also hope that the general consumer does not take things at face value all the time. It’s okay to be a skeptic and ask questions. Monsanto always contended that if the Environmental Protection Agency (EPA) said glyphosate was safe, then it was safe. I think what the readers are going to notice is that just because the EPA said it's safe, it doesn't necessarily mean it's safe. I really hope that this leads to more people asking critical questions, because ultimately, we all could be in the shoes of these patients.
Q: Since 1974, over 1.7 million tons of glyphosate-based weed killers were sprayed on fields, lawns, and gardens worldwide, making the potential human health impacts of Roundup and similar products enormous. Can you explain the link between Roundup and non-Hodgkin's lymphoma? How did you arrive at the conclusions you did about that link?
A: Whenever you want to try to explore the causation and association between a compound and the development of cancer, such as non-Hodgkin lymphoma, you have to look at the totality of evidence. You cannot look at one piece of evidence and ignore another. So first, we look at mechanistic studies: Is there evidence out there that human cells, when they are exposed to glyphosate, develop damage to their DNA? Second, we look at animal studies. Are there animal studies to demonstrate that exposure to Roundup or glyphosate causes tumors or cancers in animals? Third, we look at epidemiologic studies. So, is there epidemiologic evidence that people exposed to glyphosate have a higher risk of developing cancer or non-Hodgkin lymphoma than people that are not exposed?
We have to put all of these types of research together to come to the conclusion that there is a link. Since the trials have concluded, there have been more papers that have shown the link between Roundup and the development of non-Hodgkin lymphoma. In fact, there was a paper published a few weeks ago that showed that the risk of developing non-Hodgkin lymphoma after glyphosate exposure is almost double that of people who have not been exposed. So, more evidence keeps coming out.
This does not mean that every person who sprays Roundup will develop non-Hodgkin lymphoma. And this does not mean that Roundup causes every case of non-Hodgkin lymphoma. So I think we have to be careful. But could Roundup cause non-Hodgkin lymphoma in some patients? Yes. That's the main issue.
Q: What did the trials teach you about the US regulatory system, and whether it successfully protects the public?
A: Roundup was sold commercially for the first time in the United States and around the world in 1974, and at the time, the EPA was a very young agency. It did not have as many scientists, as many epidemiologists, or as many experts as it has now.
What we know from regulatory records is that some very early studies backed by Monsanto turned out to be fraudulent, and one very large study the company submitted to the EPA initially led EPA scientists to say glyphosate should be classified as possibly carcinogenic. But the EPA ultimately overturned the opinions of its lower-level scientists and agreed with Monsanto that glyphosate should be classified as not likely to be carcinogenic.
What has happened with Monsanto and Roundup should make us demand a higher level of scrutiny and rigor from the regulatory agencies. I was very disappointed with the EPA continuing to say that glyphosate is safe, and it was a claim that Monsanto always relied on. I'm very happy that the legal team and the jury were able to see through these arguments, but I worry a lot about something similar happening in the future.
Toxic Exposure: The True Story behind the Monsanto Trials and the Search for Justice is out now.
