Use, Throw and Forget – Or Do We? The Health, Environmental & Social Hazards Of Sanitary Napkins
When the world was less connected physically and when everything had to move in sync with the lunar and solar cycles, it is said that women used to indulge in self-care, and collect the menstrual blood for fertilizing their fields. Unless the woman had any major infectious disease that could be transmitted by blood, this was perfect; soil with its moisture and microbial flora and sunlight, paved the way for quick decomposition of blood, and the minerals in it, just nourished the soil.
Most think that the traditional practice of sitting and doing just about nothing other than bleeding freely without generating any non-biodegradable waste, is a utopian thought. The first two articles in this series talk about initiation of menstruation through the lens of culture and menstrual management initiatives especially in rural India. The responsibility of menstruation starts right there, when a menstrual management option is present. So, what else do we do, in these modern times,where sanitary napkins are slowly turning into a huge socio-economic luxury for various profiteers (except the menstruators)?
Today, in our fast-paced world, it is an ultimate comfort to be able to use disposable sanitary napkins (DSNs – also encapsulating here other MHM options such as tampons, synthetic fleece etc., all which are disposed after one-time use), but at what price? There are 3 major concerns to using DSNs:
Health hazards to the user due to the chemical cocktail involved (dioxin, furan, pesticides and other endocrine disruptors)
Environmental hazard due to non-biodegradable parts and chemical toxins – to every living being through direct handling, and indirectly through food chains
Social hazard due to acceptability of disposables and shaming of reusables
Health Hazards and Environmental Pollution – blurred links and toxic secrets
To understand this, we need to begin at the point of origin of disposables.
Bulk of it contains super-absorbent polymers mixed with bleached cellulose or synthetic pulp.
Super-absorbent polymers are generally the sodium salts of poly acrylic acid, capable of absorbing water, up to 30 times its weight (ie, 1g of sodium polyacrylate can absorb up to 30 ml water). This property makes it absorb moisture from skin, being the primary cause of rashes.
This is also the contributor to Toxic Shock Syndrome, while over-exposing our body to tampons.
Cellulose is mostly bleached to give it the white look, that has been marketed so well, that manufacturers are finding it so hard to change the narrative of “white” pad equated to “safety” and “hygiene”. Most of the bleaching happens using chlorine, which releases dioxins during the process. (Dioxin is formed as an unintentional by-product of many industrial processes involving chlorine such as waste incineration, chemical and pesticide manufacturing and pulp and paper bleaching)
So, even before the humble plant-originated cellulose makes its way into a pad, it starts emitting hazardous dioxins into the atmosphere, putting at risk the bleaching plant operators, and anyone else in vicinity.
Traces of dioxin continue to be present in the pad. Even though studies have not proven that a one-time exposure to dioxin-laden pad can be hazardous, there is nothing refuting the toxicity of repeated exposure to dioxin. Also, higher incidence of reproductive disorders in urban areas with more than 70% DSNs users cannot be ignored as one of the problem factors.
The maximum hazard is seen at the disposal stage, when dioxins in pads can leach into soil, water or air due to incineration or landfilling, and produce an accumulated toxic effect. Synthetic pulp again contains lots of non-biodegradable polymers which could have their origin from crude petroleum refining, which is a totally different story on environmental hazards.
Sanitary napkins contain two more layers than a tampon; a leak-proof plastic layer and a dri-weave non-woven layer, which is again a derivative of polyethylene or polypropylene; plastics that do not biodegrade.
Fragrances, a new addition on some DSNs are said to be phthalate or aromatic derivatives that are endocrine disruptors and carcinogens, respectively. These have been assumed to be the cause of endometriosis, affecting many women, and leading in extremely painful periods; and infertility among women.
The problem does not end at the exposure during usage of a DSN. It starts right from manufacture, to disposal and continues at each stage when these layers and the chemicals in it get transferred between soil, water and air and do not degrade, and get bio-accumulated in plants and animals and enter our food-chain. The logic is simple; plastics doesn’t biodegrade fully; they break down into micro particles (their pollution is worse) and chemicals are extremely hazardous from the first moment that they are synthesized, and cannot naturally degrade and be removed from the planet.
Social Hazards of DSNs
The branding of DSNs has been so compelling that it has become nearly unimaginable for any mother, who has handed her daughter the safety, cleanliness and freedom of DSNs, to switch to reusables. Our narrative in the long run has been that “blood/bleeding is shameful and needs to be hidden”, “stains are a crime”, “pure white pads spell hygiene and safety”, and “comfort of use and throw”. Added to this was the subtext that cloth is uncomfortable, suitable for inactive people, cause staining and washing off blood is gross. There was also some level of ‘upper-class’ status attached to DSNs. With both these narratives, I can easily say that the current generation of reusable-users, who used to be ex-DSN-users would have never imagined themselves going against DSNs few years back. These issues are significant at an individual level, and can be overcome at some point. However, there are larger social implications to DSN use.
DSNs have no ‘right’ way of disposal. Following are the most common methods of disposal that are to be strictly prohibited:
Wash the blood and open the cleaned pad. Flush off the absorbent-cellulose layer and dispose off the non-woven and plastic layers along with other plastic wastes – less risky method
Burn the entire pad – highly hazardous, as it releases apart from dioxins, another component called furans, extreme carcinogens, released from the synthetic/plastic layers
Bury the entire pad – slightly better method, and preferable if blood can be washed away, so that dogs do not dig it out; can’t be employed if land availability is low. There is also a high possibility of chemicals leaching out and spoiling soil and underground water quality
Wrapped in paper and disposed in designated bins – problem is removed from sight, but here also it ends up either in a landfill, or is burned
Flush off the entire pad – is a to be totally avoided, as the super-absorbents present will soak up all water, and clog drains. In India, clogged drains and sewages are cleaned manually. Given the pitiable work conditions and compensation for manual scavengers, it should be common sense for people to not flush off DSNs at least when they know of the repercussions
Discarding into water-bodies – similar to buying, this method too entails leaching out of chemicals into water and entering our food chain
Throwing into landfills – in all the above methods, the risk of contamination through blood is not a major hazard, as most virus/bacteria may not easily survive for long under those conditions. Also, a healthy woman’s blood is generally not a source of infection on its own. However, in landfills, there is a condition for the blood in the sanitary pad to remain undisturbed for long periods of time, without encountering more moisture or sunlight or high heat. This makes it ideal for other bacteria to easily colonise the DSN and bear infection. The conditions in a landfill makes it impossible even for ‘degradable’ napkins to decompose.
Decomposable pads are another example of DSNs. Even though they seem to be promising at the outset, their decomposition in natural conditions is nearly impossible. Thus, unless there is a proper decentralised system enabling its decomposition, it is no different from DSNs. Some decomposable pads claim to be made of plant starch; this is a bigger problem, as it could easily escalate to a food security issue, similar to the food-vs-fuel debate that significantly brought down the popularity of bio-fuels.
These days along with DSNs, many government schools and few colleges also have the option of an electric incinerator. Incinerators and similar ‘napkin destroyers’ are now locally made and distributed. However there does not seem to be any mandate for its specifications regarding design or operation. Therefore, there are no standard products, adhering to ISI or similar guidelines in the market currently. Incineration of plastic with chlorinated chemical content at lower temperatures results in higher quantity of dioxins, furans and biphenyls (ncbi). So, they need to be incinerated at temperatures above 800 degree celsius and unless an incinerator meets certain design specifications, this temperature cannot be achieved. There also does not seem to be any mandate on the treatment of the burnt residue. In western countries where burning used DSNs and diapers are the norm, it is done in large thermal power plants, and the burned residue is used as a raw material to cement manufacturing industry, in a closed industrial loop. Advantages of centralised system of sanitary waste collection from site and its transport to thermal power plants,advanced technology, large amounts of space, away from major sites of human habitation to locate the power plants, excess alternative energy (solar or wind) to operate these plants, and heat requirements in temperate regions which act as a perfect sink for the excess heat generated, make the burning process less problematic in european countries, where this practice is prevalent.
So, what is the right MHM option for women?
There is not one right option for any woman, because, menstruation is just another regular body function, prone to a lot of variations, imperfections and errors. There are some months with no periods, some with 2 or 3 periods, some heavy, some painless, some that drives us crazy and moody, some that opens the fountain of life and sees us in the best of times. So, ultimately when there is no standardisation for our periods, there cannot be a right, or standard MHM option too. The ideal solution is to know what works how, and use the best suited option, and responsibly.
A lot of reusables – cloth, cloth pads, cloth pads with leak-proof layer and/or fasteners, period panties, microfibre pads, menstrual cups, etc., are available. All these, if maintained with some care and caution would last for a long period, and reduce the burden of health and environmental hazard, even if they cannot eliminate the hazards. The ideal method, as already mentioned would be to not use any product and let the blood flow, and use the time for self.
Why should I give up my napkin?
As a menstrual educator, I have faced this question from many people, including myself, “Why should I make the switch?” Do you know that the omnipresent plastic is there in our comfortable and breathable sportswear, mobile phones that we discard every year, in our kitchen cabinets, baby toys, and all other comfort products, and even in baby diapers?* My take on this is that ‘plastic is a necessary evil’ in today’s world, Reduce, Reuse, and Refuse is the way to go about it. I choose “Refuse” when it comes to sanitary napkins, because I do not feel that my blood is gross, or stains are bad, or that washing my pads is difficult and want to slow down a bit once every month. It is the battle between “Periods is bad and shameful and attacking me” versus “Can I own it”. Deciding to flush out one more toxic plastic has been a slow and steady change. Our movement is here to stay, and slowly help everyone to be comfortable with their bodies, and help the earth.
*Some baby diapers are now being bleached without chlorine by few manufacturers, and they specifically mark it. Even though these come at a premium, this is a first step towards a better disposable product, but a lot needs to be done to convince most of the reusable-converts.
About the writer: Kavya Menon, a biotechnology graduate from IIT Madras, worked with rural communities to understand the need for menstrual hygiene, addressing taboos, introducing simple home remedies during her SBI Youth Fellowship tenure. Currently, she resides in Chennai, and conducts sessions for urban and semi-urban communities on menstrual health and hygiene and various MHM options. She is associated with Sustainable Menstruation Kerala Collective since early this year.
This is the third article in the series of seven for Earth Day and is done in a collaboration with Bhoomi College, a center for learning for those who wish to take up green paths, as well as those who wish to live with more ecological consciousness and personal fulfilment. The last article in the series of seven will be published on Menstrual Hygiene Day On 28th May.
In these 7 weeks, we will cover a variety of topics around menstruation, which are eye opening, thought provoking and will inform you more about sustainable menstruation options. We urge our readers to stay tuned and participate in this crusade.