Zhang Duo, Lu Shaoyou
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
Sci Total Environ. 2023 May 10;872:162114. doi: 10.1016/j.scitotenv.2023.162114. Epub 2023 Feb 9.
Triclosan (TCS) and triclocarban (TCC) are antimicrobials that are widely applied in personal care products, textiles, and plastics. TCS and TCC exposure at low doses may disturb hormone levels and even facilitate bacterial resistance to antibiotics. In the post-coronavirus disease pandemic era, chronic health effects and the spread of antibiotic resistance genes associated with TCS and TCC exposure represent an increasing concern. This study sought to screen and review the exposure levels and sources and changes after the onset of the coronavirus disease (COVID-19) pandemic, potential health outcomes, bacterial resistance and cross-resistance, and health risk assessment tools associated with TCS and TCC exposure. Daily use of antimicrobial products accounts for most observed associations between internal exposure and diseases, while secondary exposure at trace levels mainly lead to the spread of antibiotic resistance genes. The roles of altered gut microbiota in multi-system toxicities warrant further attention. Sublethal dose of TCC selects ARGs without obviously increasing tolerance to TCC. But TCS induce persistent TCS resistance and reversibly select antibiotic resistance, which highlights the benefits of minimizing its use. To derive reference doses (RfDs) for humans, more sensitive endpoints observed in populational studies need to be confirmed using toxicological tests. Additionally, the human equivalent dose is recommended to be incorporated into the health risk assessment to reduce uncertainty of extrapolation.
三氯生（TCS）和三氯卡班（TCC）是广泛应用于个人护理产品、纺织品和塑料制品中的抗菌剂。低剂量接触TCS和TCC可能会扰乱激素水平，甚至促进细菌对抗生素的耐药性。在新冠疫情大流行后的时代，与TCS和TCC接触相关的慢性健康影响以及抗生素耐药基因的传播日益受到关注。本研究旨在筛选和综述新冠疫情（COVID-19）大流行开始后TCS和TCC的接触水平、来源及变化、潜在健康结果、细菌耐药性和交叉耐药性，以及与TCS和TCC接触相关的健康风险评估工具。日常使用抗菌产品是观察到的内部接触与疾病之间关联的主要原因，而痕量水平的二次接触主要导致抗生素耐药基因的传播。肠道微生物群改变在多系统毒性中的作用值得进一步关注。亚致死剂量的TCC会选择抗生素耐药基因，而不会明显增加对TCC的耐受性。但TCS会诱导持续性TCS耐药，并可逆地选择抗生素耐药性，这凸显了尽量减少其使用的益处。为了得出人类的参考剂量（RfDs），需要使用毒理学试验来确认在人群研究中观察到的更敏感的终点。此外，建议将人类等效剂量纳入健康风险评估，以减少外推的不确定性。
