MonoFoil® Technology vs. Silver Based Antimicrobials Durable vs. Leaching: mode of action Microbe adaptation and bioaccumulation: University studies Toxicity of silver Nano-silver: many questions remain Impact of silver on the environment: independent studies Conclusion and summary

MonoFoil® Technology : Polymeric Antimicrobial Bonded to Surface Bonded = No Release Micropolymer network is: Resistant to all organic solvents Resistant to strong acids and bases Does not leach in water, salt, or sweat solutions Thermally stable to 257 Degrees C Durable to over 100 launderings Lasts the life of the goods

Antimicrobials 101 LEACHING ANTIMICROBIALS Diffuse from the surface or product to react with the microbe Leach or migrate off the product Are consumed by microorganisms Chemically interrupt (poison) the cell Transfers to the skin Transfers to the environment Able to cause microbial adaptation Leaching Technology

Facts About Silver Silver is NOT a trace metal in the human body and fulfills no functional or physiological value. Silver metal is INERT but many of the silver products offered as antimicrobials are in the ionic form, which is TOXIC. Silver ions readily combine with proteins and are inactivated, and thereby are not available for microbial control. Silver ions react with all kinds of non-target organisms. Silver is a heavy metal and is a serious and persistent environmental threat. In its ionic form, this heavy metal enters the food chain by adsorption and ingestion.

Silver 101 Leach = Release

Silver Providers “Release” “A Release of Silver on Demand” “The maximum release rate ensures continuous antimicrobial action.” “Silver releases ions spontaneously.”

Is Silver a non-migrating technology? Claim: No Zone of Inhibition is observed, so, therefore, silver is a non-migrating technology? NO ZOI: Inability of silver to diffuse through a nutrient agar due to adsorption This is not a true indication of non-migrating behavior

Is Silver a non-migrating technology? ASTM E2149-01 antibacterial test If migrating antimicrobials are present, residual activity would be detected after filtering the solution. Samples: Test on 100% cotton socks Untreated socks Socks treated with silver technology Socks treated with triclosan ( a migrating antimicrobial) Socks treated with MonoFoil Results after filtering the microbial solutions through non-reactive media.

Is Silver a non-migrating technology? ANTIMICROBIAL ACTIVITY 100% Cotton Samples FABRIC ASTM E2149-01 DSF ZOI ASTM 147 ZOI Solution ASTM E2149-01 Filtration Untreated Standard 0% No Silver Treated 99.9% 99.6% Triclosan Treated 99.5% Yes Treated Conclusion: Triclosan and silver are migrating technologies!

Migrating Technologies Diffuse from the product to come in contact with the microbe: Leach or migrate out of the product into the environment Are consumed by microorganisms Chemically interrupt (poison) the cell Can be used up by microbial contact or inactivating materials in the environment or on the skin. Cause adaptive microorganisms No means of attachment for performance

Silver Killing Process Destruction of cell membranes Inhibition of DNA replication Inhibition of enzymes Silver ions (Ag+)

Silver Killing Process: Speed Silver needs to be in contact with the organism for >24hr to have a significant killing rate Untreated Treated with Silver >24h significant killing rate

MonoFoil® vs. Silver Killing Process: Speed

Silver: Human Exposure Silver is detected in the blood of most people (Argyraemia) FDA (Food & Drug Administration) Max. Ag/ drinking water = <0. 01mg/ L FDA Max. Ag./ daily intake = 5µg/ kg/ day A regular daily diet may contain up to 90µg Ag “The FDA is issuing a final rule establishing that products containing colloidal silver ingredients or silver salts for internal or external use are not generally recognized as safe and effective and are misbranded.”

Silver Absorption by Skin Silver ions enter bacterial cell, destroy DNA and RNA, and alters bacterial metabolism. Bioaccumulation Liver Kidney Eye Brain Blood-Bone marrow

Silver Resistance & Bioaccumulation University of Illinois Paper FEMS Microbiology Reviews 27, 341-353 (2003) University of Minnesota paper University of Kent Paper University College London Paper

Bacterial Resistance to Silver Silver Resistant strains have been isolated from burns, and other skin wounds. These bacteria show a genetically determined inability to take up or retain silver ion. They are expected where bacteria are exposed to any antibiotic for a prolonged period ? MUTATION Bacteria have been isolated from skin wounds treated with silver for several months – bacterial self-preservation through BIOFILM formation.

Toxic Silver Mines Where does your silver come from? Children as young as 10 are working in silver mines. Average life expectancy of these miners is 45 years of age. Production of Silver involves: Cyanide Lead Mercury Arsenic Strong acids Cadmium

Toxic Silver Mines Water flowing out of this abandoned silver mine is still contaminated even 34 years after its closing. Water Impacts Human Health Impacts Wildlife Impacts Konomai Mine, Japan

Nano-Silver Economist Article Is smaller better? The uncertainty of Nano-Silver “The unusual properties of tiny particles contain huge promise. But nobody knows how safe they are. And too few people are trying to find out.”

Nano Silver Silver Coated Future More questions A distinct lack of answers

Fraud Of Environmental Friendliness Federal Governmental Agencies Silver Contaminate Study In a test with 22 other metals, silver was named the most toxic. Long term exposure to silver increases blood concentrations to toxic levels which can cause sarcomas, anemia, and enlargement of the heart. State Governmental Agencies California Sanitations Group “Silver is a toxic and bioaccumulative element”

Fraud Of Environmental Friendliness Politically Active Environmental Groups: Speaking out against silver NRDC is one of the nation's most effective environmental action organizations. They have the support of 1.2 million members and a budget of over 70 million to protect the planet's wildlife and wonders. With board members like Leonardo DiCaprio, Robert Redford and James Taylor and many successful campaigns it is easy to see why this is a very influential group Silver Toxic To Environment University of Rhode Island / EPA Study California Berkeley Conference on San Francisco Bay

Fraud Of Environmental Friendliness Politically Active Environmental Groups: Speaking out against silver Toxicity risk to human health and environment Antibiotic resistance among harmful bacteria Neurological problems, kidney damage, headaches, fatigue and skin irritation Most extensive environmental network in the world, with almost 1 million supporters across five continents and more than 70 national organizations worldwide.

Research by Pew Charitable Trusts: September, 2008 “Silver itself is classified as an environmental hazard . . . because it is more toxic to aquatic plants and animals than any metal except mercury. Even if a nanoparticle itself is not especially toxic, silver nanoparticles increase the effectiveness of delivering toxic silver ions to locations where they can cause toxicity.”

Silver vs MonoFoil ® Differences MonoFoil Silver Chemical nature Bonded Polymer Salts and Ions Mode of antimicrobial action Cell "Wall" Destruction "Wall," DNA, Enzymes - POISON Durability Chemically Bonded Leaches / Releases Effectiveness Quick Kill Broad Spectrum Spectrum and Time to Kill Limited Safety No Risks Risks to Humans and Envrionment Cost Cost / Effective Expensive / Effective Verification Easy Test (Mill & Store) Complicated Test Regulatory compliance Compliant Range of antimicrobial activity Broad Spectrum Limited

MonoFoil Antimicrobial Silver vs MonoFoil® Silver MonoFoil Antimicrobial Risk of Bacterial Resistance No Risk of any Bacterial Resistance Risk of Bacterial Adaptation No Risk of Bacterial Adaptation Silver Allergy Skin Friendly Grey Shading Transparent Silver ions can be deactivated by other counter ions like S²⁻ Not sensitive to other chemicals

Conclusions Silver is a migrating technology: Migration to the environment Migration to the skin Some bacteria can develop resistance to silver. Silver is an efficacious antibacterial agent but silver resistant bacteria do occur. Silver Allergy and grey shading do occur At least 24 hours to have a significant bacterial reduction. High cost = Safe Technology No risk of any bacterial adaptation or resistance

References A. B. G. Lansdown, PhD, FRCPath, Clinical Research Fellow Department of Clinical Chemistry, Imperial College, Faculty of Medicine. London UK Russell AD, Hugo WB. Antimicrobial activity and action of silver… In: Ellis GP, Luscombe DK, editors. Progress in Medicinal Chemistry. : Elsevier Science, 1994; 351-369. www.worldwidewounds.com : Introducing Silver Dressings. www.ncbi.nlm.nih.gov : National center for Biotechnology Information www.fda.gov : Food and Drug Administration