Vegetarian Times: Red Alert

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Red Alert

Leora Tanenbaum

Warning: Your tampon may be hazardous to your health.

Back in the late 1970s, women got the scare of their lives when tampons were linked with toxic shock syndrome (TSS), a potentially fatal infection. The super-absorbent synthetic fibers used in tampons were causing Staphylococcus aureus (a bacterium commonly found in the vagina) to produce poisonous compounds.

These toxins spread quickly into the bloodstream, resulting in high fevers, low blood pressure, flulike symptoms, skin rashes, vomiting and diarrhea.

More than 50 women died. The cases were traced back to Proctor & Gamble's highly absorbent Rely tampon, which was subsequently pulled from the market. Tampon manufacturers also stopped using synthetic materials in their products--with the exception of rayon. Across the country, women relaxed. While reports of TSS occasionally still surface, the danger seems to be over.

But is it? Nearly 20 years later, we think of tampons as safe, yet a new health hazard looms. Despite the feminine hygiene products' clean, healthy and convenient image, tampons (and to a lesser extent pads) actually contain several chemical substances that women would do well to avoid. Studies conducted by the sanitary product industry have found that lurking within tampons are trace amounts of dioxin, a chemical deemed a probable carcinogen by the Environmental Protection Agency (EPA). Dioxin is a byproduct of the chlorine bleaching process used in manufacturing tampons' cotton and viscose rayon--a mixture of wood pulp, sawdust, lye and other chemicals that together form an extremely absorbent fiber.

Because the vagina is a main entry point into the body, health experts are worried about the impact these tampons are having on women's overall health. "The vagina is like a sieve," explains Philip Tierno, Jr., M.D., director of clinical microbiology and diagnostic immunology at New York University's Medical Center, TSS researcher and leading expert on the health risks of tampons. "Whatever is in there goes right into the blood circulation." Even at trace levels, dioxin is cause for concern. According to Joe Thornton, author of Achieving Zero Dioxin, a report published by Greenpeace in 1994, there is no "safe" dose of dioxin, which accumulates in human fat.

When you consider that the average woman will use more than 11,000 tampons in her lifetime, the health risks multiply, according to Karen Houppert, author of the forthcoming book The Curse (Farrar, Straus, Giroux, March 1999). Carolyn DeMarco, M.D., a women's health specialist in British Columbia, theorizes that lifelong exposure could increase a woman's risk for breast cancer and endometriosis (in which uterine tissue grows outside the uterus). Scientific studies have already suggested a connection between dioxin and endometriosis. Because dioxin mimics estrogen, and because estrogen has been associated with breast cancer, experts feel dioxin may have similar effects.

While it's true that no studies have been done linking reproductive disorders and cancer specifically to dioxin in tampons, the chemical alone has racked up a long rap sheet of health offenses. According to a 1994 EPA report, dioxin, a common paper and pulp industry pollutant, threatens public health. Along with cancer, the report states that dioxin may lower sperm count, cause birth defects and damage the immune system.

After reviewing hundreds of epidemiological reports on dioxin and cancer, in 1993, a panel of the U.S. National Institutes of Medicine (a division of the National Academy of Sciences) concluded that there is "sufficient evidence" of an association between exposure to dioxin and dioxin-contaminated herbicides and soft-tissue sarcoma, non-Hodgkins' lymphoma and Hodgkin's disease.

"We don't know all the ramifications [of tampons with dioxin]," says Tierno. "But the absence of evidence is not evidence of absence. And we have sufficient data to show how significant dioxin is. The bottom line: No dioxin where you can help it, especially when it goes inside your body."

Nonetheless, the Food and Drug Administration (FDA) maintains that there is no scientific evidence that tampons and pads that contain traces of dioxin pose a public health risk. While the agency has never measured dioxin levels in tampons or pads or studied their potential dioxin-related health risks, the FDA stands behind research done by the feminine products industry.

Rep. Carolyn Maloney (D-N.Y.) has protested the validity of tests conducted by the manufacturers themselves. "Some of my constituents say this is the equivalent of the fox guarding the hen house," she says. Concerned that tampons' hazards aren't receiving enough attention, she introduced the Tampon Safety and Research Act in 1997. If it is put into law, the National Institutes of Health would be required to conduct independent research to determine the extent of the health risk and to publicize the results. "American women have a right to know about any potential hazards associated with tampons and other related products," she declared when she presented the legislation. "It is only when women fully understand the consequences that they can make truly informed decisions about their reproductive health." At press time, the House had not taken action on the bill. Maloney plans to reintroduce it at the start of the 106th session of Congress next year.

So what's a woman to do if she likes the convenience and comfort of tampons but doesn't want to expose herself to potential health risks? She should switch to 100 percent cotton feminine hygiene products that are bleached with chlorine-free methods. At the very least, Tierno's research has shown that these products reduce the risk of contracting TSS. "I am a big advocate of using dioxin-free tampons for myself," says DeMarco, "and I ask all my patients to use them."

Many companies manufacture all-cotton, dioxin-free tampons and pads. When shopping for these products, look on the box for key phrases such as "non-chlorine bleached" and "100 percent cotton." Other health-conscious options to consider include a reusable cup device and washable cloth pads. (For manufacturers' phone numbers, see "Editors' Picks," p. 75.)

Tampons with applicators. Made with organic cotton (free of synthetic chemicals and pesticides), Natracare tampons come with a biodegradable paper applicator and in two absorbencies, regular and super. Trutona offers biodegradable organic cotton tampons in both regular and super-absorbent styles.

Tampons without applicators. Terra Femme, Organic Essentials, Eco Yarn and Natracare all distribute all-cotton, organic tampons.

All-cotton pads. Although pads do not pose the immediate potential dangers that tampons do, their proximity to the vagina make them a possible health risk as well. Another reason to opt for all-cotton pads: Mainstream brands often use a "dry-weave cover," which is made of plastic and may cause allergic reactions. Natracare and Seventh Generation offer pads in a variety of absorbencies. Natural Choice produces pads in four sizes with flaps for a snug fit. Trutona sells biodegradable pads and panty liners.

Reusable cloth pads. For those who worry about the waste generated by disposable pads, Glad Rags manufactures a line of reusable cotton pads that are simply snapped around the crotch of your panty. (Soak used pad in cold water, then machine wash.) They come in several colors and are made of soft, chlorine-free, organically grown cotton. Absorbency options include pads for day and night. Extra liners for heavy flow days and plastic-lined carry bag are also available.

Leora Tanenbaum, a journalist living in New York City, writes about women's health for Ms., Newsday and On The Issues.