The Florence Statement

Introduction

The Florence Statement on Triclosan and Triclocarban was introduced at the 36th International Symposium on Halogenated Persistent Organic Pollutants (DIOXIN 2016) in Florence, Italy.

This consensus statement has over 200 signatories from 29 countries, representing expertise on health and environmental impacts and efficacy of antimicrobials. The statement was published in Environmental Health Perspectives in June 2017.

Scientists from academia and nonprofit organizations coauthored The Florence Statement to share current scientific research on two widely used antimicrobial chemicals and to motivate broader consideration of the long-term impacts of antimicrobial use.


The Florence Statement

Read the statement in Environmental Health Perspectives.

Authors: Rolf U. Halden,1 Avery E. Lindeman,2 Allison E. Aiello,3 David Andrews,4 William A. Arnold,5 Patricia Fair,6 Rebecca E. Fuoco,7 Laura A. Geer,8 Paula I. Johnson,9 Rainer Lohmann,10 Kristopher McNeill,11 Victoria P. Sacks,12 Ted Schettler,13 Roland Weber,14 R. Thomas Zoeller,15 and Arlene Blum16

1Biodesign Center for Environmental Security, Arizona State University, Tempe, Arizona, USA 
2Green Science Policy Institute, Berkeley, California, USA 
3Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA 4Environmental Working Group, Washington, District of Columbia, USA 
 5Department of Civil, Environmental, and Geo-Engineering, University of Minnesota, Minneapolis, Minnesota, USA 
 6Medical University of South Carolina, Department of Public Health Sciences, Charleston, South Carolina, USA
 7Health Research Communication Strategies, Los Angeles, California, USA
 8Department of Environmental and Occupational Health Sciences, State University of New York, Downstate School of Public Health, Brooklyn, New York, USA
 9California Safe Cosmetics Program, California Department of Public Health, Richmond, California, USA
 10University of Rhode Island Graduate School of Oceanography, Narragansett, Rhode Island, USA
 11Institute for Biogeochemistry and Pollutant Dynamics, ETH Zurich, Zurich, Switzerland
 12Independent Researcher, Berkeley, California, USA
 13Science and Environmental Health Network, Ames, Iowa, USA 
 14POPs Environmental Consulting, Schwäbisch Gmünd, Germany
 15University of Massachusetts Amherst, Amherst, Massachusetts, USA
 16Department of Chemistry, University of California at Berkeley, Berkeley, California, USA

As scientists, medical doctors, and public health professionals, we are concerned about the continued widespread use of the chlorinated antimicrobials triclosan and triclocarban for the following reasons:

  1. Triclosan and triclocarban are used as antimicrobials, a class of chemicals present in >2,000 products including soaps, toothpastes, detergents, clothing, toys, carpets, plastics, and paints. In personal care products like hand soap, there is no evidence that use of triclosan and triclocarban improves consumer or patient health or prevent disease.
  2. Triclosan and triclocarban used in consumer products end up in the environment and have been detected in a wide variety of matrices worldwide.
  3. Triclosan and triclocarban persist in the environment and are a source of toxic and carcinogenic compounds including dioxins, chloroform, and chlorinated anilines.
  4. Triclosan, triclocarban, and their transformation products and byproducts bioaccumulate in aquatic plants and animals, and triclosan partitions into human blood and breast milk.
  5. Triclosan and triclocarban have detrimental effects on aquatic organisms.
  6. Humans are exposed to triclosan and triclocarban through direct contact with personal care products and from other sources including food, drinking water, and dust. Triclosan has been detected in the urine of a majority of humans tested.
  7. Triclosan and triclocarban are endocrine disruptors and are associated with reproductive and developmental impactts in animal and in vitro studies. Potential implications for human reproduction and development are of concern and merit further study.
  8. Human epidemiology and animal studies suggest triclosan exposure can increase sensitivity to allergens.
  9. Overuse of triclosan may contribute to antibiotic/antimicrobial resistance and may modify the microbiomes.
  10. A number of authorities, including the FDA [U.S. Food and Drug Administration], have restricted the use of triclosan and triclocarban in certain types of soaps. These and other antimicrobial chemicals are generally not restricted from use in other products.

We therefore call on the international community to limit the production and use of triclosan and triclocarban and to question the use of other antimicrobials. We urge scientists, governments, chemical and product manufacturers, purchasing organizations, retailers, and consumers to take the actions recommended below:

Recommendations

  1. Avoid the use of triclosan, triclocarban, and other antimicrobial chemicals except where they provide an evidence-based health benefit (e.g. physician-prescribed toothpaste for treating gum disease) and there is adequate evidence demonstrating they are safe.
  2. Where antimicrobials are necessary, use safer alternatives that are not persistent and pose no risk to humans or aquatic ecosystems.
  3. Label all products containing triclosan, triclocarban, and other antimicrobials, even in cases where no health claims are made.
  4. Evaluate the safety of antimicrobials and their transformation products throughout the entire product lifecycle, including manufacture, long-term use, disposal, and environmental release.

Resources

  • The Florence Statement in Environmental Health Perspectives, including Appendices of Supporting Information, References, and Signatories.