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FOR DECADES, THE QUIET SADNESS FOR MANY HAS BEEN TOXIC SHOCK SYNDROME RESULTANT FROM THE USE OF TAMPONS. In recent decades, many young women were not allowed to use tampons as sad stories abounded about families orphaned or bereaved by the loss of a woman to toxic shock syndrome.
Toxic shock, in which a woman becomes very ill and/or dies due to the use of a tampon, continues to be a risk with tampon use. Between 1980 to 1982, 1,660 cases of tampon-related toxic shock syndrome were documented by the CDC, along with 88 deaths; Alleged News. [1] Five cases of toxic shock syndrome were reported between 2022 and 2023, in Wisconsin; Alleged News. [1] Most of these cases were tied to the use of superabsorbent tampons, Alleged News. [1] Many women in recent decades have chosen simply to use pads, as an alternative during menstruation.
16 metals such as Arsenic and lead found in tampons
Recently, metals such as arsenic and lead have been found in tampons; Alleged News. [2] In August 2024, a study by Shearston et al. was published. The study researched tampons as a source of exposure to metal(loid)s. [3] The results were that measurable concentrations of 16 metals were found in a selection of widely available tampons. [3]
Lead, arsenic and cadmium found in tampons
Shearston et al found measurable concentrations of all 16 metals assessed, arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, manganese, mercury, nickel, lead, selenium, strontium, vanadium, and zinc. [3] and [4]. Metals found in tampons included the toxic metals lead, cadmium and arsenic. Lead was found as follows - Pb (lead) (geometric mean GM = 120 ng/g). [3] Cadmium was found as as follows - Cd (cadmium) (GM = 6.74 ng/g). Arsenic was found as follows - As (arsenic) (GM = 2.56 ng/g). [3] Shearston et al. also found elevated concentrations of Ca (calcium) (GM = 39,000 ng/g) and Zn (zinc) (GM = 52,000 ng/g) in tampons. [3]
In at least one sampled tampon, all 16 metals were detected, including some toxic metals like lead which has no 'safe' exposure level. [3]
Risk for high uptake of substances
The vagina has a highly permeable and vascularized mucosal membrane, and contains rugae, or small folds, resulting in an increased surface area.
This means that substances can move through the vaginal walls (permeable) and be easily circulated to the body, as there are many blood vessels which can transport substances through blood (vascularized). The small folds afford a larger area for uptake of chemicals (rugae). [3] This allows for efficient absorption. [3]
Vaginally absorbed chemicals do not undergo first-pass metabolism and detoxification via the liver. [3] They directly enter systemic circulation. [3]
Heavy metal toxicity
There are several health risks associated with heavy metal toxicity. [3] The plausible presence of metals in tampons is concerning not only given the known adverse effects of metals exposure on health but also the characteristics of the vaginal epithelium that allow for efficient chemical absorption into the systemic circulation. [3]
Heavy metals are among the most harmful contaminants in the ecosystem, according to Ati-Hellal and Hellal. [5] Lead, cadmium and mercury are among the list of 10 chemicals of major public concern due to their high water solubility, toxicity and carcinogesis (production of cancer) [5]
Health risks of lead
Lead is highly toxic. [6] One of the major mechanisms of lead toxicity is its ability to interact with proteins and to inhibit enzyme activity. [6] Acute lead toxicity can cause many symptoms, including neurological disorders, cognitive impairments, premature birth, brain injury, kidney disfunctions, reproductive pathologies (problems with reproduction), liver damage, paralysis and even death. [6]
Organ toxicity from lead can cause CNS injury (central nervous system problems), lungs dysfunction (improper working of the lungs), hematological changes or anemia (changes in the blood which causes problems), GI colic (gastro-intestinal colic which causes pain), liver damage, reduced pulmonary function (lungs don't breathe as well as they should), cardiovascular dysfunction (problems with the heart and blood circulation through the body). [8]
Health risks of arsenic
Arsenic and its compounds are classified as human carcinogens, and have associations with skin, lung and bladder cancer. Other effects include developmental effects, diabetes, and pulmonary and cardiovascular disease. [7] In other words, arsenic can cause cancer, cause problems with development, can cause diabetes, and can cause lung and heart disease.
Health risks of cadmium
Cadmium can cause cancer, liver damage, kidney dysfunction, degenerative bone disease, lung injuries, gastro-intestinal disorders, disorders in the metabolism of Zn (zinc) and Cu (copper). [8]
Health risks of mercury
Organ toxicity from mercury can lead to CNS injuries (central nervous system injuries), renal dysfunction (improper working of the kidneys), GI ulceration (ulcers in the gastro-intestinal areas), hepatotoxicity (toxic state of the liver). [8]
Health risks of chromium
Organ toxicity from chromium can lead to kidney dysfunction (improper working of the kidneys), GI disorders (problems with the gastro-intestinal areas), dermal diseases (diseases of the skin), increasing the incidence of cancers including lungs, larynx, bladder, kidneys, testicular, bone and thyroid. [8]
[1] The terror of toxic shock syndrome once ruled headlines - so why did it fizzle out? Alleged News
https://gizmodo.com/toxic-shock-bacterial-infection-high-absorbency-tampons-1851529413
[2] Lead, arsenic and other heavy metals in tampons prompt FDA investigation; Alleged News
https://edition.cnn.com/2024/09/10/health/fda-tampons-heavy-metals-wellness/index.html
[3] Elsevier. Environment International. Volume 190, August 2024, 108849. Shearston et al. Tampons as a source of exposure to metal(loid)s.
https://www.sciencedirect.com/science/article/pii/S0160412024004355#bb0095
[4] Concerning levels of arsenic and lead found in tampons in world first study, Alleged News
[5] Environmental Health. Edited by Takemi Otsuki. 2021. Chapter 4, Heavy metals in the environment and health impact, Myriam El Ati-Hellal and Faycal Hellal, page 51
[6] Environmental Health. Edited by Takemi Otsuki. 2021. Chapter 4, Heavy metals in the environment and health impact, Myriam El Ati-Hellal and Faycal Hellal, page 54
[7] Poison Center & Public Health Collaboration Community of Practice (PCPH CoP) Newsletter. February 2024. Toxic Metals
[8] National Library of Medicine. Balali-Mood et al. Toxic mechanisms of five heavy metals: mercury, lead, chromium, cadmium and arsenic
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078867/
With thanks to gizmodo.com, edition.cnn.com, sciencedirect.com, sciencealert.com, Environmental health book, cdc.gov and pmc.ncbi.nlm.nih.gov