The ban of some antibacterial ingredients, such as triclosan (TCS) and triclocarban (TCC), in personal care products (PCPs) in some countries (but not in China) has resulted in the increasing use of antibacterial alternatives, such as chloroxylenol (PCMX). However, the underlying human health risks and environmental impacts of PCMX exposure are largely unknown. Thus, the distribution characteristics of PCMX in PCPs and susceptible populations and the major routes and health risks of human exposure to PCMX were investigated. The PCMX, TCS, and TCC concentrations in PCPs, urine, drinking water, and surface water were determined using high-performance liquid chromatograph system equipped with diode array detector or triple quadrupole mass spectrometer. Results showed that PCMX is widely used in antibacterial hand sanitizers and household disinfectants in China. The addition of PCMX as an antibacterial ingredient in PCPs showed an increasing trend. The geomean concentrations of urinary PCMX in children and pregnant women were 21.6 and 31.9 μg·L−1, respectively, which were much higher than TCS and TCC. A considerable concentration of PCMX ranging from 1.62 to 9.57 μg·L−1 was observed in the aquatic environment, suggesting a potential massive-use of PCMX by humans. Human PCMX exposure via drinking was negligible because the PCMX concentrations in drinking water were less than 2.00 ng·L−1. During human simulation experiment, we found that dermal contact was the dominant route of human PCMX exposure, accounting for 92.1% of the urinary PCMX concentration. The estimated daily intake of PCMX in 9.68% of children and 5.66% of pregnant women was higher than the reference dose. However, the urinary 8-hydroxy-2′-deoxyguanosine concentrations remained stable despite the elevated PCMX concentrations, thereby suggesting that daily PCMX exposure may not cause oxidative DNA damage in humans. Nevertheless, the potential ecotoxicity and health risks induced by chronic PCMX exposure cannot be ignored because of its increasing use.
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