Everyday consumer products, ranging from cosmetics to personal care items, frequently contain chemicals that present potential health hazards, including carcinogenic properties. Ingredients such as phthalates, parabens, formaldehyde, synthetic fragrances, colors, and PEGs are commonly found in these products and have been associated with adverse health effects. For instance, formaldehyde, often used as a preservative, is classified as a human carcinogen, with its releasers present in products like eyelash glue and hair gel. Compounds like coal tar, benzene, mineral oils, and chromium also raise concerns, with some studies indicating possible links to conditions such as breast cancer, particularly in relation to permanent hair dye use.
The regulation of cosmetics and personal care products by the FDA is relatively lax compared to other regions. While bodies such as the International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) classify substances as known, probable, or possible carcinogens, regulatory standards vary across different jurisdictions. Taking a proactive approach involves scrutinizing product labels, identifying harmful ingredients, and opting for reputable brands. The European Union has stricter regulations compared to the United States, where restrictions often lag behind emerging research findings.
Recent studies have shed light on the landscape of personal care products used by communities, highlighting disparities in exposure and regulation. A study conducted last year focused on women of color in California, revealing gaps in understanding the prevalence of carcinogens, reproductive toxicants, and endocrine disruptors in their personal care products. Utilizing targeted analysis and suspect screening, the research provided a comprehensive evaluation of potentially hazardous chemicals across six product categories. Hair products, in particular, were found to contain a significant number of Chemicals of Concern (CoCs), with parabens being a predominant group detected in multiple products.
The study underscored concerns regarding undisclosed fragrance ingredients, which were found in a substantial percentage of products, including those used by Black women. The presence of Prop 65-listed carcinogens and reproductive toxicants on product labels further underscored potential health risks associated with routine use. Moreover, linguistic barriers were noted, with some products bearing labels in languages other than English, in violation of U.S. federal law.
Laboratory testing revealed a spectrum of CoCs, encompassing endocrine disruptors, carcinogens, and reproductive toxicants. Examples included benzyl chloride, unintentional additives like 1,4-dioxane, and significant levels of diethyl phthalate, a suspected endocrine disruptor commonly found in leave-on skin moisturizers. Fragrance-related issues persisted, with undisclosed ingredients detected in nail products and other categories, posing additional challenges to consumer safety and informed decision-making.
Despite limitations in sample size and product representation, the study called for expanded research efforts and automated screening tools to better monitor and disclose potentially harmful ingredients. It advocated for enhanced regulatory transparency and consumer education to promote safer cosmetic practices. Highlighting recent legislative initiatives in California, the study emphasized the importance of ingredient transparency and urged comprehensive reforms to ensure the safety of personal care products.
In summary, the study underscored the need for continued investigation into the health risks posed by CoCs in personal care items. It urged policymakers to reevaluate current regulatory frameworks, emphasizing the importance of comprehensive ingredient disclosure and informed consumer choices. By raising awareness and advocating for safer practices, the study aimed to mitigate potential health hazards associated with everyday cosmetic and personal care product use.
Helicobacter pylori (H pylori) is a gram-negative bacterium that primarily colonizes the gastric mucosa. It is one of the most common bacterial infections, with estimates suggesting half to two-thirds of the global population is infected by H pylori. H pylori is typically transmitted via fecal-oral routes and less commonly by oral-oral, gastric-oral, or zoonotic transmission. Infected patients are usually asymptomatic but may present with abdominal pain and cramps, bloating, nausea and vomiting, or unintentional weight loss. H pylori is recognized as a major pathogen responsible for gastrointestinal disorders such as gastritis and peptic ulcer disease – accounting for 90-95% of duodenal ulcers and 70-85% of gastric ulcers. However, the most significant concern associated with infection is the increased risk of gastric cancers such as gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma.
The link between H pylori infection and gastric malignancy is well-established; epidemiological studies estimate >75% of gastric cancers are related to infection. In 1994, the World Health Organization recognized H pylori as a group 1 carcinogen, indicating a strong association with cancer development. The mechanisms by which H pylori contributes to cancer development are multifaceted. Adhesion molecules including SabA, BabA, and OipA contribute to the formation of membrane attachments that allow the bacterium to avoid immune destruction and colonize epithelium. H pylori neutralizes gastric acid through excessive urease production, promoting its survival and proliferation. The host immune response to urease incites an inflammatory reaction that stimulates release of cytokines (IL-8, IL-1, IL-6, and TNF-alpha) and perpetrates tissue injury. The chronic inflammation triggered by persistent H pylori infection may lead to progressive gastric mucosa destruction, potentially resulting in gastric atrophy and intestinal metaplasia. Additionally, specific strains, characterized by the presence of cytotoxin-associated gene A (CagA) and the vacuolating cytotoxin A (VacA), increase the risk of gastric cancer in infected patients. It remains unclear if H pylori infection is associated with other cancers; however, studies suggest infection may increase the risk of pancreatic and colorectal cancer, while decreasing the risk of esophageal adenocarcinoma.
Treatment of H pylori should be recommended to all patients positive for infection. Eradication of H pylori is shown to significantly decrease gastric cancer risk in infected individuals without precancerous lesions. One randomized clinical trial found that patients who received eradication therapy had a gastric cancer incidence of 1.6% as compared to 2.4% in the placebo group. Another long-term trial showed that eradication therapy reduced the incidence of gastric cancer by almost 50% over 22 years of follow-up. Furthermore, there is strong evidence to suggest MALT lymphoma can be completely cured by eradication of H pylori in early stages of infection. Several treatment options are available to eradicate H pylori, involving a combination of antibiotics, bismuth compounds, and proton pump inhibitors (PPIs). The addition of PPIs helps stabilize gastric pH to enhance the effectiveness of commonly used antibiotics such as clarithromycin, amoxicillin, and metronidazole. Careful selection of eradication therapy is necessary due to high rates of antibiotic resistance; guidelines recommend avoiding clarithromycin-based regimens if local resistance rates exceed 15% or the patient has past exposure to macrolide therapy. The prevalence of H pylori and escalation of antibiotic resistance support the need for further preventive measures. Research for a potential vaccine appears promising and may prove beneficial in reducing H pylori prevalence and preventing its associated complications.
Everyday products we use, from cosmetics to personal care items, often contain chemicals that may pose health risks, including carcinogenic properties. Ingredients like phthalates, parabens, formaldehyde, fragrances, synthetic colors, and PEGs, commonly found in various products, have been linked to adverse health effects. Formaldehyde, for example, listed as a preservative, has been classified as a human carcinogen, and its releasers are present in products like eyelash glue and hair gel. Products containing coal tar, benzene, mineral oils, or chromium raise concerns, and some may even contribute to breast cancer, as seen in studies on permanent hair dye use.
Understanding these risks is crucial, given that cosmetics and personal care products are not rigorously regulated by the FDA. The International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) classify substances as known, probable, or possible carcinogens, yet regulations vary between regions. A proactive approach involves reading product labels, recognizing harmful ingredients, and choosing reputable brands. While the EU has stricter regulations, the U.S. often lags in implementing restrictions.
There was a study done last year that delves into the landscape of personal care products used by women of color in three communities of California. Despite some existing research on personal care product chemicals, the study emphasizes the gaps in understanding the presence of carcinogens, reproductive toxicants, and endocrine disruptors in products.
Employing targeted analysis and suspect screening, the research explores ingredient labels and conducts laboratory testing, presenting one of the first comprehensive evaluations of potentially hazardous chemicals in personal care products specific to racial/ethnic groups. The investigation spans six categories, with hair products exhibiting the highest number of Chemicals of Concern (CoCs). Parabens emerge as a prevalent group of chemicals, often co-occurring in the same product. Concerningly, Prop 65-listed carcinogens and reproductive toxicants appear on labels, signaling potential health risks for users.
The study unravels the issue of undisclosed fragrance ingredients, with 74% of products harboring these components. Fragrance-related concerns extend to products used by Black women, where 93% feature undisclosed fragrances. Across all categories, except makeup and nail products, "fragrance" or "parfum" dominates labels, obscuring the actual composition. The research spotlights a linguistic challenge as well, where 21 stores carry products with labels in languages other than English, violating U.S. federal law.
Laboratory analysis exposes a spectrum of CoCs, encompassing endocrine disruptors, carcinogens, and reproductive toxicants. The study reveals the presence of contaminants like benzyl chloride and unintentional additives such as 1,4-dioxane. Diethyl phthalate, a suspected endocrine disruptor, surfaces prominently, notably in a leave-on skin moisturizer. The detection of undisclosed fragrance ingredients and triphenyl phosphate in nail products raises additional concerns.
Despite limitations in sample size and product representation, the study contributes vital insights. It underscores the cumulative exposure risk stemming from multiple product use, emphasizing the need for further research on formaldehyde-releasing preservatives. The discussion contends that current regulations fall short, particularly in disclosing fragrance ingredients, urging a transformative shift. Applauding recent California legislation, the study champions ingredient transparency and advocates for safer cosmetics.
In conclusion, the research amplifies the call for expanded investigations, automated screening tools, and heightened consumer awareness. It urges a reevaluation of regulatory frameworks to ensure comprehensive ingredient disclosure, fostering informed consumer choices. The study illuminates the imperative to address health risks posed by CoCs in personal care items calling for safer cosmetic practices and regulatory reforms.
References:
Batyrova G, Kononets V, Amanzholkyzy A, Tlegenova Z, Umarova G. Chromium as a Risk Factor for Breast Cancer: A Meta-Analysis. Asian Pac J Cancer Prev. 2022 Dec 1;23(12):3993-4003
Johnson PI, Favela K, Jarin J, Le AM, Clark PY, Fu L, Gillis AD, Morga N, Nguyen C, Harley KG. Chemicals of concern in personal care products used by women of color in three communities of California. J Expo Sci Environ Epidemiol. 2022 Nov;32(6):864-876.
Kazemi Z, Aboutaleb E, Shahsavani A, Kermani M, Kazemi Z. Evaluation of pollutants in perfumes, colognes and health effects on the consumer: a systematic review. J Environ Health Sci Eng. 2022 Feb 3;20(1):589-598.
Cancer is one of the leading causes of death worldwide and arises due to complex interactions between genetic factors and environmental exposure. Although, genetics plays a crucial role in cancer susceptibility, exposure to certain cancer-causing agents significantly contributes to the development of various cancer types. The two significant categories of cancer-causing agents are environmental carcinogens and lifestyle-related risk factors.
Environmental carcinogens are substances or agents present in the surroundings that can induce cancer formation. They may infiltrate the air we breathe, the water we drink, and the food we consume, leading to potential long-term health hazards. Several environmental carcinogens have been identified, including polycyclic aromatic hydrocarbons (PAHs), asbestos, and ultraviolet (UV) radiation. PAHs are a group of organic compounds commonly released through incomplete combustion of fossil fuels, tobacco smoke, and certain industrial processes. Numerous studies have associated exposure to PAHs with lung, skin, and bladder cancers. This exposure is particularly concerning for those living in urban areas where there is constant heavy traffic causing the concentration of PAHs in the air to pose significant health risks. Asbestos is a group of naturally occurring minerals that were extensively used in construction materials due to their fire-resistant properties. Inhalation of asbestos fibers can lead to mesothelioma, lung cancer, and other respiratory diseases. Finally, excessive exposure to ultraviolet (UV) radiation from the sun or artificial sources, such as tanning beds, is a known cause of skin cancer, including melanoma, the most dangerous form of skin cancer. Regular use of sunscreen, protective clothing, and avoiding direct sun exposure during peak hours can reduce the risk.
On the other hand, lifestyle choices have a significant impact on an individual's risk of developing cancer. Unhealthy habits and behaviors can expose individuals to various cancer-causing agents. Some notable lifestyle-related cancer risk factors include tobacco use, having an unhealthy diet, and alcohol consumption. Tobacco consumption, either through smoking or smokeless products, is a primary cause of cancer worldwide. Cigarettes contain numerous carcinogens, such as polonium-210, benzene, and nitrosamines, which can trigger cancers in the lungs, throat, mouth, and other organs. Additionally, a diet high in red meats, saturated fats, and low in fruits and vegetables has been associated with an increased risk of colorectal, pancreatic, and breast cancers. Lastly, excessive alcohol consumption is a significant risk factor for several cancers, including those of the liver, breast, esophagus, and mouth.
Citations:
Loomis, D., Guyton, K., Grosse, Y., El Ghissasi, F., Bouvard, V., Benbrahim-Tallaa, L., Guha, N., Mattock, H., Straif, K., & International Agency for Research on Cancer Monograph Working Group, IARC, Lyon, France (2015). Carcinogenicity of lindane, DDT, and 2,4-dichlorophenoxyacetic acid. The Lancet. Oncology, 16(8), 891–892. https://doi.org/10.1016/S1470-2045(15)00081-9
Islami, F., Goding Sauer, A., Miller, K. D., Siegel, R. L., Fedewa, S. A., Jacobs, E. J., McCullough, M. L., Patel, A. V., Ma, J., Soerjomataram, I., Flanders, W. D., Brawley, O. W., Gapstur, S. M., & Jemal, A. (2018). Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: a cancer journal for clinicians, 68(1), 31–54. https://doi.org/10.3322/caac.21440
The skin, also known as the integumentary system, is one of the largest organs in the human body. The skin mainly functions as a protective barrier against external factors. It also regulates body temperature through moisture control and reduces the harmful effects of UV radiation.
Throughout history, people have been trying to use different types of skin care techniques to make themselves look younger and have healthier skin. But with all of the skin care products available on the market, how do we really know which ones are safe to use? According to a study that was tested in the United States and in Canada, there are over one hundred harmful chemicals that have been identified in household skin care products (American Cancer Society). These substances can include chemicals such as perfluorooctanoic acid, which can cause cancer and other abnormalities over time.
The types of reactions that may occur with toxic skin care products can include rash, redness, itchiness, burning, and stinging. If you’ve ever experienced any of these side effects while using a particular brand, then it is likely that your skin care item contains chemicals that are not as healthy as you thought they were. Even common ingredients like parabens and exfoliants can leave your skin feeling red, flakey, and uncomfortable.
Most skin care products contain lists of ingredients that are impossible to pronounce… which ultimately diverts our attention. It is very important to stay away from products that contain polyethylene glycol, methyl and propyl parabens, aluminum, formaldehyde, phthalates, and oxybenzone’s (Healthline).
In addition to these toxic substances, it may also be a good idea to avoid using products that have fragrances and perfumes. Most of the fragrances that are added to skin care products contain benzene derivatives which can lead to skin cell abnormalities and cancer as well.
Natural/ Safe Products
In most cases, it is always best to stick to natural substances and avoid synthetic ones. Below is a list of safe ingredients that may benefit all skin types.
· Tea tree oil
· Coconut oil
· Elderberry Extract
· Willow Bark Extract
· Products that are Alcohol Free
· Products that do not contain steroids
· 100% Pure and Cruelty Free
· Products that contain Zinc
Resources
Mayer, Beth Ann. “Derms Say Avoid These 6 Skin Care Bad Guys.” Healthline, Healthline Media, 1 Sept. 2022, https://www.healthline.com/health/beauty-skin-care/ingredients-to-avoid-for-stress-free-skin-care#takeaway.
Lichterfeld, Andrea et al. “Evidence-Based Skin Care: A Systematic Literature Review and the Development of a Basic Skin Care Algorithm.” Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society vol. 42,5 (2015): 501-24. doi:10.1097/WON.0000000000000162
Have you ever stopped to look at the back of a product label and wonder what that endless ingredient list really consists of? Many of the daily use products we use contain chemicals/ingredients that can cause harm to our bodies, and can even be carcinogenic. Some products that are found to be carcinogenic are phthalates, parabens, formaldehyde, fragrances, synthetic colors, PEGs, triclosan, along with many others. It is important to understand what these products are and why we should or should not have them in our products.
Formaldehyde is one of those ingredients listed in products used as a preservative, but is seen to be a human carcinogen. In 1981, The National Toxicology Program (NTP) first listed formaldehyde in the 2nd Report on Carcinogens as reasonably anticipated to be a human carcinogen. You can find formaldehyde in many of our adhesive products, such as eyelash glue, hair gel, shampoos and soaps, as well as binders for wood and plastic.1 Formaldehyde is able to create cross links between DNA-DNA and DNA-protein due to its ability to bind to DNA. This is seen to be the relation of formaldehyde’s cytotoxic ability.2 Formaldehyde releasers, which are chemicals that slowly release formaldehyde, are found in products in order to preserve it. A few of these formaldehyde releasing agents include: imidazolidinyl urea, DMDM hydantoin, and diazolidinyl urea. What makes it so hard to find these names on the label is that there can be variations of the names of these formaldehyde carrying agents. In Europe, a concentration of 0.02% for formaldehyde releasing agents is allowed while in the U.S., a concentration of up to 0.1 ppm is allowed due to Americans having more ventilation for these products than Europe. When formaldehyde is present in the air at levels higher than 0.1 parts per million (ppm), some people may experience: watery eyes, burning sensations of the eyes, nose, and throat, coughing, wheezing, nausea, and skin irritation. According to the European Cosmetic Directive, all products containing formaldehyde or its releasers must be labelled “contains formaldehyde” when the concentration of formaldehyde in the finished product exceeds 0.05% (500 ppm). Since formaldehyde is common in many household products, it is difficult to completely remove it from the air, but you can try to reduce how much of its levels are in your home by increasing ventilation.
Triclosan is another example of an ingredient to look out for, which is an antimicrobial compound that has been used in consumer products for about 40 years, found in 75% of liquid hand soap and 30% of bar soap. Triclosan is what makes many of our soaps antibacterials, which work by denaturing proteins and disrupting membranes. Per various studies, triclosan seems to harm immune function, endocrine function and reproductive health. In studies conducted on rats, triclosan affects the levels of estrogen, testosterone, and thyroid seen in their bodies. Triclosan in antimicrobial soap has not been found to be superior to washing hands with regular soap, therefore in September 2016, triclosan was banned from soap products following the risk assessment by the U.S.A. Food and Drug Administration (FDA). However, triclosan is still permitted to be in toothpastes, hand sanitizers, and mouthwash as it is widely utilized to help fight gingivitis.3 The European Union (EU) also banned triclosan from all human hygiene biocidal products in January 20174. Some researchers were also concerned that using triclosan for long periods of time would create more antibacterial-resistant bacteria. The issue of triclosan resistant organisms arises due to its use, an example being salmonella enterica. Ultimately, washing your hands with good old fashioned hand soap is the way to go!
Every day we are exposed to many different chemicals in our environment, including those in personal care products. “Less is more” is certainly the lesson to be taken away from these examples. Although it can be difficult, less chemical exposure means less risk of cancers. It’s become increasingly clear that most mainstream cosmetic and personal care products contain at least one hazardous chemical compound, some of which have been deemed toxic by the National Institute of Occupational safety. Cosmeticsdatabase.com is a great resource to find what chemicals are in your personal care products and what risks are associated with these chemicals. This database is provided by The Environmental Working Group (EWG), which is a non-profit organization that specializes in research of toxic chemicals. Since we know that the FDA does not assess the safety of personal care products or their ingredients, it is up to consumers to protect themselves by educating themselves and identifying the best possible choices when shopping.
References:
1 Bosetti C, McLaughlin JK, Tarone RE, Pira E, La Vecchia C. Formaldehyde and cancer risk: a quantitative review of cohort studies through 2006. Ann Oncol. 2008;19(1):29-43. doi:10.1093/annonc/mdm202
2 Allegra A, Spatari G, Mattioli S, et al. Formaldehyde Exposure and Acute Myeloid Leukemia: A Review of the Literature. Medicina (Kaunas). 2019;55(10):638. Published 2019 Sep 25. doi:10.3390/medicina55100638
3 Weatherly LM, Gosse JA. Triclosan exposure, transformation, and human health effects. J Toxicol Environ Health B Crit Rev. 2017;20(8):447-469. doi:10.1080/10937404.2017.1399306
4Juncker J-C. Commission impementing decision not approving triclosan as an existing active substance for use in biocidal products for product-type 1. 2016.
As indicated in its name, a carcinogen is something that can cause/make a person more susceptible to (a) certain type of cancer(s). How much exposure and even genetic makeup play a crucial role in developing cancer from a carcinogen. Extensive research has been done on this topic, primarily on lab animals such as mice as the test subject. Common examples of carcinogens include formaldehyde, ultraviolet rays, smoking, processed meat, pollution, and alcohol. As mentioned in the International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP), human carcinogens include alcohol under different classifications. More specifically, the International Agency for Research on Cancer- Group 1: Carcinogenic to humans has known human carcinogens listed as- acetaldehyde (from consuming alcoholic beverages), alcoholic beverages, ethanol in alcoholic beverages, and isopropyl alcohol manufacture using strong acids.
There is clear evidence that alcohol drinking can cause cancer. The evidence that the consumption of alcoholic beverages is a known human carcinogen is that the more alcohol a person drinks, in particular the more alcohol that a person would regularly drink (let’s say on a daily basis), the higher that person is subjected his or her risk of developing an alcohol-associated cancer. This can even include light alcohol drinkers which is defined as those who have only one drink per day. An estimated 3.5% of cancer deaths (which accounts for roughly 19,500 deaths) in the United States of America were related to alcohol consumption. Alcohol consumption is correlated with attributing to these types of cancer- breast cancer, colorectal cancer, esophageal cancer, head and neck cancer, and liver cancer. It is important for physicians to categorize patients based on their pattern of alcohol use in order to best assist them. For example, even if moderate alcohol consumption has some limited risks, the question arises of how much of a risk it is, and, more importantly, if the risk is worth taking for that patient. Alcohol consumption is frequently done socially and possibly for enjoyment so all of these factors must be taken into account to outweigh the personal benefits to the possible risks for each and every specific patient.
There have been many ways hypothesized as to exactly how alcohol increases the risk of cancer. One of these ways is by metabolizing ethanol in alcoholic drinks into acetaldehyde, which is a toxic chemical and a potential human carcinogen. Acetaldehyde can even damage both DNA and proteins. Another hypothesized way is by the generation of reactive oxygen species (which are chemically reactive molecules that contain oxygen), which can damage DNA, proteins, and lipids in the body through a scientific process called oxidation. A third way is impairing the body’s ability to break down and absorb a variety of nutrients that may be associated with cancer risk, including vitamin A, nutrients in the vitamin B complex (such as folate, also known as vitamin B9) vitamin C, vitamin D, and vitamin E. There are also ways in which alcohol can be linked to a specific type of cancer such as alcohol increasing the blood levels of estrogen in a female, estrogen being a sex hormone linked to increasing the risk of breast cancer.
Nelson DE, Jarman DW, Rehm J, et al. Alcohol-attributable cancer deaths and years of potential life lost in the United States. American Journal of Public Health 2013;103(4):641-648.
As humans living in this modern day and age, we are exposed to various DNA-damaging agents known as carcinogens. Carcinogen exposure will lead to many forms of DNA damage which includes single and double strand breaks, oxidative induced lesions, and DNA-DNA and DNA-protein cross links. Carcinogens that are directly associated with DNA damage includes: ultraviolet light, heterocyclic aromatic amines, mycotoxins, polycyclic aromatic hydrocarbons, nitrosamines, ionising radiation, aristolochic acid and particulate matter. Carcinogens will either be chemical or physical agents and will cause DNA damage through multiple different processes with an extent of damage that depends on their physicochemical properties.For example, ionising radiation carcinogens are able to cause DNA double strand breaks (DSBs) through free radical generation.
Carcinogens also fall into two more categories which are either activation dependent and activation independent. Direct acting carcinogens that are able to directly interact with DNA and do not need metabolic activation or molecular modification to cause DNA damage include ultraviolet (UV), nitrosamines, and alkylating agents. Altering DNA bases will disrupt the arrangement of genetic material and lead to formation of DNA adducts depending on the carcinogen. The corrupted DNA mechanisms will lead to DNA lesions inherited by daughter cells and the accumulation of DNA damage, ultimately resulting in cancer. Indirect acting carcinogens require bioactivation in host cells in order to turn them into carcinogenic metabolites capable of genotoxicity.
Polycyclic aromatic hydrocarbons (PAHs) are the largest group of indirect acting carcinogens to which humans are exposed to. Exposure to PAHs has been most commonly linked to the development of lung, breast and skin cancers. Carcinogenic PAHs and tobacco-specific nitrosamines are carcinogens commonly found in tobacco smoke. The combustion of a single cigarette alone is capable of producing thousands of carcinogenic agents that are DNA damaging. After the bioactivation of PAHs through the CYP mixed function oxidase system, electrophilic metabolites will covalently bind to DNA bases forming DNA adducts. Forming DNA adducts could lead to mutations at the sites they are located due to DNA replication of unrepaired DNA.
The International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) determine if a substance is classified as a carcinogen. The lists of carcinogens made by the IARC and NTP only includes substances that have been evaluated by those agencies. Their lists include substances that are classified as “known” and “probable” carcinogens and will not include “possible” carcinogens. However the IARC and NTP act independently and if there is a substance listed as a carcinogen on one list and not the other, it may only mean that only that agency had evaluated. Also it is not necessarily true that a carcinogen will cause cancer with any type of exposure or in every human being in the same manner. Some carcinogens may lead to cancer after a small exposure and others lead to cancer after greater exposure over a long period of time.
To find out how to reduce and avoid exposure to carcinogens especially in the workplace among other resources, you can also visit the official Occupational Safety and Health Administration website.
Barnes JL, Zubair M, John K, Poirier MC, Martin FL. Carcinogens and DNA damage. Biochem Soc Trans. 2018;46(5):1213-1224.
There are a plethora of harmful chemicals, toxins and carcinogens found in personal cosmetic products. Parabens are a common preservative used in products like cosmetics, lotions, moisturizers, shampoo, shaving and tanning products. Parabens include methyl, propyl, and butyl parabens, which are known to have cancer side effects. Parabens can act similar to estrogen in increasing the risk of breast cancer. They can increase cell growth and promote growth of estrogen-positive breast tumors, and can even decrease the effects of tamoxifen which is chemotherapy used to block estrogen effects.
These effects are on the general endocrine system because they can disrupt normal hormone production, which happens in males too. They can cause low sperm count and decreased levels of testosterone, and this is usually in a dose dependent manner. Ironically, a lot of skin care products marketed for anti-aging actually contain parabens which accelerate aging in the skin. Skin cells can die at a faster rate when parabens on the skin are exposed to the sun and UV light.
A study found a clinical effect of Methylparaben on the skin’s keratinocytes. Daily application of a product containing Methylparaben on the forearm resulted in unmetabolized paraben and persistence in the stratum corneum. The final results suggest that application of dermatological formulations results in Methylparaben persistence and accumulation in the skin, and that it might influence the aging and differentiation of keratinocytes. This is also due to the fact that it was found to decrease hyaluron synthase and collagen, two components to skin that keep it healthy and young.
With all we know about the harmful effects of parabens, we as pharmacists have a responsibility to inform our patients how to select safer products. There are many common cosmetic products on the market that may contain parabens. Its best to avoid any that contain these ingredients.
1. Ishiwatari S, Suzuki T, Hitomi T, Yoshino T, Matsukuma S, Tsuji T. Effects of methyl paraben on skin keratinocytes. J Appl Toxicol. 2007;27(1):1-9.
Many ingredients we use daily may have carcinogenic properties that can cause cancer later on if used in excess. It is crucial for a health care provider to educate patients on these products when the patient is said to inquire regarding using something new. It is important to establish a trusting relationship between the health care provider and the patient in order to have the patient feel more comfortable asking questions to the providers. Cosmetics as well as other personal care products are not strictly regulated by the FDA, so harmful ingredients are allowed in products in a very small amount. Some ingredients commonly used today associated with causing cancer are BHA, BHT, DEA, DEP, formaldehyde, SLS or sodium lauryl sulfate, siloxane, PEGs, parabens and fragrance. Formaldehydes are actually a preservative that is found in many daily use products such as nail polish, body wash and even shampoos. Formaldehyde is also known to cause skin and eye irritation. Formaldehydes have also been linked to nasopharyngeal cancer as well as leukemia and respiratory problems. Its use has still not been regulated even though there is a link between use and emergence of cancer. In fact, the European Union (EU) has restricted use to not more than 0.2% of formaldehyde in personal care products. The FDA is yet to put a regulation on the amount of formaldehyde in cosmetic and personal care products despite the risks. Butylated hydroxy anisole (BHA) and butylated hydroxytoluene (BHT) are antioxidants that also provide many products with fragrance, they are present in many lipsticks and other cosmetic products. SLS or sodium lauryl sulfate is found in shampoos, to provide a surfactant to the shampoo also inducing the suds when one lathers. SLS or sodium lauryl sulfate is considered to be harmful with long term use. This is dangerous in those patients that stick to one product over the course of their lifetime. Another process that is harmful is the modern process of manufacturing these products. When manufacturing is going on, there can be impurities released into the product or improper cleaning of machines can cause contamination within these products. Metals such as nickel and even mercury can contaminate these products. This can affect a patient’s health from cancer to causing a hormone imbalance. The hormone imbalance can cause pregnancy complications infertility in both males and females. Although many argue that small amounts of these ingredients are not harmful, these products are not FDA regulated therefore are able to cause increase risk because of the lack of testing. It is important for a patient to do personal research before purchasing any product, as if it were a food, to truly see if it may be potentially harmful to them. As health care providers, it is important to know the potential dangers of certain ingredients in order to educate patients on what to refrain from. A tip to use to avoid potential skin irritation or allergy is to test the product on a small patch of skin before use and see the skin’s reaction after a couple of days. PEGs are cleaning ingredients that are found in skincare and makeup products. PEGs often contain harmful carcinogens like ethylene oxide so it is best to avoid products with PEGs in them.
Cosmetics and personal care products are often products that are either applied to the skin or hair, and a lot of the added chemicals in these cosmetics have the potential to be absorbed into the body. It is important to have an interest in whether these products can cause a potential health risk to the consumer using them. In some products, there has been an association between their ingredients and cancer. It is worthwhile having a deeper look and understanding into what ingredients are included in our everyday cosmetic products .
In a 2008 study, the International Agency for Research on Cancer analyzed data for potential association between permanent, semi-permanent, and natural hair dyes and their link to cancer. This agency has determined that the personal use of hair dye is not classifiable as a human carcinogen, and that there is very limited evidence for carcinogenicity in humans and experimented animals. Since then, many meta-analysis have been published including a 2018 analysis which included eight case control studies that found a modest increase in the risk of breast cancer among women who used hair dye. Many cohort studies done since then included telephone interviews, home visits, and follow up questionnaires to determine if there was an association between hair dye in cancer. The studies actually found out that permanent hair dye used every 5 to 8 weeks was associated with a significantly higher risk of breast cancer compared to women that didn't use hair dye. When divided up by race, the study found that the association with permanent hair dye was particularly evident in African American women, who had a 45% higher risk for breast cancer
There have been multiple theories associating the risk of underarm antiperspirant's and breast cancer. Cancer causing substances in antiperspirants are absorbed through razor nicks from underarm shaving, and these substances are said to be absorbed through lymph nodes under the arm. These toxins are not able to get removed from the underarm area, and eventually can lead to cells mutating and forming into cancer. Using antiperspirant can increase the intake of parabens to be absorbed through the skin. Parabens can raise a possible concern because studies have shown that parabens have weak estrogen like properties, and estrogen is a female hormone known to cause breast cells to grow and divide. Some conditions that increase the body's exposure to estrogen such as obesity or late menopause have been linked to an increased risk of breast cancer.
Some cancer-causing agents that are found in potential cosmetics and personal care products contain formaldehyde and formaldehyde releasing preservatives. In addition , consumers should be aware of coal tar, benzene, mineral oils, or chromium found in any ingredient section of a cosmetic product. There is often little study done on the type of carcinogens in cosmetic products , therefore scientists must resort to other types of tests which include taking one or two ingredients at a time at much higher doses to try to determine the potential of that chemical to cause cancer.
US Food and Drug Administration. FDA Authority Over Cosmetics. 2013. Accessed at http://www.fda.gov/cosmetics/guidanceregulation/lawsregulations/ucm074162.htm on April 14, 2014.
There are many things we use on a daily basis that we think are beneficial for us to use, but have not realized contain ingredients that are harmful or full of carcinogens. These items we use on a daily basis range from personal or self-care products to cosmetics and makeup. Some of these agents include: BHA, BHT, DEA, DMP, formaldehyde, PEGs, parabens, SLS, siloxane, and triclosan. Although the purpose of these ingredients can range from preservative to pH adjuster to foaming agent to fragrance to conditioning/cleaning agents to an emulsifying agent to a softening or moisturizing agent, they can also be considered harmful if used for a prolonged period of time. As mentioned in the powerpoint, these chemicals can affect our health because they can be cancer causing, cause hormone interruption, lead to birth and pregnancy complications, cause contact dermatitis/skin irritation, or skin disorders. This may not occur right away, because the items we use may contain small amounts of carcinogens, but over a prolonged period of time, these chemicals can cause mutations of some sort and lead to an increased risk of cancer.
Agencies such as the International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) determine whether or not a certain chemical is a carcinogen or cancer-causing. The IARC is independent of the NTP and each organization has their own list. The IARC is a part of the World Health Organization (WHO). The IARC consolidates information or data gathered and classifies the chemicals into five different levels. Group 1 is carcinogenic to humans, Group 2A is possibly carcinogenic to humans, Group 2B is possibly carcinogenic to humans, Group 3 is not classifiable as their carcinogenicity to humans, and Group 4 is probably not carcinogenic to humans. Group 1 contains 11 agents or chemicals that have been used or are currently being used in personal care products and are known to be carcinogenic in humans. These agents are: formaldehyde, phenacetin, coal tar, benzene, untreated or mildly treated mineral oils, methylene glycol, ethylene oxide, chromium, cadmium and its compounds, arsenic, and crystalline silica or quartz.
As a consumer or for our patient population, it is best to try and understand what products are harmful or potentially carcinogenic and we should be mindful in reading the product labels. Once we understand what all the terms mean, we can narrow down what brands to purchase from and which to avoid. These products are being used or rubbed into our skin, which can cause damage in the long run. It is also not fully regulated, so legally cancer-causing chemicals or carcinogens are allowed into personal care products in small quantities. Some things to look out for on labels include: formaldehyde and formaldehyde releasing preservatives (quaternium-15, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, and 2-bromo-2-nitropropane-1,3 diol), phenacetin, coal tar, benzene, untreated or mildly treated mineral oils, ethylene oxide, chromium, cadmium and its compounds, arsenic and crystalline silica (or quartz). More regulations against these agents, such as being prohibited for use or restricted for use exist more in the EU, whereas in America, although the IARC and NTP gather information and see if a chemical is potentially carcinogenic or harmful, there is limited regulation on whether or not it can be added to a product. The best way any patient or consumer can be mindful is to try and avoid long term use of a single product, pay attention to expiration dates, purchase cosmetics and personal care products from reputable brands, and apply a small amount of the product to a test area before applying a large amount to avoid any skin irritations or allergic reactions.
Reference(s):
“Carcinogens in Cosmetics.” Safe Cosmetics, www.safecosmetics.org/get-the-facts/chemicals-of-concern/known-carcinogens/#:~:text=Of%20the%20113%20agents%20listed,and%20its%20compounds%2C%20arsenic%2C%20and.
“Known and Probable Human Carcinogens.” American Cancer Society, www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-carcinogens.html.
Carcinogens, as substances that either indirectly or directly alter the structure or function of DNA, promote DNA mutation. Although we are still learning the exact pathologic processes involved, it is clear that carcinogenesis is multifactorial, including our individual genetic makeup and the substances we ingest or apply.
Potential carcinogens exist in our common cosmetic items. Although cosmetic ingredients fall under the overview of the Food and Drug Administration (FDA), they aren’t as heavily regulated. As such, the rigorous testing involved in determining the safety and long-term risks associated with cosmetic items aren’t as apparent. However, the International Agency of Research on Cancer (IARC) has worked to classify carcinogens according to their carcinogenic potential.
According to the IARC 2012 Report on Carcinogens, several household chemicals, such as coal tar, formaldehyde, ethylene oxide, and heavy metals, like chromium, arsenic, lead, and mercury, have been confirmed to be carcinogenic.
Formaldehyde has long been linked to nasopharyngeal cancer and leukemia, along with a host of respiratory issues. Despite this clear relationship, the FDA has not limited its use as a preservative in hair care and nail polishes, and only acts when products fail to warn consumers of potential risks. The Cosmetic Ingredient Review (CIR), an independent safety panel, has chosen to adopt the European Union (EU)’s regulation that restricts more than 0.2% of formaldehyde in personal care products. But whereas this is a law in the EU, the CIR’s recommendation can only serve as a guideline in the US. Regardless, cosmetic companies have elected to use “formaldehyde releasers”, such as imidazolidinyl urea and quaternium-15 that decompose over time or when exposed to heat.
Phthalates are currently used in the US as fragranced external cosmetic items, hair care products, and nail polish. Phthalates, including diethylphthalate (DEP), dibutylphthalate (DBP), and dimethylphthalate (DMP) have been historically used in cosmetic and household items as fragrances and plasticizers, respectively. The FDA concluded that there was no evidence that phthalates in cosmetic items had health risks and that the exposure of phthalates in those items were minimal compared to the levels required to cause adverse events in animals. However, the European Commission Health and Consumers decided to restrict phthalates in cosmetic products due to studies linking its use with endocrine dysfunction and reproductive interference.
Heavy metals are still found in many personal care items. The FDA has published guidelines on heavy metal limits. Lead, which is commonly present as an impurity in color additives in lipstick and eye shadows, is limited to 10-20 parts per million (ppm). Mercury is limited to 65 ppm when it is used as a preservative in eye area products.
Although it is ultimately the consumer’s responsibility to be well-informed and choose safe products for his or herself, pharmacists can play a guiding role in identifying potentially harmful ingredients.
References
1. Cosmetics. Cancer.org. https://www.cancer.org/cancer/cancer-causes/cosmetics.html. Published 2020. Accessed June 20, 2020.
2. Hutzinger O. Carcinogens: Identification and mechanisms of action. Chemosphere. 1980;9(2):N10-N11. doi:10.1016/0045-6535(80)90108-3
3. JC B. Mechanisms of Action of Known Human Carcinogens. PubMed. https://pubmed.ncbi.nlm.nih.gov/1428078/. Published 2020. Accessed June 20, 2020.
4. Phthalates. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/cosmetic-ingredients/phthalates. Published 2020. Accessed June 20, 2020.
5. Ec.europa.eu. https://ec.europa.eu/health/ph_risk/committees/04_sccp/docs/sccp_o_106.pdf. Published 2020. Accessed June 20, 2020.
6. Monographs.iarc.fr. https://monographs.iarc.fr/wp-content/uploads/2018/06/mono100F-29.pdf. Published 2020. Accessed June 20, 2020.
7. Hair-Smoothing Products That Release Formaldehyde When Heated. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/cosmetic-products/hair-smoothing-products-release-formaldehyde-when-heated. Published 2020. Accessed June 20, 2020.
8. Lead in Cosmetics. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/potential-contaminants-cosmetics/lead-cosmetics. Published 2020. Accessed June 20, 2020.
In this day and age, it’s very important to be aware of every ingredient we use not just in our diets but also in the cosmetics and products we put on our skin. Chemicals like BHA, DEA, formaldehyde, and parabens can be harmful to the body in more ways than one. Some chemicals can mimic endogenous hormones and cause imbalances and interruptions in hormone production further leading to infertility and pregnancy complications. Other chemicals can lead to skin irritations, dermatitis, and even skin disorders depending on the percentage of harmful chemicals as well as the individual’s skin sensitivity. Such agents may also be carcinogenic. And while they may not directly cause cancers, the absorption of harmful chemicals through the skin can increase the risk of mutations that can lead to cancers, especially in high risk patients. In particular, Butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) act as antioxidants, preservatives, and stabilizers and can be mostly found in cosmetics like lipsticks and eyeshadows. Diethanolamine (DEA) is an undesirable chemical that acts as a foaming agent and pH adjuster most commonly found in facial cosmetics like foundation. Another group of chemicals found in nail polish, hair sprays, perfumes, lotions, soaps, and shampoos are Phthalates dibutyl phthalate (DBP), dimethyl phthalate (DMP), and diethyl phthalate (DEP). These agents are used as plasticizers, solvents, as well as fragrance ingredients. Formaldehyde is a preservative agent that is also found in nail and hair products, as well as baby shampoo, body soap, and color cosmetics. PEGs are conditioning and cleaning agents found in a big majority of skincare and makeup products. These agents often include carcinogens like ethylene oxide and 1,4-dioxane, which is why it’s best to avoid products with PEGs. Other harmful chemicals include parabens, sodium lauryl sulfate, and synthetic colors derived from petroleum or coal tar sources. This wide variety of harmful chemicals is found in almost every product used in our daily lives. For this reason, as pharmacists, we always advise our patients to buy their products from reputable brands, test each product before committing to it, and check expiration dates.
Ty Bollinger. Cosmetics and Cancer Causing Ingredients. The Truth about Cancer. December 2014. <https://thetruthaboutcancer.com/cosmetics-cancer-causing-ingredients/> [Accessed 29 May 2020].
Carcinogens may be present in common personal care products. Cosmetics and other personal care products are not strictly regulated, so these chemicals are legally allowed in their small quantities. The mission of the International Agency of Research on Cancer (IARC), which is a part of the World Health Organization (WHO), is to identify causes of cancer and enhance cancer research internationally. IARC evaluates chemicals for their cancer-causing potential and classifies them into five levels. Group 1 agents are carcinogenic to humans while Group 4 agents are classified as probably not carcinogenic.
Of the known carcinogens categorized as Group 1, some have been or are currently being used in personal care products. They include formaldehyde, phenacetin, coal tar, benzene, methylene glycol, ethylene oxide, chromium, arsenic, etc. Some are more commonly used than others. Formaldehyde is a widely used preservative added to products like eye shadow, mascara, nail polish, nail treatments, shampoos, and soaps as a preservative, yet it is a classified human carcinogen. In regard to formaldehyde, there are also concerns about irritation to the eyes, nose, throat, and respiratory system.
Other ingredients present in cosmetic products (BHA, BHT, DEA, PEGs, parabens, fragrances, synthetic colors, etc.) can also be harmful but through other mechanisms. They can cause hormone interruption, birth and pregnancy complications, contact dermatitis, skin irritation, and skin disorders.
The best way to avoid these possible carcinogens and harmful ingredients in personal care products is to be aware of them and read labels. Try to buy from reputable brands, and test new products on a small patch of skin first in case of irritation.
Reference:
Carcinogens in Cosmetics. Safe Cosmetics. http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/known-carcinogens/. Accessed May 29, 2020.
There are many things we use daily that have cancer causing agents in them. It is very important for patients to be aware of these ingredients before purchasing these products. Some commonly used cancer causing agents are BHA, BHT, DEA, DBP, DMP, DEP, Formaldehyde, fragrance, PEGs, Parabens, Sodium, laureth sulfate/ Sodium lauryl sulfate, synthetic colors, siloxane, triclosan, and contaminants. BHA and BHT are antioxidants and fragrance ingredients which are commonly found in lipsticks and eyeshadows. Diethanolamine is a cancerous agent found in face makeup (foundations,etc). Formaldehyde is a very common preservative which is found in nail products, shampoo, body soap, color cosmetics, etc. Parabens is a very common product/preservative found in shampoos, lotions, conditioners, scrubs, etc. SLS is also found more commonly in shampoos which is considered not safe to use in the long run. There are many different alternatives for products which don't contain SLS. During manufacturing there can be other impurities and byproducts of ingredients that can lead to cancerous agents being released. Heavy metals such as lead, mercury, nickel, and cobalt are some examples. However, they won't be listed on the ingredients labels. Hence, it is very important to do your research and use products with very benign ingredients. These products can affect your health in different ways: cancer, hormone imbalances which can lead to infertility in both males and females, pregnancy complications which can lead to birth defects in babies, and skin irritation due to the harsh chemicals being applied on the skin. These products have small amounts of cancer agents, however since these products are not regulated by the FDA there is no supporting data showing the effect of these agents on a greater scale.
Reference:
Cosmetics. American Cancer Society. https://www.cancer.org/cancer/cancer-causes/cosmetics.html. Accessed May 29, 2020.
Everyday consumer products, ranging from cosmetics to personal care items, frequently contain chemicals that present potential health hazards, including carcinogenic properties. Ingredients such as phthalates, parabens, formaldehyde, synthetic fragrances, colors, and PEGs are commonly found in these products and have been associated with adverse health effects. For instance, formaldehyde, often used as a preservative, is classified as a human carcinogen, with its releasers present in products like eyelash glue and hair gel. Compounds like coal tar, benzene, mineral oils, and chromium also raise concerns, with some studies indicating possible links to conditions such as breast cancer, particularly in relation to permanent hair dye use.
The regulation of cosmetics and personal care products by the FDA is relatively lax compared to other regions. While bodies such as the International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) classify substances as known, probable, or possible carcinogens, regulatory standards vary across different jurisdictions. Taking a proactive approach involves scrutinizing product labels, identifying harmful ingredients, and opting for reputable brands. The European Union has stricter regulations compared to the United States, where restrictions often lag behind emerging research findings.
Recent studies have shed light on the landscape of personal care products used by communities, highlighting disparities in exposure and regulation. A study conducted last year focused on women of color in California, revealing gaps in understanding the prevalence of carcinogens, reproductive toxicants, and endocrine disruptors in their personal care products. Utilizing targeted analysis and suspect screening, the research provided a comprehensive evaluation of potentially hazardous chemicals across six product categories. Hair products, in particular, were found to contain a significant number of Chemicals of Concern (CoCs), with parabens being a predominant group detected in multiple products.
The study underscored concerns regarding undisclosed fragrance ingredients, which were found in a substantial percentage of products, including those used by Black women. The presence of Prop 65-listed carcinogens and reproductive toxicants on product labels further underscored potential health risks associated with routine use. Moreover, linguistic barriers were noted, with some products bearing labels in languages other than English, in violation of U.S. federal law.
Laboratory testing revealed a spectrum of CoCs, encompassing endocrine disruptors, carcinogens, and reproductive toxicants. Examples included benzyl chloride, unintentional additives like 1,4-dioxane, and significant levels of diethyl phthalate, a suspected endocrine disruptor commonly found in leave-on skin moisturizers. Fragrance-related issues persisted, with undisclosed ingredients detected in nail products and other categories, posing additional challenges to consumer safety and informed decision-making.
Despite limitations in sample size and product representation, the study called for expanded research efforts and automated screening tools to better monitor and disclose potentially harmful ingredients. It advocated for enhanced regulatory transparency and consumer education to promote safer cosmetic practices. Highlighting recent legislative initiatives in California, the study emphasized the importance of ingredient transparency and urged comprehensive reforms to ensure the safety of personal care products.
In summary, the study underscored the need for continued investigation into the health risks posed by CoCs in personal care items. It urged policymakers to reevaluate current regulatory frameworks, emphasizing the importance of comprehensive ingredient disclosure and informed consumer choices. By raising awareness and advocating for safer practices, the study aimed to mitigate potential health hazards associated with everyday cosmetic and personal care product use.
Hatta MNA, Mohamad Hanif EA, Chin S-F, Neoh H-m. Pathogens and Carcinogenesis: A Review. Biology. 2021; 10(6):533. https://doi.org/10.3390/biology10060533
Parsa N. Environmental factors inducing human cancers. Iran J Public Health. 2012;41(11):1-9.
Helicobacter pylori (H pylori) is a gram-negative bacterium that primarily colonizes the gastric mucosa. It is one of the most common bacterial infections, with estimates suggesting half to two-thirds of the global population is infected by H pylori. H pylori is typically transmitted via fecal-oral routes and less commonly by oral-oral, gastric-oral, or zoonotic transmission. Infected patients are usually asymptomatic but may present with abdominal pain and cramps, bloating, nausea and vomiting, or unintentional weight loss. H pylori is recognized as a major pathogen responsible for gastrointestinal disorders such as gastritis and peptic ulcer disease – accounting for 90-95% of duodenal ulcers and 70-85% of gastric ulcers. However, the most significant concern associated with infection is the increased risk of gastric cancers such as gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma.
The link between H pylori infection and gastric malignancy is well-established; epidemiological studies estimate >75% of gastric cancers are related to infection. In 1994, the World Health Organization recognized H pylori as a group 1 carcinogen, indicating a strong association with cancer development. The mechanisms by which H pylori contributes to cancer development are multifaceted. Adhesion molecules including SabA, BabA, and OipA contribute to the formation of membrane attachments that allow the bacterium to avoid immune destruction and colonize epithelium. H pylori neutralizes gastric acid through excessive urease production, promoting its survival and proliferation. The host immune response to urease incites an inflammatory reaction that stimulates release of cytokines (IL-8, IL-1, IL-6, and TNF-alpha) and perpetrates tissue injury. The chronic inflammation triggered by persistent H pylori infection may lead to progressive gastric mucosa destruction, potentially resulting in gastric atrophy and intestinal metaplasia. Additionally, specific strains, characterized by the presence of cytotoxin-associated gene A (CagA) and the vacuolating cytotoxin A (VacA), increase the risk of gastric cancer in infected patients. It remains unclear if H pylori infection is associated with other cancers; however, studies suggest infection may increase the risk of pancreatic and colorectal cancer, while decreasing the risk of esophageal adenocarcinoma.
Treatment of H pylori should be recommended to all patients positive for infection. Eradication of H pylori is shown to significantly decrease gastric cancer risk in infected individuals without precancerous lesions. One randomized clinical trial found that patients who received eradication therapy had a gastric cancer incidence of 1.6% as compared to 2.4% in the placebo group. Another long-term trial showed that eradication therapy reduced the incidence of gastric cancer by almost 50% over 22 years of follow-up. Furthermore, there is strong evidence to suggest MALT lymphoma can be completely cured by eradication of H pylori in early stages of infection. Several treatment options are available to eradicate H pylori, involving a combination of antibiotics, bismuth compounds, and proton pump inhibitors (PPIs). The addition of PPIs helps stabilize gastric pH to enhance the effectiveness of commonly used antibiotics such as clarithromycin, amoxicillin, and metronidazole. Careful selection of eradication therapy is necessary due to high rates of antibiotic resistance; guidelines recommend avoiding clarithromycin-based regimens if local resistance rates exceed 15% or the patient has past exposure to macrolide therapy. The prevalence of H pylori and escalation of antibiotic resistance support the need for further preventive measures. Research for a potential vaccine appears promising and may prove beneficial in reducing H pylori prevalence and preventing its associated complications.
References
Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017 Feb;112(2):212-39. https://journals.lww.com/ajg/fulltext/2017/02000/acg_clinical_guideline__treatment_of_helicobacter.12.aspx
Lamont JT. Bacteriology and epidemiology of Helicobacter pylori infection. Wolters Kluwer: UpToDate. 2022 Aug. https://www-uptodate-com.jerome.stjohns.edu/contents/bacteriology-and-epidemiology-of-helicobacter-pylori-infection
Polk DB, Peek RM. Helicobacter pylori: gastric cancer and beyond. Nat Rev Cancer. 2010 Jun;10(6):403-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957472/
Reyes VE. Helicobacter pylori and its role in gastric cancer. Microorganisms. 2023 May;11(5):1312. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220541/
Wroblewski LE, Peek RM, Wilson KT. Helicobacter pylori and gastric cancer: factors that modulate disease risk. Clin Microbiol Rev. 2010 Oct;23(4):713-39. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952980/
Everyday products we use, from cosmetics to personal care items, often contain chemicals that may pose health risks, including carcinogenic properties. Ingredients like phthalates, parabens, formaldehyde, fragrances, synthetic colors, and PEGs, commonly found in various products, have been linked to adverse health effects. Formaldehyde, for example, listed as a preservative, has been classified as a human carcinogen, and its releasers are present in products like eyelash glue and hair gel. Products containing coal tar, benzene, mineral oils, or chromium raise concerns, and some may even contribute to breast cancer, as seen in studies on permanent hair dye use.
Understanding these risks is crucial, given that cosmetics and personal care products are not rigorously regulated by the FDA. The International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) classify substances as known, probable, or possible carcinogens, yet regulations vary between regions. A proactive approach involves reading product labels, recognizing harmful ingredients, and choosing reputable brands. While the EU has stricter regulations, the U.S. often lags in implementing restrictions.
There was a study done last year that delves into the landscape of personal care products used by women of color in three communities of California. Despite some existing research on personal care product chemicals, the study emphasizes the gaps in understanding the presence of carcinogens, reproductive toxicants, and endocrine disruptors in products.
Employing targeted analysis and suspect screening, the research explores ingredient labels and conducts laboratory testing, presenting one of the first comprehensive evaluations of potentially hazardous chemicals in personal care products specific to racial/ethnic groups. The investigation spans six categories, with hair products exhibiting the highest number of Chemicals of Concern (CoCs). Parabens emerge as a prevalent group of chemicals, often co-occurring in the same product. Concerningly, Prop 65-listed carcinogens and reproductive toxicants appear on labels, signaling potential health risks for users.
The study unravels the issue of undisclosed fragrance ingredients, with 74% of products harboring these components. Fragrance-related concerns extend to products used by Black women, where 93% feature undisclosed fragrances. Across all categories, except makeup and nail products, "fragrance" or "parfum" dominates labels, obscuring the actual composition. The research spotlights a linguistic challenge as well, where 21 stores carry products with labels in languages other than English, violating U.S. federal law.
Laboratory analysis exposes a spectrum of CoCs, encompassing endocrine disruptors, carcinogens, and reproductive toxicants. The study reveals the presence of contaminants like benzyl chloride and unintentional additives such as 1,4-dioxane. Diethyl phthalate, a suspected endocrine disruptor, surfaces prominently, notably in a leave-on skin moisturizer. The detection of undisclosed fragrance ingredients and triphenyl phosphate in nail products raises additional concerns.
Despite limitations in sample size and product representation, the study contributes vital insights. It underscores the cumulative exposure risk stemming from multiple product use, emphasizing the need for further research on formaldehyde-releasing preservatives. The discussion contends that current regulations fall short, particularly in disclosing fragrance ingredients, urging a transformative shift. Applauding recent California legislation, the study champions ingredient transparency and advocates for safer cosmetics.
In conclusion, the research amplifies the call for expanded investigations, automated screening tools, and heightened consumer awareness. It urges a reevaluation of regulatory frameworks to ensure comprehensive ingredient disclosure, fostering informed consumer choices. The study illuminates the imperative to address health risks posed by CoCs in personal care items calling for safer cosmetic practices and regulatory reforms.
References:
Batyrova G, Kononets V, Amanzholkyzy A, Tlegenova Z, Umarova G. Chromium as a Risk Factor for Breast Cancer: A Meta-Analysis. Asian Pac J Cancer Prev. 2022 Dec 1;23(12):3993-4003
Johnson PI, Favela K, Jarin J, Le AM, Clark PY, Fu L, Gillis AD, Morga N, Nguyen C, Harley KG. Chemicals of concern in personal care products used by women of color in three communities of California. J Expo Sci Environ Epidemiol. 2022 Nov;32(6):864-876.
Kazemi Z, Aboutaleb E, Shahsavani A, Kermani M, Kazemi Z. Evaluation of pollutants in perfumes, colognes and health effects on the consumer: a systematic review. J Environ Health Sci Eng. 2022 Feb 3;20(1):589-598.
Cancer Causing Agents
Cancer is one of the leading causes of death worldwide and arises due to complex interactions between genetic factors and environmental exposure. Although, genetics plays a crucial role in cancer susceptibility, exposure to certain cancer-causing agents significantly contributes to the development of various cancer types. The two significant categories of cancer-causing agents are environmental carcinogens and lifestyle-related risk factors.
Environmental carcinogens are substances or agents present in the surroundings that can induce cancer formation. They may infiltrate the air we breathe, the water we drink, and the food we consume, leading to potential long-term health hazards. Several environmental carcinogens have been identified, including polycyclic aromatic hydrocarbons (PAHs), asbestos, and ultraviolet (UV) radiation. PAHs are a group of organic compounds commonly released through incomplete combustion of fossil fuels, tobacco smoke, and certain industrial processes. Numerous studies have associated exposure to PAHs with lung, skin, and bladder cancers. This exposure is particularly concerning for those living in urban areas where there is constant heavy traffic causing the concentration of PAHs in the air to pose significant health risks. Asbestos is a group of naturally occurring minerals that were extensively used in construction materials due to their fire-resistant properties. Inhalation of asbestos fibers can lead to mesothelioma, lung cancer, and other respiratory diseases. Finally, excessive exposure to ultraviolet (UV) radiation from the sun or artificial sources, such as tanning beds, is a known cause of skin cancer, including melanoma, the most dangerous form of skin cancer. Regular use of sunscreen, protective clothing, and avoiding direct sun exposure during peak hours can reduce the risk.
On the other hand, lifestyle choices have a significant impact on an individual's risk of developing cancer. Unhealthy habits and behaviors can expose individuals to various cancer-causing agents. Some notable lifestyle-related cancer risk factors include tobacco use, having an unhealthy diet, and alcohol consumption. Tobacco consumption, either through smoking or smokeless products, is a primary cause of cancer worldwide. Cigarettes contain numerous carcinogens, such as polonium-210, benzene, and nitrosamines, which can trigger cancers in the lungs, throat, mouth, and other organs. Additionally, a diet high in red meats, saturated fats, and low in fruits and vegetables has been associated with an increased risk of colorectal, pancreatic, and breast cancers. Lastly, excessive alcohol consumption is a significant risk factor for several cancers, including those of the liver, breast, esophagus, and mouth.
Citations:
Loomis, D., Guyton, K., Grosse, Y., El Ghissasi, F., Bouvard, V., Benbrahim-Tallaa, L., Guha, N., Mattock, H., Straif, K., & International Agency for Research on Cancer Monograph Working Group, IARC, Lyon, France (2015). Carcinogenicity of lindane, DDT, and 2,4-dichlorophenoxyacetic acid. The Lancet. Oncology, 16(8), 891–892. https://doi.org/10.1016/S1470-2045(15)00081-9
Islami, F., Goding Sauer, A., Miller, K. D., Siegel, R. L., Fedewa, S. A., Jacobs, E. J., McCullough, M. L., Patel, A. V., Ma, J., Soerjomataram, I., Flanders, W. D., Brawley, O. W., Gapstur, S. M., & Jemal, A. (2018). Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: a cancer journal for clinicians, 68(1), 31–54. https://doi.org/10.3322/caac.21440
Written by Aleksandra Agranovich
Products to Avoid
The skin, also known as the integumentary system, is one of the largest organs in the human body. The skin mainly functions as a protective barrier against external factors. It also regulates body temperature through moisture control and reduces the harmful effects of UV radiation.
Throughout history, people have been trying to use different types of skin care techniques to make themselves look younger and have healthier skin. But with all of the skin care products available on the market, how do we really know which ones are safe to use? According to a study that was tested in the United States and in Canada, there are over one hundred harmful chemicals that have been identified in household skin care products (American Cancer Society). These substances can include chemicals such as perfluorooctanoic acid, which can cause cancer and other abnormalities over time.
The types of reactions that may occur with toxic skin care products can include rash, redness, itchiness, burning, and stinging. If you’ve ever experienced any of these side effects while using a particular brand, then it is likely that your skin care item contains chemicals that are not as healthy as you thought they were. Even common ingredients like parabens and exfoliants can leave your skin feeling red, flakey, and uncomfortable.
Most skin care products contain lists of ingredients that are impossible to pronounce… which ultimately diverts our attention. It is very important to stay away from products that contain polyethylene glycol, methyl and propyl parabens, aluminum, formaldehyde, phthalates, and oxybenzone’s (Healthline).
In addition to these toxic substances, it may also be a good idea to avoid using products that have fragrances and perfumes. Most of the fragrances that are added to skin care products contain benzene derivatives which can lead to skin cell abnormalities and cancer as well.
Natural/ Safe Products
In most cases, it is always best to stick to natural substances and avoid synthetic ones. Below is a list of safe ingredients that may benefit all skin types.
· Tea tree oil
· Coconut oil
· Elderberry Extract
· Willow Bark Extract
· Products that are Alcohol Free
· Products that do not contain steroids
· 100% Pure and Cruelty Free
· Products that contain Zinc
Resources
Mayer, Beth Ann. “Derms Say Avoid These 6 Skin Care Bad Guys.” Healthline, Healthline Media, 1 Sept. 2022, https://www.healthline.com/health/beauty-skin-care/ingredients-to-avoid-for-stress-free-skin-care#takeaway.
Lichterfeld, Andrea et al. “Evidence-Based Skin Care: A Systematic Literature Review and the Development of a Basic Skin Care Algorithm.” Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society vol. 42,5 (2015): 501-24. doi:10.1097/WON.0000000000000162
Natalie Eshaghian & Donna Salib
Cancer Causing Ingredients
Have you ever stopped to look at the back of a product label and wonder what that endless ingredient list really consists of? Many of the daily use products we use contain chemicals/ingredients that can cause harm to our bodies, and can even be carcinogenic. Some products that are found to be carcinogenic are phthalates, parabens, formaldehyde, fragrances, synthetic colors, PEGs, triclosan, along with many others. It is important to understand what these products are and why we should or should not have them in our products.
Formaldehyde is one of those ingredients listed in products used as a preservative, but is seen to be a human carcinogen. In 1981, The National Toxicology Program (NTP) first listed formaldehyde in the 2nd Report on Carcinogens as reasonably anticipated to be a human carcinogen. You can find formaldehyde in many of our adhesive products, such as eyelash glue, hair gel, shampoos and soaps, as well as binders for wood and plastic.1 Formaldehyde is able to create cross links between DNA-DNA and DNA-protein due to its ability to bind to DNA. This is seen to be the relation of formaldehyde’s cytotoxic ability.2 Formaldehyde releasers, which are chemicals that slowly release formaldehyde, are found in products in order to preserve it. A few of these formaldehyde releasing agents include: imidazolidinyl urea, DMDM hydantoin, and diazolidinyl urea. What makes it so hard to find these names on the label is that there can be variations of the names of these formaldehyde carrying agents. In Europe, a concentration of 0.02% for formaldehyde releasing agents is allowed while in the U.S., a concentration of up to 0.1 ppm is allowed due to Americans having more ventilation for these products than Europe. When formaldehyde is present in the air at levels higher than 0.1 parts per million (ppm), some people may experience: watery eyes, burning sensations of the eyes, nose, and throat, coughing, wheezing, nausea, and skin irritation. According to the European Cosmetic Directive, all products containing formaldehyde or its releasers must be labelled “contains formaldehyde” when the concentration of formaldehyde in the finished product exceeds 0.05% (500 ppm). Since formaldehyde is common in many household products, it is difficult to completely remove it from the air, but you can try to reduce how much of its levels are in your home by increasing ventilation.
Triclosan is another example of an ingredient to look out for, which is an antimicrobial compound that has been used in consumer products for about 40 years, found in 75% of liquid hand soap and 30% of bar soap. Triclosan is what makes many of our soaps antibacterials, which work by denaturing proteins and disrupting membranes. Per various studies, triclosan seems to harm immune function, endocrine function and reproductive health. In studies conducted on rats, triclosan affects the levels of estrogen, testosterone, and thyroid seen in their bodies. Triclosan in antimicrobial soap has not been found to be superior to washing hands with regular soap, therefore in September 2016, triclosan was banned from soap products following the risk assessment by the U.S.A. Food and Drug Administration (FDA). However, triclosan is still permitted to be in toothpastes, hand sanitizers, and mouthwash as it is widely utilized to help fight gingivitis.3 The European Union (EU) also banned triclosan from all human hygiene biocidal products in January 20174. Some researchers were also concerned that using triclosan for long periods of time would create more antibacterial-resistant bacteria. The issue of triclosan resistant organisms arises due to its use, an example being salmonella enterica. Ultimately, washing your hands with good old fashioned hand soap is the way to go!
Every day we are exposed to many different chemicals in our environment, including those in personal care products. “Less is more” is certainly the lesson to be taken away from these examples. Although it can be difficult, less chemical exposure means less risk of cancers. It’s become increasingly clear that most mainstream cosmetic and personal care products contain at least one hazardous chemical compound, some of which have been deemed toxic by the National Institute of Occupational safety. Cosmeticsdatabase.com is a great resource to find what chemicals are in your personal care products and what risks are associated with these chemicals. This database is provided by The Environmental Working Group (EWG), which is a non-profit organization that specializes in research of toxic chemicals. Since we know that the FDA does not assess the safety of personal care products or their ingredients, it is up to consumers to protect themselves by educating themselves and identifying the best possible choices when shopping.
References:
1 Bosetti C, McLaughlin JK, Tarone RE, Pira E, La Vecchia C. Formaldehyde and cancer risk: a quantitative review of cohort studies through 2006. Ann Oncol. 2008;19(1):29-43. doi:10.1093/annonc/mdm202
2 Allegra A, Spatari G, Mattioli S, et al. Formaldehyde Exposure and Acute Myeloid Leukemia: A Review of the Literature. Medicina (Kaunas). 2019;55(10):638. Published 2019 Sep 25. doi:10.3390/medicina55100638
3 Weatherly LM, Gosse JA. Triclosan exposure, transformation, and human health effects. J Toxicol Environ Health B Crit Rev. 2017;20(8):447-469. doi:10.1080/10937404.2017.1399306
4Juncker J-C. Commission impementing decision not approving triclosan as an existing active substance for use in biocidal products for product-type 1. 2016.
As indicated in its name, a carcinogen is something that can cause/make a person more susceptible to (a) certain type of cancer(s). How much exposure and even genetic makeup play a crucial role in developing cancer from a carcinogen. Extensive research has been done on this topic, primarily on lab animals such as mice as the test subject. Common examples of carcinogens include formaldehyde, ultraviolet rays, smoking, processed meat, pollution, and alcohol. As mentioned in the International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP), human carcinogens include alcohol under different classifications. More specifically, the International Agency for Research on Cancer- Group 1: Carcinogenic to humans has known human carcinogens listed as- acetaldehyde (from consuming alcoholic beverages), alcoholic beverages, ethanol in alcoholic beverages, and isopropyl alcohol manufacture using strong acids.
There is clear evidence that alcohol drinking can cause cancer. The evidence that the consumption of alcoholic beverages is a known human carcinogen is that the more alcohol a person drinks, in particular the more alcohol that a person would regularly drink (let’s say on a daily basis), the higher that person is subjected his or her risk of developing an alcohol-associated cancer. This can even include light alcohol drinkers which is defined as those who have only one drink per day. An estimated 3.5% of cancer deaths (which accounts for roughly 19,500 deaths) in the United States of America were related to alcohol consumption. Alcohol consumption is correlated with attributing to these types of cancer- breast cancer, colorectal cancer, esophageal cancer, head and neck cancer, and liver cancer. It is important for physicians to categorize patients based on their pattern of alcohol use in order to best assist them. For example, even if moderate alcohol consumption has some limited risks, the question arises of how much of a risk it is, and, more importantly, if the risk is worth taking for that patient. Alcohol consumption is frequently done socially and possibly for enjoyment so all of these factors must be taken into account to outweigh the personal benefits to the possible risks for each and every specific patient.
There have been many ways hypothesized as to exactly how alcohol increases the risk of cancer. One of these ways is by metabolizing ethanol in alcoholic drinks into acetaldehyde, which is a toxic chemical and a potential human carcinogen. Acetaldehyde can even damage both DNA and proteins. Another hypothesized way is by the generation of reactive oxygen species (which are chemically reactive molecules that contain oxygen), which can damage DNA, proteins, and lipids in the body through a scientific process called oxidation. A third way is impairing the body’s ability to break down and absorb a variety of nutrients that may be associated with cancer risk, including vitamin A, nutrients in the vitamin B complex (such as folate, also known as vitamin B9) vitamin C, vitamin D, and vitamin E. There are also ways in which alcohol can be linked to a specific type of cancer such as alcohol increasing the blood levels of estrogen in a female, estrogen being a sex hormone linked to increasing the risk of breast cancer.
References-
Known and Probable Human Carcinogens. American Cancer Society. https://www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-carcinogens.html
Prevention- Limit Alcohol. Cancer Council- Victoria. https://www.cancervic.org.au/preventing-cancer/limit-alcohol/how-alcohol-causes-cancer
Nelson DE, Jarman DW, Rehm J, et al. Alcohol-attributable cancer deaths and years of potential life lost in the United States. American Journal of Public Health 2013;103(4):641-648.
Alcohol and Cancer Risk. National Cancer Institute. https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet#r8
As humans living in this modern day and age, we are exposed to various DNA-damaging agents known as carcinogens. Carcinogen exposure will lead to many forms of DNA damage which includes single and double strand breaks, oxidative induced lesions, and DNA-DNA and DNA-protein cross links. Carcinogens that are directly associated with DNA damage includes: ultraviolet light, heterocyclic aromatic amines, mycotoxins, polycyclic aromatic hydrocarbons, nitrosamines, ionising radiation, aristolochic acid and particulate matter. Carcinogens will either be chemical or physical agents and will cause DNA damage through multiple different processes with an extent of damage that depends on their physicochemical properties.For example, ionising radiation carcinogens are able to cause DNA double strand breaks (DSBs) through free radical generation.
Carcinogens also fall into two more categories which are either activation dependent and activation independent. Direct acting carcinogens that are able to directly interact with DNA and do not need metabolic activation or molecular modification to cause DNA damage include ultraviolet (UV), nitrosamines, and alkylating agents. Altering DNA bases will disrupt the arrangement of genetic material and lead to formation of DNA adducts depending on the carcinogen. The corrupted DNA mechanisms will lead to DNA lesions inherited by daughter cells and the accumulation of DNA damage, ultimately resulting in cancer. Indirect acting carcinogens require bioactivation in host cells in order to turn them into carcinogenic metabolites capable of genotoxicity.
Polycyclic aromatic hydrocarbons (PAHs) are the largest group of indirect acting carcinogens to which humans are exposed to. Exposure to PAHs has been most commonly linked to the development of lung, breast and skin cancers. Carcinogenic PAHs and tobacco-specific nitrosamines are carcinogens commonly found in tobacco smoke. The combustion of a single cigarette alone is capable of producing thousands of carcinogenic agents that are DNA damaging. After the bioactivation of PAHs through the CYP mixed function oxidase system, electrophilic metabolites will covalently bind to DNA bases forming DNA adducts. Forming DNA adducts could lead to mutations at the sites they are located due to DNA replication of unrepaired DNA.
The International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) determine if a substance is classified as a carcinogen. The lists of carcinogens made by the IARC and NTP only includes substances that have been evaluated by those agencies. Their lists include substances that are classified as “known” and “probable” carcinogens and will not include “possible” carcinogens. However the IARC and NTP act independently and if there is a substance listed as a carcinogen on one list and not the other, it may only mean that only that agency had evaluated. Also it is not necessarily true that a carcinogen will cause cancer with any type of exposure or in every human being in the same manner. Some carcinogens may lead to cancer after a small exposure and others lead to cancer after greater exposure over a long period of time.
To find out how to reduce and avoid exposure to carcinogens especially in the workplace among other resources, you can also visit the official Occupational Safety and Health Administration website.
Barnes JL, Zubair M, John K, Poirier MC, Martin FL. Carcinogens and DNA damage. Biochem Soc Trans. 2018;46(5):1213-1224.
Known and Probable Human Carcinogens. American Cancer Society. https://www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-carcinogens.html. Reviewed 2019 August 14. Accessed 2021 June 8.
Carcinogens: Possible Solutions. Occupational Safety and Health Administration. https://www.osha.gov/carcinogens/solutions. Accessed 2021 June 8.
There are a plethora of harmful chemicals, toxins and carcinogens found in personal cosmetic products. Parabens are a common preservative used in products like cosmetics, lotions, moisturizers, shampoo, shaving and tanning products. Parabens include methyl, propyl, and butyl parabens, which are known to have cancer side effects. Parabens can act similar to estrogen in increasing the risk of breast cancer. They can increase cell growth and promote growth of estrogen-positive breast tumors, and can even decrease the effects of tamoxifen which is chemotherapy used to block estrogen effects.
These effects are on the general endocrine system because they can disrupt normal hormone production, which happens in males too. They can cause low sperm count and decreased levels of testosterone, and this is usually in a dose dependent manner. Ironically, a lot of skin care products marketed for anti-aging actually contain parabens which accelerate aging in the skin. Skin cells can die at a faster rate when parabens on the skin are exposed to the sun and UV light.
A study found a clinical effect of Methylparaben on the skin’s keratinocytes. Daily application of a product containing Methylparaben on the forearm resulted in unmetabolized paraben and persistence in the stratum corneum. The final results suggest that application of dermatological formulations results in Methylparaben persistence and accumulation in the skin, and that it might influence the aging and differentiation of keratinocytes. This is also due to the fact that it was found to decrease hyaluron synthase and collagen, two components to skin that keep it healthy and young.
With all we know about the harmful effects of parabens, we as pharmacists have a responsibility to inform our patients how to select safer products. There are many common cosmetic products on the market that may contain parabens. Its best to avoid any that contain these ingredients.
1. Ishiwatari S, Suzuki T, Hitomi T, Yoshino T, Matsukuma S, Tsuji T. Effects of methyl paraben on skin keratinocytes. J Appl Toxicol. 2007;27(1):1-9.
Many ingredients we use daily may have carcinogenic properties that can cause cancer later on if used in excess. It is crucial for a health care provider to educate patients on these products when the patient is said to inquire regarding using something new. It is important to establish a trusting relationship between the health care provider and the patient in order to have the patient feel more comfortable asking questions to the providers. Cosmetics as well as other personal care products are not strictly regulated by the FDA, so harmful ingredients are allowed in products in a very small amount. Some ingredients commonly used today associated with causing cancer are BHA, BHT, DEA, DEP, formaldehyde, SLS or sodium lauryl sulfate, siloxane, PEGs, parabens and fragrance. Formaldehydes are actually a preservative that is found in many daily use products such as nail polish, body wash and even shampoos. Formaldehyde is also known to cause skin and eye irritation. Formaldehydes have also been linked to nasopharyngeal cancer as well as leukemia and respiratory problems. Its use has still not been regulated even though there is a link between use and emergence of cancer. In fact, the European Union (EU) has restricted use to not more than 0.2% of formaldehyde in personal care products. The FDA is yet to put a regulation on the amount of formaldehyde in cosmetic and personal care products despite the risks. Butylated hydroxy anisole (BHA) and butylated hydroxytoluene (BHT) are antioxidants that also provide many products with fragrance, they are present in many lipsticks and other cosmetic products. SLS or sodium lauryl sulfate is found in shampoos, to provide a surfactant to the shampoo also inducing the suds when one lathers. SLS or sodium lauryl sulfate is considered to be harmful with long term use. This is dangerous in those patients that stick to one product over the course of their lifetime. Another process that is harmful is the modern process of manufacturing these products. When manufacturing is going on, there can be impurities released into the product or improper cleaning of machines can cause contamination within these products. Metals such as nickel and even mercury can contaminate these products. This can affect a patient’s health from cancer to causing a hormone imbalance. The hormone imbalance can cause pregnancy complications infertility in both males and females. Although many argue that small amounts of these ingredients are not harmful, these products are not FDA regulated therefore are able to cause increase risk because of the lack of testing. It is important for a patient to do personal research before purchasing any product, as if it were a food, to truly see if it may be potentially harmful to them. As health care providers, it is important to know the potential dangers of certain ingredients in order to educate patients on what to refrain from. A tip to use to avoid potential skin irritation or allergy is to test the product on a small patch of skin before use and see the skin’s reaction after a couple of days. PEGs are cleaning ingredients that are found in skincare and makeup products. PEGs often contain harmful carcinogens like ethylene oxide so it is best to avoid products with PEGs in them.
References:
https://www.cancer.org/cancer/cancer-causes/cosmetics.html
Cosmetics and personal care products are often products that are either applied to the skin or hair, and a lot of the added chemicals in these cosmetics have the potential to be absorbed into the body. It is important to have an interest in whether these products can cause a potential health risk to the consumer using them. In some products, there has been an association between their ingredients and cancer. It is worthwhile having a deeper look and understanding into what ingredients are included in our everyday cosmetic products .
In a 2008 study, the International Agency for Research on Cancer analyzed data for potential association between permanent, semi-permanent, and natural hair dyes and their link to cancer. This agency has determined that the personal use of hair dye is not classifiable as a human carcinogen, and that there is very limited evidence for carcinogenicity in humans and experimented animals. Since then, many meta-analysis have been published including a 2018 analysis which included eight case control studies that found a modest increase in the risk of breast cancer among women who used hair dye. Many cohort studies done since then included telephone interviews, home visits, and follow up questionnaires to determine if there was an association between hair dye in cancer. The studies actually found out that permanent hair dye used every 5 to 8 weeks was associated with a significantly higher risk of breast cancer compared to women that didn't use hair dye. When divided up by race, the study found that the association with permanent hair dye was particularly evident in African American women, who had a 45% higher risk for breast cancer
There have been multiple theories associating the risk of underarm antiperspirant's and breast cancer. Cancer causing substances in antiperspirants are absorbed through razor nicks from underarm shaving, and these substances are said to be absorbed through lymph nodes under the arm. These toxins are not able to get removed from the underarm area, and eventually can lead to cells mutating and forming into cancer. Using antiperspirant can increase the intake of parabens to be absorbed through the skin. Parabens can raise a possible concern because studies have shown that parabens have weak estrogen like properties, and estrogen is a female hormone known to cause breast cells to grow and divide. Some conditions that increase the body's exposure to estrogen such as obesity or late menopause have been linked to an increased risk of breast cancer.
Some cancer-causing agents that are found in potential cosmetics and personal care products contain formaldehyde and formaldehyde releasing preservatives. In addition , consumers should be aware of coal tar, benzene, mineral oils, or chromium found in any ingredient section of a cosmetic product. There is often little study done on the type of carcinogens in cosmetic products , therefore scientists must resort to other types of tests which include taking one or two ingredients at a time at much higher doses to try to determine the potential of that chemical to cause cancer.
US Food and Drug Administration. FDA Authority Over Cosmetics. 2013. Accessed at http://www.fda.gov/cosmetics/guidanceregulation/lawsregulations/ucm074162.htm on April 14, 2014.
International Agency for Research on Cancer (IARC) Working Group on the Evaluation of Carcinogenic Risks to Humans. Occupational exposures of hairdressers and barbers and personal use of hair colourants. In: Some Aromatic Amines, Organic Dyes, and Related Exposures. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans; v. 99. Lyon, France: International Agency for Cancer Research; 2010.
Written by: Denise Cotter and Niyati Doshi
There are many things we use on a daily basis that we think are beneficial for us to use, but have not realized contain ingredients that are harmful or full of carcinogens. These items we use on a daily basis range from personal or self-care products to cosmetics and makeup. Some of these agents include: BHA, BHT, DEA, DMP, formaldehyde, PEGs, parabens, SLS, siloxane, and triclosan. Although the purpose of these ingredients can range from preservative to pH adjuster to foaming agent to fragrance to conditioning/cleaning agents to an emulsifying agent to a softening or moisturizing agent, they can also be considered harmful if used for a prolonged period of time. As mentioned in the powerpoint, these chemicals can affect our health because they can be cancer causing, cause hormone interruption, lead to birth and pregnancy complications, cause contact dermatitis/skin irritation, or skin disorders. This may not occur right away, because the items we use may contain small amounts of carcinogens, but over a prolonged period of time, these chemicals can cause mutations of some sort and lead to an increased risk of cancer.
Agencies such as the International Agency for Research on Cancer (IARC) and the US National Toxicology Program (NTP) determine whether or not a certain chemical is a carcinogen or cancer-causing. The IARC is independent of the NTP and each organization has their own list. The IARC is a part of the World Health Organization (WHO). The IARC consolidates information or data gathered and classifies the chemicals into five different levels. Group 1 is carcinogenic to humans, Group 2A is possibly carcinogenic to humans, Group 2B is possibly carcinogenic to humans, Group 3 is not classifiable as their carcinogenicity to humans, and Group 4 is probably not carcinogenic to humans. Group 1 contains 11 agents or chemicals that have been used or are currently being used in personal care products and are known to be carcinogenic in humans. These agents are: formaldehyde, phenacetin, coal tar, benzene, untreated or mildly treated mineral oils, methylene glycol, ethylene oxide, chromium, cadmium and its compounds, arsenic, and crystalline silica or quartz.
As a consumer or for our patient population, it is best to try and understand what products are harmful or potentially carcinogenic and we should be mindful in reading the product labels. Once we understand what all the terms mean, we can narrow down what brands to purchase from and which to avoid. These products are being used or rubbed into our skin, which can cause damage in the long run. It is also not fully regulated, so legally cancer-causing chemicals or carcinogens are allowed into personal care products in small quantities. Some things to look out for on labels include: formaldehyde and formaldehyde releasing preservatives (quaternium-15, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, and 2-bromo-2-nitropropane-1,3 diol), phenacetin, coal tar, benzene, untreated or mildly treated mineral oils, ethylene oxide, chromium, cadmium and its compounds, arsenic and crystalline silica (or quartz). More regulations against these agents, such as being prohibited for use or restricted for use exist more in the EU, whereas in America, although the IARC and NTP gather information and see if a chemical is potentially carcinogenic or harmful, there is limited regulation on whether or not it can be added to a product. The best way any patient or consumer can be mindful is to try and avoid long term use of a single product, pay attention to expiration dates, purchase cosmetics and personal care products from reputable brands, and apply a small amount of the product to a test area before applying a large amount to avoid any skin irritations or allergic reactions.
Reference(s):
“Carcinogens in Cosmetics.” Safe Cosmetics, www.safecosmetics.org/get-the-facts/chemicals-of-concern/known-carcinogens/#:~:text=Of%20the%20113%20agents%20listed,and%20its%20compounds%2C%20arsenic%2C%20and.
“Known and Probable Human Carcinogens.” American Cancer Society, www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-carcinogens.html.
Carcinogens, as substances that either indirectly or directly alter the structure or function of DNA, promote DNA mutation. Although we are still learning the exact pathologic processes involved, it is clear that carcinogenesis is multifactorial, including our individual genetic makeup and the substances we ingest or apply.
Potential carcinogens exist in our common cosmetic items. Although cosmetic ingredients fall under the overview of the Food and Drug Administration (FDA), they aren’t as heavily regulated. As such, the rigorous testing involved in determining the safety and long-term risks associated with cosmetic items aren’t as apparent. However, the International Agency of Research on Cancer (IARC) has worked to classify carcinogens according to their carcinogenic potential.
According to the IARC 2012 Report on Carcinogens, several household chemicals, such as coal tar, formaldehyde, ethylene oxide, and heavy metals, like chromium, arsenic, lead, and mercury, have been confirmed to be carcinogenic.
Formaldehyde has long been linked to nasopharyngeal cancer and leukemia, along with a host of respiratory issues. Despite this clear relationship, the FDA has not limited its use as a preservative in hair care and nail polishes, and only acts when products fail to warn consumers of potential risks. The Cosmetic Ingredient Review (CIR), an independent safety panel, has chosen to adopt the European Union (EU)’s regulation that restricts more than 0.2% of formaldehyde in personal care products. But whereas this is a law in the EU, the CIR’s recommendation can only serve as a guideline in the US. Regardless, cosmetic companies have elected to use “formaldehyde releasers”, such as imidazolidinyl urea and quaternium-15 that decompose over time or when exposed to heat.
Phthalates are currently used in the US as fragranced external cosmetic items, hair care products, and nail polish. Phthalates, including diethylphthalate (DEP), dibutylphthalate (DBP), and dimethylphthalate (DMP) have been historically used in cosmetic and household items as fragrances and plasticizers, respectively. The FDA concluded that there was no evidence that phthalates in cosmetic items had health risks and that the exposure of phthalates in those items were minimal compared to the levels required to cause adverse events in animals. However, the European Commission Health and Consumers decided to restrict phthalates in cosmetic products due to studies linking its use with endocrine dysfunction and reproductive interference.
Heavy metals are still found in many personal care items. The FDA has published guidelines on heavy metal limits. Lead, which is commonly present as an impurity in color additives in lipstick and eye shadows, is limited to 10-20 parts per million (ppm). Mercury is limited to 65 ppm when it is used as a preservative in eye area products.
Although it is ultimately the consumer’s responsibility to be well-informed and choose safe products for his or herself, pharmacists can play a guiding role in identifying potentially harmful ingredients.
References
1. Cosmetics. Cancer.org. https://www.cancer.org/cancer/cancer-causes/cosmetics.html. Published 2020. Accessed June 20, 2020.
2. Hutzinger O. Carcinogens: Identification and mechanisms of action. Chemosphere. 1980;9(2):N10-N11. doi:10.1016/0045-6535(80)90108-3
3. JC B. Mechanisms of Action of Known Human Carcinogens. PubMed. https://pubmed.ncbi.nlm.nih.gov/1428078/. Published 2020. Accessed June 20, 2020.
4. Phthalates. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/cosmetic-ingredients/phthalates. Published 2020. Accessed June 20, 2020.
5. Ec.europa.eu. https://ec.europa.eu/health/ph_risk/committees/04_sccp/docs/sccp_o_106.pdf. Published 2020. Accessed June 20, 2020.
6. Monographs.iarc.fr. https://monographs.iarc.fr/wp-content/uploads/2018/06/mono100F-29.pdf. Published 2020. Accessed June 20, 2020.
7. Hair-Smoothing Products That Release Formaldehyde When Heated. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/cosmetic-products/hair-smoothing-products-release-formaldehyde-when-heated. Published 2020. Accessed June 20, 2020.
8. Lead in Cosmetics. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/potential-contaminants-cosmetics/lead-cosmetics. Published 2020. Accessed June 20, 2020.
In this day and age, it’s very important to be aware of every ingredient we use not just in our diets but also in the cosmetics and products we put on our skin. Chemicals like BHA, DEA, formaldehyde, and parabens can be harmful to the body in more ways than one. Some chemicals can mimic endogenous hormones and cause imbalances and interruptions in hormone production further leading to infertility and pregnancy complications. Other chemicals can lead to skin irritations, dermatitis, and even skin disorders depending on the percentage of harmful chemicals as well as the individual’s skin sensitivity. Such agents may also be carcinogenic. And while they may not directly cause cancers, the absorption of harmful chemicals through the skin can increase the risk of mutations that can lead to cancers, especially in high risk patients. In particular, Butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) act as antioxidants, preservatives, and stabilizers and can be mostly found in cosmetics like lipsticks and eyeshadows. Diethanolamine (DEA) is an undesirable chemical that acts as a foaming agent and pH adjuster most commonly found in facial cosmetics like foundation. Another group of chemicals found in nail polish, hair sprays, perfumes, lotions, soaps, and shampoos are Phthalates dibutyl phthalate (DBP), dimethyl phthalate (DMP), and diethyl phthalate (DEP). These agents are used as plasticizers, solvents, as well as fragrance ingredients. Formaldehyde is a preservative agent that is also found in nail and hair products, as well as baby shampoo, body soap, and color cosmetics. PEGs are conditioning and cleaning agents found in a big majority of skincare and makeup products. These agents often include carcinogens like ethylene oxide and 1,4-dioxane, which is why it’s best to avoid products with PEGs. Other harmful chemicals include parabens, sodium lauryl sulfate, and synthetic colors derived from petroleum or coal tar sources. This wide variety of harmful chemicals is found in almost every product used in our daily lives. For this reason, as pharmacists, we always advise our patients to buy their products from reputable brands, test each product before committing to it, and check expiration dates.
Ty Bollinger. Cosmetics and Cancer Causing Ingredients. The Truth about Cancer. December 2014. <https://thetruthaboutcancer.com/cosmetics-cancer-causing-ingredients/> [Accessed 29 May 2020].
Carcinogens may be present in common personal care products. Cosmetics and other personal care products are not strictly regulated, so these chemicals are legally allowed in their small quantities. The mission of the International Agency of Research on Cancer (IARC), which is a part of the World Health Organization (WHO), is to identify causes of cancer and enhance cancer research internationally. IARC evaluates chemicals for their cancer-causing potential and classifies them into five levels. Group 1 agents are carcinogenic to humans while Group 4 agents are classified as probably not carcinogenic.
Of the known carcinogens categorized as Group 1, some have been or are currently being used in personal care products. They include formaldehyde, phenacetin, coal tar, benzene, methylene glycol, ethylene oxide, chromium, arsenic, etc. Some are more commonly used than others. Formaldehyde is a widely used preservative added to products like eye shadow, mascara, nail polish, nail treatments, shampoos, and soaps as a preservative, yet it is a classified human carcinogen. In regard to formaldehyde, there are also concerns about irritation to the eyes, nose, throat, and respiratory system.
Other ingredients present in cosmetic products (BHA, BHT, DEA, PEGs, parabens, fragrances, synthetic colors, etc.) can also be harmful but through other mechanisms. They can cause hormone interruption, birth and pregnancy complications, contact dermatitis, skin irritation, and skin disorders.
The best way to avoid these possible carcinogens and harmful ingredients in personal care products is to be aware of them and read labels. Try to buy from reputable brands, and test new products on a small patch of skin first in case of irritation.
Reference:
Carcinogens in Cosmetics. Safe Cosmetics. http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/known-carcinogens/. Accessed May 29, 2020.
There are many things we use daily that have cancer causing agents in them. It is very important for patients to be aware of these ingredients before purchasing these products. Some commonly used cancer causing agents are BHA, BHT, DEA, DBP, DMP, DEP, Formaldehyde, fragrance, PEGs, Parabens, Sodium, laureth sulfate/ Sodium lauryl sulfate, synthetic colors, siloxane, triclosan, and contaminants. BHA and BHT are antioxidants and fragrance ingredients which are commonly found in lipsticks and eyeshadows. Diethanolamine is a cancerous agent found in face makeup (foundations,etc). Formaldehyde is a very common preservative which is found in nail products, shampoo, body soap, color cosmetics, etc. Parabens is a very common product/preservative found in shampoos, lotions, conditioners, scrubs, etc. SLS is also found more commonly in shampoos which is considered not safe to use in the long run. There are many different alternatives for products which don't contain SLS. During manufacturing there can be other impurities and byproducts of ingredients that can lead to cancerous agents being released. Heavy metals such as lead, mercury, nickel, and cobalt are some examples. However, they won't be listed on the ingredients labels. Hence, it is very important to do your research and use products with very benign ingredients. These products can affect your health in different ways: cancer, hormone imbalances which can lead to infertility in both males and females, pregnancy complications which can lead to birth defects in babies, and skin irritation due to the harsh chemicals being applied on the skin. These products have small amounts of cancer agents, however since these products are not regulated by the FDA there is no supporting data showing the effect of these agents on a greater scale.
Reference:
Cosmetics. American Cancer Society. https://www.cancer.org/cancer/cancer-causes/cosmetics.html. Accessed May 29, 2020.