Microbiologically Contaminated and Over-preserved Cosmetic Products According Rapex 2008–2014

We investigated the Rapid Alert System (RAPEX) database from January 2008 until week 26 of 2014 to give information to consumers about microbiologically contaminated cosmetics and over-preserved cosmetic products. Chemical risk was the leading cause of the recalls (87.47%). Sixty-two cosmetic products (11.76%) were recalled because they were contaminated with pathogenic or potentially pathogenic microorganisms. Pseudomonas aeruginosa was the most frequently found microorganism. Nine cosmetic products were recalled because they contained methylisothiazolinone (0.025%–0.36%), benzalkonium chloride (1%), triclosan (0.4%) in concentrations higher than the limits allowed by European Regulation 1223/2009. Fifteen products were recalled for the presence of methyldibromo glutaronitrile, a preservative banned for use in cosmetics. Thirty-two hair treatment products were recalled because they contained high concentrations of formaldehyde (0.3%–25%).


Introduction
The European Commission (EC) has an early warning system for safety management called the Rapid Alert System (RAPEX).In the database of this system we can find information about dangerous cosmetic products sold in EU markets.Dangerous cosmetic products pose a risk to the consumers due to the presence of certain substances which are banned or the use of which is restricted in these products under cosmetic legislation [1].
Cosmetic products are recognized to be substrates for the survival and development of a large variety of microorganisms, since they posses some of the nutrients that facilitate growth such as water, lipids, polysaccharides, alcohol, proteins, amino acids, glycosides, peptides and vitamins [2].The presence of pathogenic microorganisms in cosmetic products can pose a health risk for consumers.The use of preservatives, Good Manufacturing Practices (GMP) and quality control programs has improved the quality, but several studies have reported cases of contaminated cosmetic products [3][4][5][6][7][8].Studies have shown that the most frequently found microorganisms in cosmetics are P. aeruginosa, K. oxytoca, B. cepacia, S. aureus, E. coli, C. albicans, E. gergoviae, and S. marcescens, but also other bacteria, fungi, and yeasts.Skin and mucous membranes are protected from microorganisms; however, these may be damaged and slight trauma may be caused by the action of some cosmetics that may enhance microbial infection [9].Research studies have shown cases of infections caused by contaminated cosmetics [10][11][12].According to SCCP's (Scientific Committee on Consumer Products) "Notes of Guidance", cosmetic products are divided into two different categories: (1) Products specifically intended for children under three years or to be used in the eye area and on mucous membranes and (2) other products.Products intended for use on babies and the eye area (category 1) should have not more than 10 2 Cfu/g or mL of aerobic mesophilic microorganism (other products not more than 10 3 Cfu/g or mL).Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans or Escherichia coli must not be detectable in 0.5 g or 0.1 mL of product category 1 and in 0.1 g or 0.1 mL of product category 2 [13].To prevent the microbial contamination of cosmetic products, chemical substances with known antimicrobial properties are used.The EU regulation 1223/2009 provides a list of allowed preservatives in cosmetic products with maximum concentrations in ready-for-use preparation.
Preservatives are known as one of the most relevant allergens found in cosmetic products [14,15].Studies suggest that the problem is much bigger because contact dermatitis prevalence appears to be underestimated [16].In recent years a significant increase in cases of methylisothiazolinone contact allergy (MI) has been reported [17][18][19][20][21].

Experimental Section
We used the RAPEX database to find microbiologically contaminated cosmetic products from January 2008 until week 26 of 2014.We also selected recalled cosmetic products with high concentrations of preservatives.

Microbiologically Contaminated Cosmetics
The risks of recalled cosmetic products were divided in two categories: chemical and microbiological.Chemical risks were the leading cause of the recalls (87.47%).Sixty-two cosmetic products contaminated with microorganisms were recalled during this period.The most frequently found microorganism was the pathogenic Pseudomonas aeruginosa (35.48%).Other microorganisms found were: mesophilic aerobic microorganisms (bacteria, yeast and molds), Burkholderia cepacia, Klebsiella oxytoca, Serratia marcescens, Enterobacter gergoviae, Enterobacter cloacae, Staphylococcus aureus, Achromabacter xylosoxidans, Rhizobium radiobacter, Candida albicans, Pantoea agglomerans, Citrobacter freundii, Pseudomonas putida, Enterococcus faecium and Klebsiella pneumoniae.The types of cosmetic products contaminated were different: skin lightening products, eye creams, eye make-up products, children's shampoos, skin care products, baby creams, baby balms, toothpastes (Table 1).The recalled products were notified by 14 different countries and 41.67% of them were notified by Germany.The number of recalled contaminated cosmetic products was higher in the last two years (2013,2014).
In 21 cosmetic products (33.87%),Pseudomonas were present, especially Pseudomonas aeruginosa.P. aeruginosa is a pathogenic Gram-negative bacteria frequently found in cosmetics but also in ophthalmic preparations and, as such, is responsible for a variety of infectious diseases affecting the eye and surrounding tissues (corneal ulcer, bacterial keratitis) [22][23][24][25][26]. Six hair shampoo products were contaminated with P. aeruginosa or P. putida and these products can come in contact with eyes.These bacteria are widely recognized as nosocomial infection-causing pathogens [27,28].P. aeruginosa in some cases had showed resistance to preservatives in cosmetic products.
Burkholderia cepacia, an opportunistic pathogen, was found in five products: make-up remover, bath gel, mouth spray and mouth wash, body scrub products (4.1 ˆ10 5 -100 ˆ10 5 Cfu/g).Other studies have showed that the presence of B. cepacia in products used for mouth hygiene has frequently been implicated in B. cepacia infection [29][30][31].Contamination of cosmetics and pharmaceuticals with B. cepacia is also a frequent problem in the United States and it is a cause of major product recalls [32][33][34].B. cepacia can cause diseases primarily among immuno-compromised populations [35].Staphylococcus aureus was found in two products: shea butter and massage cream.S. aureus is also one of the most frequently found contaminants in cosmetic products [36].S. aureus is a Gram-positive microorganism and a potential human pathogen which can cause impetigo and conjunctivitis [37].Enterobacter gergoviae was present in eye creams and children's cosmetic products (shampoo, foam soap, gel, creams and lotions, skin cream, etc.) at concentrations of 1.6 ˆ10 5 -44 ˆ10 5 Cfu/g.E. gergoviae is naturally resistant to parabens at the concentrations used in cosmetics [38,39].The germs are often resistant to antibiotics and this makes treatment more difficult.Serratia marcescens is a Gram-negative bacillus (Enterobacteriaceae). S. marcescens was generally considered non-pathogenic for humans [40], but since the 1950s has become an important cause of nosocomial infection [41].Infants are at the greatest risk of S. marcescens infection (severe septicemia) or colonization [42][43][44][45].Baby death has been reported from S. marcescens meningitis and septicemia after use of contaminated baby shampoo [46].One recalled product was bath milk for babies and it was contaminated with S. marcescens.Two recalled products were contaminated with Klebsiella pneumoniae, a shampoo/shower gel and an herbal tooth powder.Klebsiella pneumonia, a Gram-negative bacterium in the Enterobacteriaceae family, is a human pathogen and can cause severe fulminating pneumonia [47].Klebsiella present in hand creams and liquid soaps in the past has caused epidemic septicemia in patients with intravenous catheters [48].Molds and yeasts were also present in two products.A make-up set was contaminated with mold which, according to RAPEX, may cause irritation, inflammation to skin around the eye, respiratory infection if inhaled or loss of eye sight.Candida albicans was isolated in one product (shea butter, Germany).
Rhizobium radiobacter (known as Agrobacterium radiobacter) was present in an eye contour cream product.It is usually of low virulence in humans and rarely acts as an opportunistic human pathogen [49].
Seven cosmetic products recalled contained the preservative methylisothiazolinone (0.01% or 0.0015% of a mixture in the ratio 3:1 of methylchloroisothiazolinone and methylisothiazolinone) in excess (0.025%-0.36%) of the approved concentration limit.The country of origin of the products was the Russian Federation.MI is a sensitizing agent and may cause skin sensitization and allergic skin reactions when it exceeds the approved maximum concentration [54,55].MI is also is an emerging allergen in the pediatric population.Wet wipes with MI were frequently the cause of allergy contact dermatitis [56][57][58][59][60].
One product contained benzalkonium chloride in a concentration 10 times higher than the maximum allowed (eyelash enhancer, 1%).Benzalkonium chloride is a well-recognized irritant for skin and eyes at concentrations greater than 0.1%.According to EU regulation 1223/2009, contact of benzalkonium chloride with eyes should be avoided.
Thirty-two cosmetic products contained formaldehyde (0.3%-25%) in concentrations higher than the limits allow (Table 3).All products recalled were hair treatment products.In the European Union, formaldehyde is not authorized as an active ingredient in hair straightening products.Formaldehyde is a chemical substance used in cosmetics as a preservative for its antimicrobial properties.According to Cosmetics Regulation 1223-2009 Annex V, formaldehyde can be used in oral products in concentrations of not more than 0.1% (free formaldehyde) and 0.2% in other products.Formaldehyde can also be used in nail-hardening products at concentrations of up to 5% (Annex III).
Formaldehyde is classified as a carcinogen [61,62].Some epidemiologic studies have also found increased numbers of nasopharyngeal carcinoma and leukemia in humans exposed to formaldehyde [63].

Conclusions
European consumers are exposed to microbiologically contaminated and over-preserved cosmetic products.Hair treatment products with high concentrations of formaldehyde were also found.These products may pose a health risk to consumers.Measures must be taken to guarantee the safety of cosmetic products.