(By Rabbi Yair Hoffman for the Five Towns Jewish Times)

Everyone has an aunt or a sister-in-law who is, perhaps, a little bit too bleach-happy. A new child is born into the family and someone brings out an older crib or other baby product. It could be anything, a high chair, a baby swing, a play item. The bleach-happy relative is there (it could also be an uncle as well) and out comes the bleach.

The bleach goes here. The bleach goes there. The bleach is everywhere. And many find the bleach unpleasant. The reader may be thinking. “Yes, I too have experienced this and it is unpleasant. But what does this have to do with halacha?”

Let’s first look at some background. In 2015, a European study was published that looked at more than 9,000 children between the ages of 6 to 12. The study discovered some shocking repercussions of the use of bleach.

THE NETHERLANDS STUDY

Those children whose parents who used bleach to clean their homes at least once a week had higher rates of respiratory and other types of infections. Specifically, the study found that these children had a 20 percent higher risk of having the flu at least once in the previous year.  They also had a 35 percent higher risk of recurrent tonsillitis.  Finally, they had an 18 percent higher risk for any other recurrent infection.

The study was led by Lidia Casas of the Center for Environment and Health at KU Leuven in Leuven, the Netherlands.  The subjects were found in the Netherlands, Finland and Spain.  The study was published April 2, 2015 in the Journal of Occupational & Environmental Medicine.

THE HALACHA

Now on to the halachic discussion.  There is no question that a] if cause and effect were determined to truly be at play here and b] these figures would be unquestionably true – there would be halachic implications as to whether we should be using bleach in our households on a regular basis.

For the sake of this discussion we will assume that both of the above factors are true – even though that may not necessarily be the case.  In general, the concept of how and when medical studies ultimately enter into normative halachic practice is a fascinating topic that needs further examination.

THE SHOMER PSA’IM HASHEM DEBATE

There is a rather fascinating debate between two major Poskim of the last century – Rav Moshe Feinstein zt”l and Rav Chaim Ozer Grodzinsky zt”l.  The debate revolves around how to halachically understand the Gemorahs that invoke a pasuk in Tehillim (116:6).  The Gemorah in several places (see, for example, Shabbos 129b, Yevamos 12b, Sanhedrin 110b) invokes the pasuk to justify why certain ostensibly dangerous practices were not, in fact, violations of the halacha of “VeNishmartem Meod b’nafshosaichem.”

Rav Moshe Feinstein zt”l (in Igros Moshe YD II #49) in a discussion that, according to his son Rav Dovid ylc”a, has since changed – presents the view that the pasuk indicates that social acceptability of the activity is the determining factor.  [The view was later clarified to this author.]  So even though there may be a statistically significant danger in an activity, as long as society still views that practice as within the norm of responsible behavior it is still permitted.  Rav Feinstein was discussing the permissibility of smoking.  Later, Rav Dovid Feinstein reclarified his father’s view and stated that his definition only applied when the known percentages of danger were smaller.  However, after the release of overwhelming evidence of the relationship between smoking and death, he stated that his father’s definition does not apply here.  Nonetheless, the general explanation of Rav Feinstein is still intact that for some issues the application of Shomer Psaim Hashem is determined by social acceptance.

THE OTHER VIEW

In the responsa of Rav Chaim Ozer Grodzinsky, (Achiezer Vol. I #23) there is a different view of the parameters of the concept of “Shomer P’sa’im Hashem – Hashem watches over fools.”  He writes that this concept only permits dangerous things when the danger is not uncommon.  When it is common – there is no question that it would not apply. (updated correction)

THE CASE OF BLEACH

If the statistics presented in the Netherlands study are accurate and there is a cause and effect relationship proven – then it would seem that, at least according to the Achiezer it would be prohibited to use bleach so often in the household.

HOW DOES IT WORK?

But if true, how does it work?  How would the use of bleach increase infections? The authors suggest that either airborne components of bleach and similar products may irritate the lining of children’s lungs, triggering inflammation and making it easier for infections to take hold, or, that somehow, someway, bleach may suppress the immune system, making infections more likely.

WILL JEWISH MEDICAL ORGANIZATIONS START MAKING THIS RECOMMENDATION?

When this question was posed to an executive of Refuah Healthshare, the Director of Operations, Moishe Katz responded:  “United Refuah Healthshare takes all preventative healthcare activities very seriously, as should everyone.  We will carefully look at this study and monitor any further research on it.  Besides providing for the medical needs of our members, we update them regularly as to what preventative measures can be taken to safeguard their health and those of their family members.”

DOES EVERYONE AGREE TO THIS STUDY?

The answer to this is clear.  The American Cleaning Institute which represents bleach manufacturers released the following statement:

“Since there was no data presented on the children’s actual exposure to bleach — nor any diagnoses of actual diseases — the authors are merely speculating.”  The group also stated that disinfecting household surfaces with bleach can protect people from bacterial infection.

Dr. Kimberly Wise of the Chemical Products & Technology Division of the American Chemistry Council, points to specific design flaws in the study:

1] The study data rely on questionnaires completed by parents who were asked to differentiate between specific medical conditions (ie, influenza, tonsillitis, sinusitis, otitis and bronchitis). It is unclear if any information was provided to the parents regarding these conditions and how to diagnosis the conditions or if the diagnosis was confirmed by a physician.

2] The high frequency of use of disinfecting irritant cleaning products may be of public health concern

3] The study did not account for potential confounding factors that could influence the occurrence of infection in the children studied (ie, passive smoke, local air pollution, pre-existing health conditions).

4] The questionnaire is limited by relying on a yes/no question regarding frequency of exposure to bleach. Specifically, parents were asked to respond yes/no regarding whether bleach was used to clean the home at least once per week. This yes/no response provides no information to help characterize the actual exposure or whether the bleach was used in appropriate quantities for cleaning or disinfection. It also does not take into consideration or request information on whether the child was present while the bleach was being used or specifically how the bleach was being used (ie, to disinfect household surfaces, toys, laundry).

5] No information has been included to determine if other cleaning products were utilized in the home and, if they were, at what frequency they were used. This information could impact the conclusions of the report.

The author of the study responded to Dr. Wise’s critique saying that these are not design flaws.  Doctors in the area that this author consulted with, however, are concerned with the overuse of bleach in the household.

WHAT ARE THE HALACHIC OBLGATIONS INVOLVED HERE IF ITS PROVEN TRUE?

There is, of course, the Mitzvah of “veNishmartem me’od l’nafshosaichem (Dvarim 4:15) – the Mitzvah of protecting our health and well-being.  But is there a halachic obligation for taking preventative measures?  Furthermore, are there any other Mitzvos involved other than veNishmartem?

The general import of the Pasuk in Shmos 23:25 – vehasirosi machala mikirbecha – generally indicates that it is a good thing to have disease entirely removed from within our midst.  This point is made by the author of Siach Shaul (page 267) – who was a leading dayan in Eretz Yisroel and a student of Rav Isser Zalman Meltzer zt”l.

We find regarding Yaakov Avinu (Bereishis 28:11) that he placed the stones around himself in a circle before he went to sleep.  Rashi explains that it was in order to protect himself against animals.  We therefore find that it is necessary to take protective measures.

OTHER TWO MITZVOS

Many people are unaware that there is actually more than the one Mitzvah of VeNishmartem.  There is also a not-so-well-known second Mitzvah.  The verse later on (Dvarim 4:15), “Rak hishamer lecha” is understood by most Poskim to actually comprise an actual second Mitzvah (See Rav Chaim Kanievsky Shlita in Shaar HaTeshuvos #25) – to take special care of one’s health. There is very often a third Mitzvah, “V’Chai Bahem – And you shall live by them” (VaYikra 18:5).

The author can be reached at [email protected]