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Health Care Worker Exposures to the Antibacterial Agent Triclosan

MacIsaac, Julia K. MD, MPH; Gerona, Roy R. PhD; Blanc, Paul D. MD, MSPH; Apatira, Latifat MD, MPH; Friesen, Matthew W.; Coppolino, Michael MD; Janssen, Sarah MD, PhD, MPH

Journal of Occupational and Environmental Medicine: August 2014 - Volume 56 - Issue 8 - p 834–839
doi: 10.1097/JOM.0000000000000183
Original Articles

Objective: We sought to quantify absorption of triclosan, a potential endocrine disruptor, in health care workers with occupational exposure to soap containing this chemical.

Methods: A cross-sectional convenience sample of two groups of 38 health care workers at separate inpatient medical centers: hospital 1 uses 0.3% triclosan soap in all patient care areas; hospital 2 does not use triclosan-containing products. Additional exposure to triclosan-containing personal care products was assessed through a structured questionnaire. Urine triclosan was quantified and the occupational contribution estimated through regression modeling.

Results: Occupational exposure accounted for an incremental triclosan burden of 206 ng/mL (P = 0.02), while triclosan-containing toothpaste use was associated with 146 ng/mL higher levels (P < 0.001).

Conclusions: Use of triclosan-containing antibacterial soaps in health care settings represents a substantial and potentially biologically relevant source of occupational triclosan exposure.

Supplemental Digital Content is Available in the Text.

From the Division of Occupational and Environmental Medicine (Drs MacIsaac, Blanc, and Janssen), Department of Medicine, and Department of Laboratory Medicine (Dr Gerona and Mr Friesen), University of California, San Francisco; Natural Resources Defense Council (Drs MacIsaac and Janssen), New York, NY; and Kaiser Permanente Medical Center (Drs Apatira, Coppolino, and Janssen), San Francisco, Calif.

Address correspondence to: Julia K. MacIsaac, MD, MPH, Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, 1600 Divisadero St Suite 1661, San Francisco, CA 94115 (

This research and publication was supported by the Passport Foundation, Science Innovation Fund, and the Natural Resources Defense Council (NRDC), Science Center, as well as the National Center for Advancing Translational Sciences (NCATS), the National Institutes of Health, through University of California, San Francisco Clinical and Translational Science Institute grant number UL1 TR000004. Drs MacIsaac and Blanc received support from the Northern California Educational Resource Center–Occupational Safety and Health Education Residency Training (T-42- OH008429 Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health) and an Occupational & Environmental Medicine Residency Training Enhancement Award (D33HP19037 Health Resources and Services Administration). Dr MacIsaac worked as a paid consultant for the Natural Resources Defense Council, a nonprofit environmental advocacy group. The authors would like to thank the Occupational Physicians Scholarship Fund and the National Institute of Occupational Safety and Health for funding a 1-year training fellowship in Occupational Medicine for Julia MacIsaac, wherein a portion of this research was completed. Isabel Allen PhD, performed data analysis as a paid consultant at the Clinical and Translational Science Institute at the University of California, San Francisco.

The contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Neither the Passport Foundation nor NCATS participated in the design or conduct of the study nor were these organizations involved in the collection, management, analysis, or interpretation of the data or the preparation, review, or approval of the manuscript. The NRDC was involved in the design and conduct of the study, as well as the collection, management, analysis, and interpretation of the data. The NRDC was not involved in the review or approval of the manuscript.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2014 by the American College of Occupational and Environmental Medicine