Nail polish comes in many varieties, each with different chemical compositions. And it's difficult to know if a brand's claims of safety are anything more than an advertising agency's veneer, writes Geoff Gratwick. Credit: Richard Drew / AP

My daughter rarely uses nail polish but she does when the occasion calls for dressing in style. I was curious about the brand she uses and looked it up.

It comes in 14 different varieties, each containing between three and 18 chemicals. Some are benign, while others are associated with allergies, impaired fetal development, cancer and a variety of other conditions that we all hope to avoid. She said that she didn’t use nail polish when she was pregnant but many women are not so careful.

Why are there so many toxic chemicals in our everyday products that we do not see, recognize and avoid?

We all have our reasons not to see. Labels are tiny and hard to read, organic chemistry is for geeks, life is already too complex. But not paying attention to the misleading claims and half-truths about nail polish and many, many other products may do us harm.

Health doesn’t happen only in the doctor’s office. As a physician I saw many patients with never-reported symptoms whose illnesses didn’t make sense to me. When I had ruled out all the causes recorded in textbooks and medical journals, I became suspicious of the chemical soup in which we all float.

The “Precautionary Principle” has been fundamental to the practice of medicine since the time of Hippocrates: “First, do no harm.”

This means that in the face of uncertainty a doctor must never expose a patient to risks without fully explaining what they are. The patient gets to make the final decision about whether to be treated, whether to take a common or an experimental drug, or whether to have a potentially risky operation. These conversations are complex and take time.

There is no equivalent “Precautionary Principle” for manufactured products in the U.S.

Some industries have safety standards but they are only suggested. The European Union is far ahead of us. In 1992, member states agreed to the Maastricht Treaty, which states that “when an activity raises threats of harm to human health or the environment … the proponent of an activity, rather than the public, should bear the burden of proof.” Its implementation has not been perfect but it puts the health of consumers ahead of profits.

There are exceptions to the U.S.’s laissez faire approach that show that government regulation can work and need not be onerous. Foods must be labeled with their ingredients, cigarette packs carry the surgeon general’s warning, all drugs must contain a package insert listing indications and side effects, and more.

However, in general our laws are weak and manufacturers rarely disclose all the ingredients in their products. They can hire advertising agencies to put a slick coat on even their unhealthiest products.

Nail polish looks exciting, shiny and sexy — and it sells. There is little mention that women should avoid toluene (a petrochemical solvent, paint thinner and potent neurotoxin that can impair fetal development), dibutyl phthalate (which may damage male reproductive system in utero), triphenyl phosphate (TPP) and other constituents.

We know little about the specific compounds in commercial products but even less about how they interact with each other to create new ingredients in the toxic soup. Since the Second World War we have made, found or used more than 50 million unique chemicals, of which 85,000 make up products in our daily lives here in the U.S. Many seem wonderful when first viewed but few have been fully studied.

Even when toxicity has been established some companies still act with greedy abandon.

A number of years ago I taught at a medical school in a third-world country. I became troubled by the high incidence of agranulocytosis, a lethal condition in which the bone marrow shuts down and makes no more blood cells. Most of the patients had taken a commonly used local pain medicine sold by a seemingly reputable international pharmaceutical company. It turned out to be aminopyrine, a distant cousin of Tylenol and very effective; many of my medical students took it for menstrual cramps.

However, because of its association with bone marrow toxicity, it was one of the first medicines banned by the FDA here in the U.S. in 1938. The manufacturer had given it a new name, published its chemical formula as a mirror image to the usual so that it was not easily recognizable, and smiled all the way to the cash register for 50 years.

I was interested in nail polish but it is the mere tip of a gigantic iceberg. Hidden behind the curtain of “proprietary” secrets are the ingredients of other cosmetics, dental floss, food additives, cleaning fluids, furniture, construction compounds — the list is endless.

There are private non-governmental groups that provide us with data but they face a long uphill slog before a product with potential toxicity is banned.

Here in Maine members of Defend Our Health often appear before the Legislature to press for better regulation. Nationally the Environmental Working Group employs organic chemists and other scientists to maintain an informative web site. These and other similar groups fill the space where government is either too slow or has been captured by financial interests.

Until the government implements the “Precautionary Principle” and gets rid of the dangers hidden in everyday products our health is at risk. We need to be smart shoppers and know the ingredients of what we are purchasing. My daughter is paying attention.

Geoff Gratwick, Health contributor

Geoff Gratwick is a retired rheumatologist who represented Bangor and Hermon in the Maine Senate from 2012 to 2020. He chaired the Health and Human Services Committee while in the Legislature. He is also...