Medical Examiner

No More Formaldehyde Baby Shampoo

How chemophobia made Johnson & Johnson reformulate its products.

baby wash.
It would take more than 40 million baby shampoo baths in a single day to reach the formaldehyde levels set by California’s Proposition 65.

Photo by Vilches/Thinkstock

It happens to me, too. When the word comes up out of context, I think first of dead things. The frogs and fetal pigs I dissected in seventh grade, open-casket funeral viewings … the word formaldehyde quickly conjures up eerie images.

Formaldehyde is often paired with another ominous term—cancer. So perhaps it’s not surprising that people freak out a bit when they hear that formaldehyde is in baby shampoo, hand lotion, or vaccines. The Environmental Working Group raised concerns several years ago about a formaldehyde-releasing preservative called quaternium-15 in Johnson & Johnson’s baby shampoo and other personal care products. The company sprang into action, promising to introduce reformulated products without the preservative by the end of 2013. And deliver it did.

But did it really need to? Before we dig into that question, keep two thoughts in mind. First, high enough doses of inhaled formaldehyde can cause cancer, leading OSHA and the EPA to set limits for safe exposures.

Second, every minute of every day on every inch of this planet, formaldehyde is all around you and inside you. Always.

Yet we’re not all dropping dead from cancer. That’s thanks to one of the most fundamental principles of toxicology: The dose makes the poison. “Unfortunately, all molecules are potentially toxic,” says American University chemist Matthew Hartings. “Toxicity is not just about the molecule but is about both the molecule and its concentration.”

The concern about formaldehyde in personal care products reveals a bit of chemophobia, which Dartmouth chemistry professor Gordon Gribble defines as “an irrational fear of chemicals based on ignorance of the facts.” He says, “people don’t know how small molecules are, and they believe that single molecules of some chemical pose a health threat.”

That’s exactly the concern EWG expressed. “The actual molecule formaldehyde itself is the carcinogen,” says Johanna Congleton, toxicologist and senior scientist at EWG. “It doesn’t matter if it’s in a liquid or if you’re inhaling particles with formaldehyde.”

In fact, the only studies that link formaldehyde to cancer are related to humans inhaling it, and inhaling large amounts of it. Funeral industry professionals with more than 34 years of experience or who had performed more than 500 embalmings and factory workers who spent years working around formaldehyde before the 1990s had higher risks for leukemia and Hodgkin’s lymphoma. The amount of exposure required to cause cancer is so high that other studies of factory workers have been inconclusive.

Formaldehyde occurs naturally in common fruits and vegetables (even organic ones). “Unless people calling for removal of quaternium-15 are also keeping their children from eating apples and french fries,” Hartings says, “I think their activism might be misplaced.”

Our own bodies create formaldehyde as a normal byproduct during amino acid synthesis and overall metabolism, including breaking down antibiotics and other medications. It’s also in drinking water and the air we breathe. Homer Swei, a scientist at Johnson & Johnson, points out that 90 percent of the formaldehyde around us is naturally occurring, with 60 percent of that coming from plants and trees, yet it’s still perfectly fine to walk through the woods. Further, the formaldehyde in synthetic or manufactured products is no different in terms of chemical structure than naturally occurring formaldehyde—it’s all CH2O.

Yet the presence of formaldehyde all around us is also part of EWG’s argument against its use in personal care products. “Formaldehyde is a known carcinogen, and we’re concerned about exposure over time,” says Heather White, executive director of EWG. “We feel that when there are safe alternatives available, we should be pushing the market in that direction. ‘When in doubt, take it out’ should be the mantra for companies.”

But is there actually any doubt regarding the safety of formaldehyde levels found in personal care products?

Since cosmetics do not require Food and Drug Administration approval before going on the market, companies follow the guidelines of the independent Cosmetic Ingredient Review. CIR requires that free formaldehyde (including that released by preservatives) make up less than 0.2 percent of a product’s total ingredients. These low levels of formaldehyde meet even the most conservative consumer notification standards in the nation, those of California’s Proposition 65. According to Swei, who says Johnson & Johnson adheres to CIR guidelines, “It would take more than 40 million baby shampoo baths in a single day to reach the formaldehyde levels set by California’s Proposition 65.”

One study measured the amount of formaldehyde released into the air when six people in one room applied massive amounts of facial moisturizer, foundation, shower gel, shampoo, deodorant, hair conditioner, hair styling gel, or body lotion containing formaldehyde-releasing preservatives. The results revealed the levels to be below what was naturally in the air and within the range found in human breath.

So why did Johnson & Johnson remove quaternium-15 if it’s safe? The consumers asked it to. The company’s job is not to combat misconceptions in the public; it’s to sell products.

Concerns about formaldehyde have cropped up before, though. One of the many disproven arguments of the anti-vaccine movement is that formaldehyde poses a danger. But again, the amount of formaldehyde in vaccines is dwarfed by the comparatively huge amounts in everyday food. The formaldehyde “added” to an infant’s body through vaccines is equivalent to adding a slice of American cheese to the top of a stack of 35 Hummers.

So what is it with formaldehyde? Why do we worry about it when it’s in the air and our food, and our exposures are so tiny as to be harmless?

Of course, it doesn’t help that EWG’s campaign used messages such as “baby’s tub is still toxic” and called attention to “cancer-causing formaldehyde in your cosmetics.” EWG’s own site does not list quaternium-15 as a carcinogen, and their risk rating for formaldehyde does not take into account dosage. If the amount of formaldehyde released in personal care products can cause cancer, then so can eating bananas or just breathing.

But once fear is established, it’s hard to overcome. Mike Mackert, a University of Texas professor who studies health literacy, points out: “Once people latch onto a particular belief, sometimes hearing contradictory, though correct, information only strengthens an incorrect belief.”

People’s sense of control influences how they respond to a perceived risk. If they feel their health could be threatened (such as from a car accident while driving), but there are effective ways to protect themselves (such as wearing a seatbelt), then they are more likely to respond to the risk logically. If people don’t have a good way to protect themselves or their loved ones, they are “more likely to respond to the threat less rationally,” says Anthony Dudo, a UT professor who studies science communication and public perceptions. The perceived lack of control ratchets up the perception of the threat, perhaps explaining why flying may seem scarier than driving despite the greater risk of a car accident than a plane crash.

With baby shampoo, consumers’ fears about formaldehyde may escalate to extreme levels because, short of boycotting the product, they feel helpless to do anything about it. The same principle helps explain vaccine fears about formaldehyde.

The mental shortcuts we use to process risks can also distort our perceptions. These filters rely on our values, ideologies, levels of trust in science, past experiences, and other factors to help us sort and evaluate information quickly. “It’s likely that individuals’ opinions are largely formed from broader established predispositions they have about health, consumer products, large companies, etc.,” Dudo says, “and not any sort of detailed scientific consideration of the potential danger posed by formaldehyde.”

In other words, the problem runs deeper than a simple misunderstanding of science or specific chemicals. Since media coverage can contribute to these factors—and we live in a media landscape which allows us to select only news sources that confirm our beliefs—then chemophobia’s proliferation is less surprising. Of course, real threats from chemicals and industry practices, such as the recent West Virginia chemical spill, don’t help. There are real risks, and blowing small risks out of proportion can prevent us from understanding the significant ones.

The question is how to reverse chemophobia and encourage more rational ways of assessing the safety of chemicals in us and around us. Ultimately it’s up to individuals to overcome their own fears and use evidence to assess risks. When it comes to formaldehyde, at least, it’s time to take a deep breath and just chill a bit.