WHAT’S THE ISSUE?
WHAT`S THE ISSUE?
In the past year, scientists and health professionals have voiced growing concern over the potential risks of using tampons and other personal hygiene products such as diapers. Increasing evidence suggests some of these products contain trace levels of toxins that, over time, could pose a significant health risk to those who use them. These toxins include dioxins and phthalates, both classed as endocrine disruptors which are coming
under increased scrutiny. New research is now linking the presence of dioxin and phthalates in these products back to the original production process – dioxin from
the chlorine used to bleach the material and phthalates which are added to the plastic compounds in these materials. The manufacturers of these products are failing to disclose the use of these harmful chemicals, which is heightening these risks further.
WHY SHOULD WE BE WORRIED?
A series of reports and investigations have drawn media attention to this issue, fuelling public concern and protest. Notable research includes the 2013 Chem Fatale study 
which highlighted potential health concerns relating to toxic and allergenic chemicals found in feminine care products, and the 2017 French documentary Tampons,
our closest enemy  which found evidence of dioxins, phthalates and other carcinogens like furans in six tampon brands.
Also in 2017, France’s National Institute of Consumption’s 60 million consumers magazine published test results showing similar potentially toxic substances in arange of tampon and diaper brands it analysed .
These findings reportedly went viral on Asian blogs targeted at mums, leading to national reports  of sales of Pampers diapers being halted in South Korea and the launch of a
government safety probe. US activists have since called for new rules  to force manufacturers to disclose the chemicals and materials they use in tampons and other
menstrual products, following the introduction of a new Congress bill, the Menstrual Products Right to Know Act .
Despite these developments, the chemicals used in such products remain for the most part, unregulated and authorities seem unwilling to act. As far back as 2002, a study  co-authored by a researcher working for the US Environmental Protection Agency found various dioxins and furans in four tampon brands, yet suggested that the use of tampons and diapers did not contribute significantly to dioxin exposure. However assumptions
were made in estimating these tampon dioxin exposure levels, and these estimates varied significantly. There still remains a lack of evidence on the direct and cumu-
lative exposure of these toxins to intimate body tissues.
WHAT ARE THE HEALTH RISKS OF THESE TOXINS?
Dioxins belong to a ‘dirty dozen’ group of chemically related compounds known as persistent organic pollutants (POPs) and as such, are classed as very dangerous
by the World Health Organisation (WHO)  . Dioxin is a cancer causing agent, but even at very low levels it can cause other adverse health effects including reproductive problems and hormone interference.
Dioxin exposure for women can increase the risk of pelvic inflammatory disease and endometriosis – one of the studies highlighted in Tampons, our closest enemy  found that patients with endometriosis had higher levels of dioxins in their bodies, a finding reflected in other research . It should be noted that once dioxins are released into the environment, they bioaccumulate and are very slow to disintegrate so repeated exposure to them – as in the case of monthly tampon or daily diaper use – may heighten these risks further. Regulation that aims to eliminate or severely restrict the production and use of dioxin and other POPs exists under the Stockholm Convention on Persistent Organic
Pollutants , an international treaty that is legally binding. Among other things, the Convention calls on relevant parties to promote “educational and public awareness programmes on POPs, as well as on their health and environmental effects and on their alternatives” especially for women and children. Phthalates meanwhile have been linked to breast cancer, diabetes, asthma, altered reproductive development and low IQ. The human health effects from exposure to low levels of phthalates are not yet fully known, but are being studied by government agencies around the world. The healthcare costs  of exposure to these types of endocrine disruptors within the EU alone is estimated
to be in the region of 157 billion a year – more than 1% of European GDP.
WHAT IS BEING DONE ABOUT IT?
Very little. One of the problems is the lack of accountability and disclosure by regulators and manufacturers. According to reports , the US Food & Drug Administration (FDA) says the bleaching methods for Rayon tampons that leave trace amounts of dioxin in the
products are no longer in use – but the FDA’s claim seems reliant on dioxin test data submitted by tampon manufacturers which is not publicly available. It’s also worth noting that FDA industry guidance  on chemical residues recommends that manufacturers identify the
bleaching process used for tampons and menstrual pads – this includes Elemental Chlorine-Free (ECF) which can still release dioxins (see next section What needs to happen now?).
In the US, tampons are classified as medical devices which means that there’s no packaging labelling requirement for ingredients like chemical residues, making it impossible for consumers to avoid any potential toxins found in these products. A similar situation exists in
Europe where there are no European standards limiting the level of these substances in tampons. Instead, tampons are covered by the General Product Safety Directive , which does not oblige manufacturers to disclose product components or ingredients on their packaging. Some consumer information on tampon composition is available from a French-based association of tampon manufacturers, GroupHygiène , but this doesn’t go into the detail of specific chemicals used. Moves are being made to try and address the situation, but progress has been limited. In 2016 MEP Michèle Rivasi wrote to the European Commission raising the issue of non-disclosure, but her concerns were disregarded . Since then, France’s Directorate-General for Competition, Consumer Affairs & Fraud Control has released a statement  on the findings of its own investigation into tampon safety, claiming that they pose no serious nor immediate danger – this is despite their analysis revealing traces of dioxins, phthalates and other toxins. Meanwhile in the US, it remains to be seen whether the recently introduced , Menstrual Products
Right to Know Act will eventually pass into law.
WHAT NEEDS TO HAPPEN NOW?
It’s important to recognise that the root of the problem goes back to the production process, in particular the bleaching process used for these products. Most of the cellulose fibres contained within these products will have been bleached using a technology known as Elemental Chlorine Free (ECF). The name is slightly misleading as ECF uses chlorine dioxide, which poses various dangers  , both to human health and the wider environment.
One of these risks is that the ECF bleaching process can leave a chlorine ‘footprint’ in the final product (tampon, menstrual pad or diaper) in the form of trace amounts
of dioxins. These chemical residues will stay embedded in the product throughout its entire lifecycle, as proven by the various safety tests carried out on such products
mentioned previously. The use of ECF also generates other chlorinated compounds during the production process such as AOX (Adsorbable Organic Halides) emissions and more acute toxic substances like chlorophenol. These are often discharged into waterways as effluent, causing pollution and further harm to wildlife and eco-systems.
The solution is for pulp mills, the producers of these fibres, to switch to a safer bleaching technology known Total Chlorine Free (TCF). Instead of using chlorine,
TCF supplements the bleaching process with oxygen, ozone and/or hydrogen peroxide. It remains the cleanest technology available for bleaching, and products made with it can be considered genuinely chlorine free. TCF also delivers wider ecological and social benefits as it eliminates the risk of toxic chlorinated compounds escaping into waterways, helping to safeguard eco-systems and local communities.
Who is Rune?
Rune Leithe is a forester based in Gothenburg, Sweden. He is an experienced environmental campaigner, and a passionate advocate for positive change in the world.
Rune spent seven years working for Greenpeace International where he honed his campaigning skills across a range of sustainable forestry issues. This included the toxicity risks of pulp and paper bleaching.
Since 1995 Rune has worked as an independent adviser and consultant for leading NGOs around the world. His ability to see the bigger picture has helped organisations develop winning strategies for their CSR campaigns and engagement programmes. Most recently, he was part of the research team behind the documentary ‘Tampon: Our Closest Enemy’.
“The documentary and the French Government report have both highlighted the dangers of using toxic tampons and diapers – now we must keep the spotlight on this issue. That’s why I created this social media platform and petition, to raise public awareness even further and drive the scale of change needed.”