Benzalkonium Chloride – Unsafe in Any Product
Every day there seem to be a few more cleaning and personal care products containing Benzalkonium Chloride (BAC) and closely related chemicals. In response to recent concerns about children ingesting alcohol based hand sanitizers a number of companies have been aggressively promoting hand sanitizers containing Benzalkonium Chloride as an alternative. Several have gone as far as marketing this synthetic biocide as “Natural.”
This is a deeply disturbing trend and reflects either a callous indifference or lack of awareness to the growing body of evidence that long term exposure to BAC and related chemicals is associated with significant health risks. These include asthma, chronic dermatitis and other immune system disorders. I urge everyone to consider very carefully before you decide to bring products containing Benzalkonium Chloride into your home.
Benzalkonium Chloride and its close relative Benzethonium Chloride are synthetic germicides belonging to the large group of germicides known as “Quats.” Quats have been around for the past 70 years and have been such a huge success that they are now found in literally tens of thousands of cleaning products, disinfectants, and a wide range of personal care and first aid products. On a global scale, millions of metric tons of these chemicals are produced every year and work their way from the chemical plants where they are manufactured into a dizzying array of consumer, industrial products, and food products, before finally ending up in our homes, the environment and our bodies. While there remains controversy about the biodegradability of these chemicals, there is little controversy that the massive annual production has overwhelmed the capacity of the environment to eliminate them. Quats are accumulating at an alarming rate especially in urban, commercial, and domestic settings where they are regularly used.
The position of the manufacturers and trade associations is that Quats are safe because they have passed extensive testing and have a long history of use. But toxicology testing has limitations and it would be a mistake to assume that achieving a “Pass” on tests means that Quats are safe for daily exposure over a long period of time. Industry and regulatory toxicology standards are very good at determining the risk as a mutagen, from ingestion, inhalation, and exposure to the skin or eyes. However they cannot be used to clear a chemical for long term, low level exposure. In fact, no testing methodology exists that can definitively determine the safety of long term low level exposure.
In fact, over the past twenty years, there has been a growing body of evidence that long term daily exposure to these chemicals is associated with a number of serious health problems suggesting immune dysfunction and hypersensitivity. Numerous studies have implicated exposure to Quats as the leading cause of occupational asthma and chronic dermatitis in janitorial and healthcare workers. Those occupations with the highest rates of occupational asthma also have the highest exposure to Quats. Similarly, there is a compelling correlation between dramatic increase in childhood asthma and the exposure to Quats through household disinfectants, sanitizers, and personal care products.
However compelling, clinical correlations are not proof that chronic exposure to Quats causes asthma and other health problems, a position that several industry trade groups have been quick to occupy. Clinical correlations do, however, raise a red flag that a causal relationship might exist and for this reason alone, the issue cannot be ignored. Prudence alone would dictate that we pay attention whenever the chemical exposure is as massive and ubiquitous as Quats, because the cost of being wrong is also massive. At the very least, there already is more than enough evidence to conclude that continued exposure to Quats may be a risk factor for the asthma and act accordingly. This is particularly important if you or anyone in your household already suffers from asthma, COPD, or any other form of pulmonary disease.
Fortunately you are still the decider. As the regulators, industry lobbyists and trade associations argue the respective agendas of their constituents, you are responsible for choosing which chemicals are used in your home and around your family. Choose wisely.
- Read the Label BEFORE you buy!
- Exercise extra caution with products that will be used frequently.
- Do the research and always choose the safest alternatives.
Quats Commonly Found in Consumer Products
Parasterol or benzalkonium chloride, Benzethonium chloride, Cetalkonium chloride, Cetrimide, Cetylpyridinium chloride, Benzyldimethylstearylammonium chloride Dimethybenzyl ammonium chloride
This entry was posted on Wednesday, July 25th, 2007 at 1:09 pm and is filed under Benzalkonium Chloride. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
I read this with much interest, aware that I suffered “hayfever” for 5 consecutive months last year, and found that nothing assisted my recovery. Finally, I gave up on any treatment and recovered after 2 months. Recently, having seen a ENT specialist, she made a passing comment that I might be allergic to the preservative that is found in almost all nasal sprays. But did not indicate any change to my previous regimens. That preservative is benzalkonium chloride, and further use of the product seems to have indicated that it irritates my sinuses acutely and chronically. I had thought that I was doing the right thing by using a saline spray (Narium), but it also has this preservative.
Jan 29th, 2009 at 8:23 pmIs benzalkonium chloride safe to hospital equipment which is stainless steel when used as disinfectant (soaked for about and hr or day). what is the safest concentration?
Mar 31st, 2009 at 10:50 pmHi Gigi, thanks for writing. Please check back to read more about benzalkonium chloride – we’ll continue to share information as Dr. Weiss becomes aware of additional studies and research that become available. Our latest post on a Harvard study on concerns with quaternary ammonia use in hospitals is at http://abetterwaytoclean.com/?p=316
Apr 21st, 2009 at 8:34 amDuring our launch of the WHO clean hands campaign, we discovered that some of our Islamic staff would not use alcohol containing hand rubs. Would Benzalkonium Chloride containing hand rubs be an effective alternative for use in a hospital setting? Is the kill rate effective enough?
May 7th, 2009 at 10:40 pmIf you are considering using it, I encourage you to become better educated about Benzalkonium Chloride – we have a few posts on this blog including a recent one siting a Harvard Study http://abetterwaytoclean.com/?p=316 . Environmental Working Group http://www.ewg.org is another excellent source to learn more.
May 11th, 2009 at 6:14 amI was found to develop a very severe allergic reaction at ophthalmologist’s clinic when given anesthetic drops with benzalkonium chloride. However I have been treated for EKC and other eye problems for several months now (with two breaks) with steroids (and other medication) all containing benzalkonium chloride!!!
I found two medical papers (Preservatives in Topical Ophthalmic Medication, Feb 2009 and Allergic Reactions to… 2005. After reading it became clear to me that most of my problems are due to toxic accumulation of benzalkonium chloride (which now can be only controlled by more steroids….)
How can I get rid off of benzalkonium chloride from my cornea?
Any advice would be appreciated
Janina
May 15th, 2009 at 6:59 pmHi Janina,
Sorry to hear about you reaction to benzalkonium chloride. This is particularly disturbing when the reaction is in the eye. The problem with quats in general and BZK specifically is that they tend to incorporate themselves into the cellular membrane of the tissues that are exposed to them. In your case this would be you cornea and the associated tissues of the eye. Fortunately, normal turnover of cells will usually remove the quats from the system soon after you stop using them. Although the concomitant use of steroids can blunt or mask the allergic response, it is prudent to avoid this class of chemicals once you know that you have an allergy. The use of quats as preservatives in eye drops, nasal sprays, and asthma medications seems reckless in that the risk of allergy is not insignificant and the consequences can be severe. To summarize, while it would be inappropriate for me to offer medical advice, in general the best solution to an allergic reaction to quats (or any medication) is first, stop using anything that contains the offending chemical, seek medical treatment for the problem, and be vigilant in avoiding any future exposure. All things that it sounds like you are doing.
Be well
Larry
May 18th, 2009 at 2:48 pmI have developed night time breathing problems like shortness of breath and shallow breathing and it seems to occur when I am taking eye drops for glaucoma. I quit the Xalatan eyedrops for now under my eye doctors supervision. Last night I couldn’t sleep because as I drifted off I felt like I wasn’t breathing and the only medication I have taken in 5 days was the anesthetic eye drop at the eye doctors yesterday done twice to do eye pressures. I have never had any breathing problems or sleep problems until recently when I was on a regime of several different eyedrops a day to try them out for glaucoma control. On the days I don’t take eye drops I fell strong enough to walk at least a mile a day.What do you think? I am unfortunately a big user of hand sanitizer when I am out and about but will quit immediately. Hope you will reply as I am very concerned. My eye doctor mentioned benzalkonium chloride once but because eye drops are his main tool for treatment and for office use he seems reluctant to discuss the other oral meds for treatment post surgery for cataracts and glaucoma. I am also allergic to sulfa drugs responding with a rash. i am on no other medications and my primary care provider read the drug fact sheets for Xalatan and Travatan and thinks my pain and breathing problems a=are due to the eye drops and gave me a ov notes saying that which I gave to the eye doctor.
Jun 3rd, 2009 at 5:44 amWhat do you think Dr. Weiss?
I
technically it is natural because it is a organic compound. I myself have used this for personal sanitization for a long time and I have yet to experience any form of allergy’s.
Jun 4th, 2009 at 4:38 amHi Virginia,
Thanks for writing. The purpose of my blog posts are to provide readers with the most current information and research on the topics of public health, infectious disease, and the chemistry used to reduce the rate of infectious diseases. Complex medical problems can present real diagnostic challenges under the best of circumstances and it is neither reasonable nor responsible to offer specific medical advice outside of an established doctor-patient relationship.
I would strongly advise you to discuss your symptoms and concerns with your internist and pursue this until you get a diagnosis.
Jun 4th, 2009 at 7:11 pmHi John,
Technically, there is no rigorous scientific or regulatory definition of the term “natural” so unless they explicitly define the term, it is hard to know exactly what any given manufacturer means when they apply it to their product. By your definition it would apply to any and all compounds contain carbon but would not apply to other naturally occurring compounds such as water, salt or oxygen.
Benzalkonium Chloride, and other closely related compounds found in many consumer products do contain carbon and thus would be “natural” by your definition but didn’t ever exist in Nature prior to being synthesized by German chemists in the early part of the last century. Moreover, the entire class of chemicals that it belongs to (dimethyl-benzyl-quaternary ammonium compounds) have no natural analogs that have ever existed prior to their introduction and mass production in the last 40 years. To make the statement that these chemicals are in any way a natural product or naturally occurring is at best misinformed and at worst misleading.
In contrast, the all-natural antibacterial active ingredient in CleanWell products is formulated from the essential oils of sustainably harvested, wild-crafted Thyme and Oregano plants. The oils are isolated by steam distillation and blended with other plant based or derived components to a consistent level of activity at the concentration that they are found in their natural state. These plants and their component oils are ubiquitous in nature and have been part of the human experience and diet for tens of thousands of years.
We are glad to hear that you haven’t had any allergies and we certainly hope that you continue to enjoy good health. The evidence suggests that populations exposed to benzalkonium chloride and related chemicals over time have a higher incidence of asthma, dermatitis, and other immune dysfunctions. This is a statistical correlation but does not imply that any given individual will suffer adverse health effects. In addition, there is laboratory evidence that these chemicals exaggerate the immune system response to environmental allergens. Taken together, we feel that there is sufficient reason for concern that frequent ongoing exposure to benzalkonium chloride and related chemicals may increase the risk of asthma, dermatitis, and allergies.
All chemicals have a potential risk profile and we absolutely suggest that if you are making a decision to buy and use any product, especially one that you would use on a regular basis, you should read the ingredients and do the homework and then decide whether you feel comfortable using the product. In general, whenever you have a choice of products, it is always prudent to always select the safer alternative.
Jun 4th, 2009 at 7:15 pm[...] are always putting their hands in their mouths). Their products do not contain any alcohol, benzalkonium chloride, or triclosan. Their products are also biodegradable and are not tested on [...]
Jun 23rd, 2009 at 3:54 amDr. Weiss,
I just got back from an allergy doctor at Mayo who told me that I may have an allergy to benzalkonium chloride. I have had a rash on two specific places on my lips for six months and have struggled with eye allergies for over a year. The only thing that worked for me was to completely stop using any and all products, including soap, lotions, cosmetics, sunscreens, contacts, drops, etc. Is there any way to tell for sure that it is benzalkonium chloride? I’d like to eventually be able to use some of these products again, but don’t want to risk a reaction again. Is it safe to do an “at home” patch test on my arm, for example? Is there some product out there that has a high concentration at a fairly cheap price?
Thank you for your community outreach and important research.
Jul 1st, 2009 at 8:08 pmHi JaxFL,
Sorry to hear that you are having this problem. From the language of your question (“I may have an allergy”) it appears that you don’t have a definitive diagnosis yet. Until you are relatively certain about what you are reacting to, making smart decisions about which cosmetics and products to use and which to avoid can be hit-and-miss. In principle, I agree that you should take steps to reach a specific diagnosis about what is causing the problem before you start making decisions about which products to use and which ones to avoid using. The difficulty with doing this on your own is that the diagnosis of a specific chemical sensitivity can be perplexing even for a medical professional who has years of experience. The DIY route is likely to be confusing and may not help you solve the problem. This is especially the case with a potential benzalkonium chloride allergy since not only is allergy to this class of chemicals relatively common (about 2 – 7 percent of the population) but this group of compounds increase the likelihood of allergies to many other chemicals and antigens. For this reason, sensitivity testing always includes pure compounds, associated compounds, and controls. Even then, interpretation of a pattern of response can be challenging. My suggestion to you is that you follow–up with a dermatologist who is a member of the American Contact Dermatitis Society and has years of experience solving these problems. Working through the problem with the right medical professional until you have an accurate diagnosis, a working understanding of what is causing the problem, and a treatment plan to avoid recurrence is your best bet.
Jul 4th, 2009 at 7:49 amI have a very high regard for benzalkonium chloride when used for anti bacterital and fungal issues topically. I have touted this ingredient to many for use in treating fungal issues both in animals and people. I was not excited initially when viewing your site, and posts bashing the ingredient. However I am concerned about this ingredient being used in eye drops, inhalers, etc. as a preservative. I have used a facial toner with this ingredient for many years, and find it very effective for keeping my skin clear. It seems a shame that some ingredients get a bad rap because of manufacturers over use …… “if it works for this let’s use it in everything” mentality.
Jul 12th, 2009 at 9:03 pmAfter reading all of above notes. I’m not sure where i can use it for cleaning. My two cats tested positive for ringworms, and thought they are on medication, i ordered the product to help disinfect my house. Where can I use this product besides the garbage pail which already has a lid and the cats do not go into that? Do i just spray and let it dry or do I have to rinse on rugs, floor, pillows?
Sep 30th, 2009 at 3:49 pmMy teenage daughter recently started having episodes of shortness of breath to the point of passing out. This was at school where they just put in hand sanitizers that contain Benzalkonium Chloride. She has now been tested for an allergy and it’s confirmed that she is allergic to Benzalkonium Chloride. Her sensitivy is so great that she can pass out from second hand contact with it.
Oct 29th, 2009 at 7:00 amI found that I recently developed an allergic reaction to benzethonium chloride. I get hives, asthma and diarrhea. I was not sure what it was until today.
Jan 22nd, 2010 at 8:00 pmIam a teacher in a Vocational Technical School. My field is Horticulture/Floriculture. I was diagnosed with pink eye last spring. Which is readily common in schools.After 11 months of eye medications 3 doctors and steriod injections around the eyes. Wills eye institute diagnoses was a allergic reaction to Benzalkonium Chloride.My school also installed hand sanitizers that contain Benzalkonium Chloride.And working in the industry of bacteriacides with Fresh Flowers and Pesticide sprays in greenhouse operations. My exposures to this chemical was overwhelming.I will shortly be undergoing surgery in my right eye.From excessive use of topical steriods use with Benzalkonim Chloride.Beware of all the over the counter products that contain this chemical.
Feb 14th, 2010 at 1:58 pmIt’s fine for occasional hand sanitizing. It’s the over use of BC which causes the problems just like alchohol or triclosan. It’s not meant for daily use.
Mar 26th, 2010 at 9:49 pmThank you for this article. I just left the Dr; i had to go in after developing an odd reaction. Three days ago I had to have a urine test done, of course I had to use an antiseptic wipe first. Less than an hour later the area swelled up to 4 times the normal size. It seems I am allergic to Benzalkonium chloride. I will now be reading the labels to see what I am actually putting in/on my body!!
Apr 2nd, 2010 at 7:49 am