New Zealand experts say findings from an international study that found heavy metals — including arsenic, lead and zinc — present in tampons sold overseas need to be contextualised and warned against what was being said on social media about the issue.
In the first reported study of its kind, published in the journal Environment International last month, researchers at UC Berkeley School of Public Health in the United States evaluated 30 tampons, of which 26 were purchased in the US and four in the EU or UK.
The tampons from 14 brands with a range of absorbency (regular, super, super plus, and ultra) found 16 heavy metals present — arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, manganese, mercury, nickel, lead, selenium, strontium, vanadium, and zinc.
Seven of the products investigated were labelled as organic.
Although the study did not reveal which tampon brand tested positive for which metal/metalloid, the study itself and subsequent news headlines sparked some fear among women who shared their concern online.
New Zealand company Hello Period said its sales of menstrual disc and menstrual cup products increased following the release of the study as worried women searched for tampon alternatives.
Chief operating officer Kat Sprowell said sales for the first half of July were up 43% compared to the same period in June. She warned against panic, however.
"People get very nervous around terms such as 'metal' and 'chemicals'. Let's not forget humans are made up of chemicals and even water is chemical. Metals are also commonly found in everyday items," she said.
Peter Cressey, chemical risk assessor at ESR, said women should not be concerned about their tampons and that the findings "need to be contextualised".
"It's an unusual publication in that they really didn't provide any context for their results. They've said 'OK, well these metals and metalloids, which can be toxic, [are] present in tampons and they've kind of all walked away from it at that stage without saying what the concentrations mean."
He said metals found in the cotton-type and synthetic blend tampons were of a low concentration and a "normal part of our environment".
"These sorts of concentrations are a small fraction of what you'd find if you went out and dug up your back garden."
The accumulation of metals in soils of cotton fields is an emerging public health concern due to rapid industrial development and increasing reliance on agrochemicals.
Cressey said while metals are present in the tampons, he pointed to a 2019 study which found there was "no significant difference" in the amount of metals found in the blood of tampon users compared to non-tampon users.
"Statistically there was no difference for cadmium and lead. The actual measured levels were a bit lower in the tampon users for non-tampon uses, but not at the level of statistical significance."
He said the reactions from people online were "understandable" as a lot of the rhetoric and discussions were hazard-based rather than risk-based.
"So if you say 'arsenic is a nasty toxic compound and we found it in tampons', people will go 'that's terrible' and that's a hazard-based approach.
"A risk-based approach would be to say 'we found arsenic in tampons at levels much lower than what you would typically see in the food supply' or something like that, so then it would be moving it from a hazard-based approach to a risk-based approach."
Fear 'hyped up by social media' - gynaecologist
Michelle Wise, an associate professor at University of Auckland's obstetrics and gynecology department, said the study was "quite limited in terms of any clinical relevance".
She said her overarching message to all women was not to be scared by the results of this study that she said had been "hyped up by social media and by people who may be able to profit out of this in some way".
She said a lot of research and studies were conducted on the metals in things being ingested by humans.
"We're just seeing that more and more environmentally like in the soil and it's managed to make its way into products such as agriculture, vegetables [and] bottled water."
"I think that's a bit different because if you're eating vegetables or you're drinking bottled water, you're obviously going to ingest that. And those things are gonna absorb whereas here the tampon may have some of these elements in it, but we don't know anything about if they come out of the tampon.
"We don't know if once it does come out into the vagina, if it gets absorbed, and if you would then see levels in the bloodstream [then] that would be of concern."
Wise pointed to research by a prominent gynecologist in North America, Dr Jen Gunter, which looked at the amount of arsenic reportedly found in a cup of organic tea, which was found to be higher than what was found in the tampon study.
"And those are things that you actually ingest, they go straight into your stomach and with the intention to be absorbed into your bloodstream," said Wise.
"So that's why I think this has been really overblown, because we don't know that any of this is actually a concern at all."
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