Dioxin Found In Tampons -
How Much Is Too Much?
By Francesca Lyman (2-10-99)
From Ruth (name on file)
Ruth's Page - Endometriosis & Dioxin
The Curse. That time of the month. Although American women don't retreat to menstrual huts, as they once did in some societies, many are squeamish talking about their periods. But since reports of tampons tainted by chemicals started surfacing, many have begun insisting on some frank talk about the health and safety of feminine hygiene products - and seeking out alternative brands.
Ruth B's periods had always been a nightmarish ordeal. The rural Wisconsin woman suffered from severe cramps and pelvic pain, eventually being diagnosed with endometriosis, a disabling menstrual-related condition that is a leading cause of infertility.
"It feels like there's a hot poker inside you, jabbing you in the gut," Ruth says of the disease in which the uterine lining somehow escapes the uterus and becomes implanted on other pelvic organs. "Sometimes I end up in a fetal position, writhing in pain."
Although rarely discussed in her day, endometriosis was the devilish disease that put Marilyn Monroe in the hospital and caused her pain throughout her life. In "Goddess," biographer Anthony Summers quoted Marilyn's first husband saying, "Norma Jean had so much trouble during her menstrual periods, the pain would just about knock her out."
Instead of suffering in silence, though, Ruth - who asked that her full name be withheld for fear of reprisal by the chemical industry - became an activist, seeking to help herself and her fellow sufferers. She learned that the causes of endometriosis, which afflicts anywhere from 6 million to 9 million American women, remain puzzling to researchers.
But new studies have begun to link the disease - as well as a variety of other reproductive ailments - to environmental toxins, specifically dioxin. Dioxin is a byproduct of many chemical, manufacturing and incineration processes.
Researching endometriosis on the Internet, the Wisconsin woman read that one route of exposure to dioxin, in addition to widespread sources in food, air and water, could be tampons and sanitary napkins - products she'd used for 15 years. The chlorine used to bleach the wood pulp and rayon fibers can leave behind traces of the chemical.
Ruth says she then launched her own Web page "to try to get the word out to women that dioxin is a problem and that there is dioxin in tampons and that more testing is required to make them safe."
During this time, Ruth also found that she is not alone: A growing number of women were beginning to fear that they may have been putting themselves at risk if they used major brands of tampons. However, many more weren't - and still aren't - aware of the issue, activists say, and neither are many physicians.
'There is very little regulation of sanitary products - manufacturers are not even required to inform consumers of the ingredients used in the products, for example.'
- MARY LOU BALLWEG author, "The Endometriosis Sourcebook"
Not satisfied with the manufacturers' claims that their products contained negligible amounts of dioxin, Ruth had her own Playtex tampons tested independently. The tests showed they did indeed contain measurable levels of the chemical - at a personal cost of about $1,000. But few women are willing to go to the trouble and expense of testing the products they buy, Ruth says.
Others agree. "Most women assume these products are sterile (they are not) and that government regulations protect them," writes Mary Lou Ballweg in an anthology of articles that comprise "The Endometriosis Sourcebook" (Contemporary Books, 1995). "Unfortunately," Ballweg states, "there is very little regulation of sanitary products - manufacturers are not even required to inform consumers of the ingredients used in the products, for example."
During the last few years, several activist groups have taken on the issue, and a number of articles, including one in New York's The Village Voice, "Pulling the Plug on the Sanitary Protection Industry," charged some companies of deliberately ignoring the health risks. In 1997, Rep. Carolyn Maloney took up the cudgel for the cause, introducing The Tampon Safety and Research Act. The bill, which called on the U.S. National Institutes of Health to fund independent studies looking into the health effects of tampon usage over time, never made it out of committee that session, but was re-introduced in the 106th Congress in 1999.
In response to these charges, the major manufacturers (Tambrands, Playtex and Johnson & Johnson) counter that their products are perfectly safe.
The FDA, which regulates these products as medical devices, agrees. "There used to be negligible amounts of dioxin in tampons and other products," says Sharon Snyder of the FDA's Public Affairs office. "But now there is none at all."
In response to consumer questions (and a rampant e-mail claiming tampons contain asbestos - which appears to all parties to be a hoax), the FDA issued a December 21, 1998 memo, stating "Chlorine is no longer used in bleaching the pulp used in making tampons. This is universal across the tampon industry."
John McKeegan, a public relations officer at Johnson & Johnson, which makes "o.b." tampons, says the company has reduced the dioxin in its tampons to "non-detectable" levels. "There are trace amounts of dioxins in many, many things," he says. "They're formed when there's fire. It's found in paper. But it is always in minute, trace amounts."
However, questions about pulp bleaching continue to surface. On Jan. 26, Congresswoman Maloney wrote the FDA, charging that there is no evidence upon which to base their statements that tampons are dioxin-free. The new bleaching processes, known as "elemental chlorine free" and "elemental free" (chlorine dioxide), still create and release dioxin, she wrote.
Maloney also sent around a "Dear Colleague" letter, saying that FDA's statements were misleading. "Exposure to this chemical has been linked to cancer, immune system suppression, pelvic inflammatory disease and infertility, and has also been linked with increased risks for endometriosis," she wrote. "Men, women and children are exposed to dioxin through the air and the water. It makes no sense for women to have an additional exposure through tampon use."
The dioxin exposure from tampons and feminine hygiene products are thought to be relatively small compared to other sources, most agree. But what are the potential risks for women? That is difficult to know, say scientists who have looked at the issue,
because there have been no relevant clinical trials.
Arnold Schecter, a professor of environmental sciences at the University of Texas School of Public Health at Houston and a specialist on dioxin's health effects, feels there should be studies to analyze how much of the dioxin in these products could be taken up by a woman's body. In initial tests of a dozen major brands on the U.S. market today, he found detectable levels of the chemical in all the feminine products, even the so-called "natural" ones.
Peter deFur, a physiologist consultant and part-time researcher with the Center for Environmental Studies at Virginia Commonwealth University in Richmond, Va., says he doesn't accept the FDA's position that the dioxin level in the products is too low to measure. His review of FDA data showed that there was a measurable amount of dioxin. And it would stand to reason, deFur says, that if the internal lining of organs - which includes a sensitive area such as the endometrium - is exposed to dioxin, there would be a "near 100 percent absorption of the chemical. It crosses membranes, it is taken up, transported and stored."
Are these products Earth-friendly?
Dr. Philip Tierno, a researcher at New York University Medical Center who studied the absorbent chemical in tampons responsible for toxic shock syndrome, is also concerned. "The vagina is a very absorbent place. No amount of this chemical is safe."
Fortunately, Tierno says, "with attention to the issue, we may be lucky that levels of dioxins are finally going down.
"What's also encouraging," says Tierno, is that "women are getting smarter. They alternate the tampons with pads and go with pads in the night."
But Rep. Maloney isn't content to leave safety to the manufacturers. "Let's just do some studies," she says. These should be independent - not industry-paid, she adds; "otherwise, it's like having the tobacco industry do their own tests to prove cigarettes are safe."
In the meantime, dozens of alternative feminine products have started springing up - everything from "sea sponges" and tampons bleached with hydrogen peroxide, a non-chlorine alternative, to organic and pesticide-free cotton pads. One company now sells reusable menstrual cups, which boast added environmental benefits: less raw material manufacture, no paper, no chlorine discharged into the air and water, and no garbage.
But until the male-dominated Congress is willing to hear the issue, says Maloney, there's no chance any of these products can be proven safe. "One thing that has gotten women talking about this," says Therese Schlachter, one of Maloney's aides, with a touch of irony in her voice, "is e-mail and the Internet. They can talk about their menstrual problems anonymously."
Francesca Lyman is an environmental and travel journalist and editor of the recently released "Inside the Dzanga Sangha Rainforest."