Itchy Itchy Skin...

By Dr Orly Zuker, Chiropractor 
(B.Appl Sci; Comp Med, Clin Chiro; Masters, B.Nursing)


The skin, also known as the integumentary system is our largest organ. The skin’s main role is in protection (of the internal organs), detoxification (through perspiration) and acts as a sense organ (hot/cold awareness).
Whether we have darker, olive or fair coloured skin, many people are frequently troubled by various skin conditions, with eczema being the most common and frequently occurring complaint.

Eczema (Atopic Dermatitis) is a chronic skin condition that brings with it patches of red, itchy and dry skin. Sufferers of eczema can often experience symptoms so severe that the patches become red raw and in some case may even bleed, ouch! Eczema can affect any skin surface (however it commonly affects the eyelids, inner elbow creases, behind the knees and the finger webs). Eczema may exist idiopathically (with no underlying condition or cause), whereas conditions such as psoriasis commonly exist alongside autoimmune diseases. Psoriasis is skin condition similar to eczema however the distribution or affected area is primarily the extensor surfaces of the body (the back of the elbows, the front of the knees and the back of the head/occiput).

The cause of eczema is widely speculated and to some extent unknown. Normally symptoms are more severe in infants and children with the condition generally improving with age. In adults, modern diet is often to blame, specifically when a person’s diet is high in sugar, fructose, wheat and dairy. Recent studies have also linked mineral and vitamin deficiencies (specifically vitamin B6) to the exacerbation of skin complaints such as eczema. Other common potential causes are allergens such as; smoke, chemicals, detergents, chemical based personal care products, environmental pollutants, heat, emotional stress and specific fruit triggers such as kiwi, banana and berries. Discovering the culprit isn't always an easy task, but attempting to eliminate triggers is a good step forward.

An Itchy Skin Action Plan:

Cortisone creams are highly effective in treating periodic ‘flare ups’ of eczema, however in long term sufferers a drug-free or natural approach with a focus on healing the body or finding/correcting the ‘cause’ is a more favourable choice. There are natural creams on the market that are helpful in dealing with psoriasis and eczema, however the best method in treating skin complaints is in not only in treating the skin but in healing from the inside-out. Improving internal health (the gut), changing lifestyle habits, improving the diet, attending to psychological health (reducing stress) and eliminating allergens are positive steps in alleviating skin conditions.

Healing Your Skin With Wholefoods:

As previously mentioned, making every effort to reduce sugar and wheat from your diet, as well as eliminating ‘deadly night shade’ foods is the first step to healing the skin with whole foods. Tomato, potato, capsicum, eggplant, red meat, coffee and alcohol are all examples of deadly night shade foods. Other common and well-known food triggers include; dairy (with the exception of goat’s milk as its proteins are low allergy), shellfish, peanuts, eggs, soy, corn, oranges, lemons, strawberries and preservatives/ additives (such as sulphates and MSG). Interestingly kiwi fruit can cause significant to severe allergic reaction when it comes to skin.
 

A study conducted with pregnant women found that higher maternal intake of meat was associated with an increased risk of eczema in infants 3-4 months of age. On the other hand, maternal intake of fish and marine omega 3 fatty acids in fact had a preventive or protective affect on eczema in infants.

Periodic liver cleansing may also help in the detoxification process, by reducing blood stagnation and toxin overload in the liver. You may detoxify the liver by eating foods high in chlorophyll (spirulina, seaweed, leafy greens; kale and spinach) and beta-carotene (papaya, carrots, squash, pumpkin and beetroot). Keep in mind that it is essential to eat these raw, slightly steamed or as fresh juice so that you can receive the greatest nutritional benefit. If you require guidance, support or are unsure of how to go about a safe and effective cleanse, consult with your Naturopath as they are trained  to administer such programs. Liver cleansing is not recommended in infants, children or during pregnancy, so during these ages/ stages it is best to find the trigger in order to rid the body of eczema.

From a Traditional Chinese Medicine (TCM) perspective, it is important to reduce fatty, spicy and astringent foods that may increase heat or dampness in the body. You may choose to try eating more ‘cooling’ foods and observe any changes in skin irritation. Cooling foods, in TCM are; cucumber, banana (if this is a trigger for you, please avoid), grapefruit, lettuce, seaweed, watermelon, oyster, pear, peppermint, radish, broccoli, cauliflower, zucchini and pineapple.

NB. Be mindful that this information also applies to breastfeeding women who have young babies with eczema. Remember that what you eat transfers to the breast milk that they take in. In addition, studies into the maternal use of probiotics (specifically Lactobacillus Rhamnosus) have shown positive effects in the reduction of eczema in breastfed babies as well as a reduction in symptom severity.

Healing Your Skin From The Outside:

Topical (directly on the skin) ointments and creams are helpful in taking the edge of the itch. Coconut oil, nutmeg oil, mashed papaya seeds, tumeric paste, paw paw/papaya ointment (petroleum free preferably) and other gentle creams that do not include alcohol (as this can cause skin inflammation and irritation).

You may also wish to prepare your own home remedies with items from your fridge or pantry, such as essential oil of Lavender that has a gentle and soothing effect and may be of benefit to inflamed skin. Home remedies may involve the application of raw honey and slices of fresh papaya on affected areas. This will have a soothing and healing effect on the skin.

Healing Your Skin From The Inside:

In dealing with conditions such as eczema it is important that treatment is approached holistically. Often people with skin complaints also have coinciding gut or digestive issues that must be corrected by healing from within, in order to resolve external symptoms. Clinical studies have found that TCM preparations and naturopathic herbs have both been effective in reducing the severity of symptoms as well as the recurrence of such skin conditions.

Some studies have established­ that EPA/DHA essential fatty acids (fish oil), zinc and vitamin D may all be helpful in treating eczema. Other studies have shown that taking 1.5 tablespoons of flaxseed oil daily may be helpful in reducing the inflammation associated with eczema. Many studies time and again have strongly indicated that probiotic use is helpful in relieving eczema.

Taking Care Of Your Skin Inside Your Home:

Being mindful of reducing chemical cleaning and personal care products is an essential key to reducing eczema symptoms. Chemicals such as sodium laureth/ lauryl sulphate (SLS), a chemical foaming agent and petrochemical based additives; propylene glycol, parabens and polyethylene glycol are known skin irritants that have been linked to skin conditions such as eczema, dermatitis and psoriasis. Be aware that soap-free or fragrance-free products such as sorbolene based products and 'fragrance-free' skin wash products that are not necessarily a better choice as these products are more often than not petrochemical based and contain an array of harsh chemicals that may cause irritation.

There is a large range of alternative products available on the market now that you may wish to trial. These products are mostly vegetable and plant based, including safe ingredients from nature such as; olive oil, vegetable glycerine, coconut, beeswax, shea butter, macadamia oil and a range of other similar constituents. Look for brands such as; Sukin, Natural Instinct, Eco Store, Kora Organics, Biologika, Organic Care, Aroma-Therapy Essentials and Gaia.

Treating the skin is complex, with some remedies and treatments working for one individual, but not others. The journey to finding answers can often be a nuisance, but if you think holistically and make finding the trigger your number one goal, you may then be able to live eczema-free. Remember that specific supplements have proven extremely helpful and making every effort to change your lifestyle can help. Reduce stress, eat a well balanced diet (eliminating trigger foods to boost immunity and digestion) and reduce chemical exposure. Keep in mind that healing takes time, so be as patient as you can. With time and appropriate care the skin will heal and 'clear up'. You may wish to have your chosen health care practitioner support and guide you through the process of eliminating foods and addressing your health and lifestyle. May your skin be itch free and good luck on your journey of health!

References:
 

Ross, SM (2003). An Integrative Approach to Eczema (Atopic Dermatitis). Holis Nurs Pract. Vol 17 (1). Pg. 56-62

 

Guilliams, TG. (2000). Fatty Acids: Essential...Therapeutic. Vol 3 (2). The Standard.

Sausenthaler, S etal. (2007). Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age. Amer Journ Clin Nutrit. Vol 85. Pg 530-537.

Kummeling, I etal. (2008). Consumption of organic foods and risk of atopic disease during the first 2 years of life in the Netherlands. Brit Journ Nutr, Vol 99. Pg. 598–605.

Ellwood, P etal. (2001). Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) data. Journ Europ Respir. Vol 17. Pg. 436–443.

Al-Waili, NS. (2003). Topical application of natural honey, beeswax and olive oil mixture for atopic dermatitis or psoriasis: partially controlled, single-blinded study. Comp Ther Med. Vol 11 (4), Pg. 226-234.

Saito, K etal. (2010). Maternal meat and fat consumption during pregnancy and suspected atopic eczema in Japanese infants aged 3–4 months: The Osaka Maternal and Child Health Study. Paed Aller Immuno. Vol 21 (1: Part 1).Pg. 38-46.

Viljanen, M etal. (2005). Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial. Aller. Vol 60 (4), Pg. 494-500.

Sausenthaler, S etal. (2006). Margarine and butter consumption, eczema and allergic sensitization in children. The LISA birth cohort study. Paed Aller Immuno. Vol 17 (2). Pg. 85-93.

PART 1: SOAP, SUDS & BUBBLES, A CHEMICAL COCKTAIL (IN THE HOME)

By Dr Orly Zuker, Chiropractor
(B.Appl.Sci: Comp Med, Clin Chiro: Masters, B.Nursing, Webster Certif)

 

 

Over the past 100 years the world has seen many hygiene and sanitation breakthroughs, allowing people to enjoy greater levels of health and more acceptable standards of living. This has without a doubt effected great change around the world and has led to a reduction in infectious diseases such as diphtheria, polio and tetanus.

These health and sanitation breakthroughs have been necessary, however as a result have created communities that are afraid of bugs, germs and dirt. The introduction of bacterial-free sprays, ‘clean’ environments and the use of alcohol based sanitisers can in actual fact cause impaired immunity and lead a person to be more susceptible to the common cold and flu.

 

The fact is that to strengthen our immune system we need dirt and microbe exposure. This is our daily natural immunisation. By constantly performing sterilisation practises (in non-surgical settings) we create an imbalance in the microbial world in and around us and strengthen the action of pathogens such as; bacteria, viruses, parasites and fungi. Without ‘exposure’, our bodies may become susceptible, our immune system weakened, leading to secondary bacterial infections such as ‘Golden Staph’ which causes (a hospital acquired infection that is resistant to antibiotic treatment).

 

In an attempt to clean and sterilise everything we come into contact with, there are now so many unnecessary chemicals in everything we touch, swallow and breathe in. We use these products and chemicals on a daily basis and we have no idea whether or not they are safe (the major concern is that there are limited studies on the long-term health effects of such chemicals). More and more people are now questioning the potentially hazardous effects and the relative safety of these chemicals and are making the switch to healthier and safer products.

 

If you take the time to study the ingredient list of our home cleaning and personal care products you would be shocked to know just how many toxic chemicals are used in their formulas. In an attempt to avoid unnecessary illness, do your best to source and choose natural and organic products. Begin the process of discarding and make the shift to healthier and less toxic products...

 

CHEMICAL WATCH…

 

Petrochemicals are a group of chemicals used commonly in various home and personal hygiene products. Alarmingly, petrochemicals are not only harmful to the environment, being responsible for 17% of the world’s total greenhouse gas emissions, but may also cause long-term harm to our bodies and skin complaints such as psoriasis and eczema. Chemical scientists are fully aware that petrochemicals act as endocrine/ hormone blockers, causing thyroid and reproductive dysfunction as well as breast cancer. Making an informed choice to switch over to natural home cleaning, personal care and cosmetic products is a great step towards a potentially healthier future.

Unfortunately you will find toxic chemicals in pretty much everything from your dishwashing and laundry detergents, to your fabric softeners, body wash, shampoo/conditioner, floor cleaner, surface sprays, soap, hairspray, makeup/ cosmetics, cleansers, ‘anti-aging creams’, skin darkening creams and toothpaste.

 

There is a huge array of chemicals used in the production of cleaning and hygiene products. Some that you might find in your home include:

-       Polypropylene glycol/ PG, Polyethylene Glycol/ PEG (known as ‘anti-freeze’)

-       Bisphenol A/ BPA

-       Sodium Laureth/ Lauryl Sulphate/ SLS

-       Tetrasodium EDTA

-       Acetone

-       Benzene, Benzyl Benzoate

-       Isobutylene

-       Parabens (an antifungal agent that is absorbed through the skin and has been found in tumour biopsies of the breast)

-       Sulphate, Salicylates

-       Triclosan

 

IN THE LAUNDRY

 

WASHING DETERGENTS/ SOFTENERS/ POWDERS:

 

Conventional detergents are laced with chemicals and harsh fragrances that may cause irritation to sensitive skin and trigger asthma symptoms. There are Australian companies such as Ecostore (the eucalyptus variety is my favourite!), Natural Instinct and Ecologic who sell great alternatives that are more gentle and soft on the skin, clothing and the environment.

 

Healthy tip: Pure eucalyptus oil is a great addition to your load of washing, giving clean clothes a fresh smell, naturally.

Healthy tip: Be aware of cleverly marketed ‘eco-friendly’ brands whose products are biodegradable, however still contain a variety of chemicals such as SLS and PEG.

If your whites are looking old, you may like to add some bicarbonate of soda for a gentle bleaching effect and dry them in the sun to ‘sun bleach’ your whites. In addition, shifting you perception away from ‘perfectly perfect’ will mean that you care a little less about having perfectly white clothing.

 

In The Kitchen:

DISHWASHING DETERGENT/ POWDER:

 

A common thought in cleaning is that we need lots of soap and foam for our detergents to achieve the best results. This is not true. The secret is not soap, it is hot water. Think health as well as the environment, because chemical detergents enter our waterways and residues that are on your glass, mug or cutlery will soon be in your stomach when you swallowing you next mouthful!

 

Sodium Lauryl Sulphate (SLS) is a common chemical ingredient that over the years has attracted a lot of negative media. SLS is a chemical foaming agent that is frequently used in industrial strength cleaning products for hard to remove grease and wax. If you study the ingredient list of your home products you will notice that SLS (in its various forms/ names) is present in almost every domestic cleaning and personal hygiene product which foams. Research has found that residual particles of SLS are easily absorbed by the skin and accumulate in the heart, liver, lungs and the brain. This accumulation is known to cause severe skin irritation, eczema, psoriasis, dermatitis, eye damage, liver toxicity, various cancers and hair follicle damage.

 

Interestingly, studies have found that exposure to domestic cleaning products (such as bleach) is a trigger for the onset of asthma symptoms. Asthma has fast become a major public health concern and is the most common ailment of childhood that if left untreated or unmanaged can have fatal consequences. Avoiding triggers is a must!

 

Healthy tip:  Consider choosing plant based detergents from Ecostore (the lemon variety is my favourite!), Natural Instinct, Ecologic or any other trusted brands that you like.

 

 

SURFACE SPRAYS/ WINDOW CLEANER

 

To avoid toxic chemicals on your bench tops and household surfaces, start making your own sprays (it is a lot easier than you think!). In a spray bottle simply add white vinegar, pure eucalyptus oil, water and a few pieces of orange peel. It works a treat! If you are time poor, Ecostore (and various other companies) make a great toxic free surface spray that will leave your house sparkling (until your toddler notices and wipes their sticky hands all over everything!). For your mirrors and windows, add a cap full of white vinegar in a bucket of water for window/ mirror cleaning and use a damp microfiber cloth or newspaper. Streak-free results guaranteed!

 

FLOOR CLEANERS

 

House hold floor cleaners may not be quite as pungent and toxic as commercial varieties, however they still contain a cocktail of chemicals that attempt to sterilise or clean your home. If you want to avoid harsh chemical cleaners (especially if you have a new crawler or toddler who eats off the floor) then a homemade pure eucalyptus oil and vinegar solution will be a terrific alternative for the mop bucket. Your floor will be clean and your house will smell delightful.

 

IN THE BATHROOM

 

The bathroom is no different to the kitchen or laundry- there are chemicals in everything!

SHAMPOO/CONDITIONER/BODY WASH/SOAP

 

Shampoo, conditioner and body wash products all contain a variety of chemicals that are easily absorbed by the skin (and mouth) and as a result may been linked to cancers of the stomach, esophagus, liver and bladder.  These personal hygiene products leave you clean and smelling fresh, however all conventional varieties contain chemicals such as Diethanolamine (DEA)/ SLS/ PG (foaming and creaming agents) and Triclosan (an anti-mould/ anti-bacterial chemical that can cause disruption to the endocrine/hormonal system). Based on research, the long term safety of these chemicals is questionable, so why not switch over to vegetable glycerine soaps (from health food and organic stores) and supermarket brands such as Organic Care or other alternatives from your local health or organic store.

 

TOOTHPASTE/ MOUTHWASH

 

Toothpaste packets all have warnings for use under the age of 6-years. However, nothing changes after the age of 6, so why does it become suitable for adults to ingest then? Toothpaste contains fluoride, SLS, Triclosan (a chemically classified pesticide that is linked to breast cancer!) artificial flavours and artificial sweeteners. Perhaps not the healthiest item to absorb during brushing and swallow!

 

Healthy tip: Make the switch to natural toothpaste brands such as New Zealand’s Red Seal ‘Naturals’. This product is SLS free, contains no fluoride and is flavoured and sweetened with essential oils and stevia.

Don’t be fooled by exciting advertising campaigns, mouthwash is probably worse than toothpaste! Commonly used and popular mouthwash brands include a cocktail of alcohol, sorbitol/ sodium saccharin (artificial sweeteners), artificial flavours, Poloxamer 407 (a surfactant used to dissolve oily substances. This is found in lens cleaners!), Benzoic acid/ Sodium Benzoate (chemical preservatives), Eucalyptol, Methyl salicylate/ thymol/ menthol (aroma/ fragrances), Sodium fluoride, CI 42053/ CI 47005 (artificial colours). For your health, perhaps consider gargling with salt water or purchasing a natural and toxic-free mouthwash from a health food or organic store.

 

DEODORANT

 

Keeping with the theme of toxic chemicals, you won’t be shocked to know that most popular deodorant brands contain butylene glycol, triclosan, alcohol, aluminum (to block the sweat glands), silicone based chemicals (for lubrication) and EDTA (a chemical solvent to counteract natural oils found on the skin).

Over the past few decades scientists have been investigating the safety of aluminum. Research has found that aluminum accumulation in tissue and cells may be a cause of Alzheimer’s and Parkinson’s disease and may be linked to the development of breast cancer. According to research, when aluminum is present in the body it has an ‘oestrogen-like’ effect, promoting cancer cell proliferation in the tissue of which it resides.

Interestingly, some studies suggest that the risk of breast cancer may be increased when shaving/ causing micro trauma to the underarms, followed by applying conventional deodorant that contains aluminium.

Healthy tip: Choose aluminum-free, natural deodorant. In addition, be keep in mind  that perspiration is a healthy bodily function. Anti-perspirant deodorants ‘plug’ our sweat glands and disrupt the body’s natural process of detoxification through the sweat glands. There are numerous natural brands which are effective in keeping you smelling nice... Biologika manufactures a terrific line of organic and aluminium-free deodorants (the Biologika ‘Live It Up’ variety is my favourite!). Natural deodorants won’t necessarily stop you sweating, but will instead reduce body odour, by neutralising sweat with essential oils, naturally.

 

SUNSCREEN:

 

There is a lot of confusion about the safety of sunscreen… If you have sensitive skin or are interested in avoiding daily chemical exposure, then another piece of advice is to stay clear of traditional sunscreens. Sunscreens, unless they are natural zinc based and organic varieties contain a multitude of toxic chemicals such as; oxybenzone, benzophenone, or triethanolamine (chemical blockers & absorbers). These chemicals provide UV protection, however at the same time may be harmful to our health, overloading the liver with unnecessary chemicals to detoxify.

 

Healthy tip: Choose brands such as WotNot, Soleo or UV Naturals as these use zinc and all natural ingredients to keep you safe. Better slip, slop and slap on natural and toxic free sunscreen and remember that we do need the sun and its vitamin D for our health and wellbeing. Be mindful to adopt healthy sun habits. 10min daily unprotected sun exposure is now considered safe and important, however bathing for hours with sun tanning oils isn’t.

 

 

 

IN THE MAKEUP CASE

Over the years of cosmetic manufacturing elemental lead has been a predominant ingredient in anything from lipstick to foundation, nail polish and sunscreen. Lead is a known neurotoxin that has many health implications including miscarriage and fertility issues.

 

With health and the environment being strong influences in consumer choice today, many cosmetic companies are now manufacturing beauty products that are chemical-free, organic and 'not tested on animals'. Mineral-based makeup has become quite popular today with makeup companies utilising naturally sourced ingredients and natural clays of Western Australia and the Northern Territory.

 

Healthy tip; avoid conventional lipsticks and other cosmetic products that are known to contain heavy metals and other toxic chemicals (which is most of them!) and instead try brands such as Couleur Caramel from France Primitive from America or Inika from Australia.

Toxic-free Tips…

The information contained in this article may be eye-opening and overwhelming, but at the same time empowering. Unfortunately clever and manipulative marketing/ advertising campaigns encourage us to buy products that may be misleading, whereas knowledge and information like in this article will allow you to use your better judgement when choosing the ‘right’ products. Many popular supermarket and commercial brands advertise their products as ‘cruelty-free’, ‘not tested on animals’, ‘pure’, ‘organic’ or ‘natural’. These companies may manufacture cruelty-free (which is very important) and may include some organic or natural ingredients, however  when you read the label you will realise that you have been misled and that they are in fact not so healthy, containing a rummage of toxic ingredients.

 

Choosing safe products is now easy. As you become more and more aware, you will notice that there are many ‘safer’ options on the market that can replace conventional cleaning and personal care products. These products are mostly vegetable and plant based, utilising the moisture of olive oil, vegetable glycerine, coconut, beeswax, shea butter, macadamia oil and so on. They are fragranced with natural essential oils for your skin and body to enjoy with peace of mind.

 

Look out for ethical brands such as; Sukin, Natural Instinct, Kora Organics, Organic Care, Aroma-Therapy Essentials, Biologika, Ecostore, Mukti, Tinderbox, Gaia and Giovanni. These all offer comparable if not better alternatives to the conventional chemically formulated products. These companies manufacture natural alternatives for absolutely everything, including; moisturisers, cleansers, hand creams, eye serum, body butter, toners, lip balm, mouthwash, soaps, toothpaste, face scrub, dishwashing and clothing detergents, makeup, floor and toilet cleaners and so on.

 

Remember, making a 180 degree turn around and changing everything in your home may not be the best approach, but rather make baby steps of change week by week. Perhaps begin by changing something small, like your toothpaste or deodorant, and then over time (before you know it) you won’t even think about it and will choice healthier products for you and your family. In conclusion and in a nut shell… Read labels, do your own research and minimise your toxic load. Enjoy your journey of health!

 

 

 

References:

1. Larson, EL. (2004). Effect of Antibacterial Home Cleaning and Handwashing Products on Infectious Disease Symptoms [A Randomized, Double-Blind Trial]. Ann Int Med. Vol. 140 (5). Pg. 321-329.
2. Nazaroff, WW & Weschler, CJ. (2004). Cleaning products and air fresheners: exposure to primary and secondary air pollutants. Atmosph Environ.
3. Ramón, MM etal. (2005). Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study. Occup Environ Med. Vol 62. Pg. 598-606. 
4. Bergfeld, WF etal. (2005). Safety of ingredients used in cosmetics. Journ Amer Acad Dermat. Vol 52 (1). Pg. 125-132.
5. William B. Grant etal. (2002). The significance of environmental factors in the etiology of Alzheimer's disease. Journ Alzh Dis. Vol 4 (3). Pg. 179-189.
6. Darbre, PD. (2005). Aluminium, antiperspirants and breast cancer. Journ Inorg Biochem. Vol 99 (9). Pg. 1912-1919.
7. Darbre, PD. (2006).  Environmental oestrogens, cosmetics and breast cancer. Journ Endocrin & Metab. Vol 20 (1). Pg. 121-143.
8. Merritt, MA etal. (2008).Talcum powder, chronic pelvic inflammation and NSAIDs in relation to risk of epithelial ovarian cancer. Internat Journ Canc. Vol 122 (1). Pg. 170–176.
9. www.breastcancerfund.org/clear-science/environmental-breast-cancer-links/cosmetics/
10. Unknown Author. (1983). Final Report on the Safety Assessment of Sodium Lauryl Sulfate. Journ Amer Coll Tox. Vol 2 (7).
11. Hrudey, SE. (2009). Chlorination disinfection by-products, public health risk tradeoffs and me. Water Res. Vol 43(8).  Pg. 2057-2092.
12. www.preventcancer.com/consumers/cosmetics/diethanolamine.htm
13. www.theecologist.org/green_green_living/behind_the_label/269558/behind_the_label_listerine_teeth_and_gum_defence.html