Insights into baby disposable diapers sustainable application.

The sustainable use of baby disposable diapers is one of the issues currently being discussed to reduce the undesirable impact on the environment and improve the public's understanding of the proper use of diapers. This issue is a step toward promoting a cleaner, greener, and waste-less environment. In this article, the authors discuss options for a viable future for both people and the planet. We believe that it inspire others in the field of sustainable use of diapers as well as future education in this area. In addition, we believe that it will be a motivation for a researchers working in industry to be focused on the production of new, biodegradable baby diapers as well as on recycling baby diapers waste (for example as composite material for a structural and architectural component of the building).

Is it reliable to make a decision based on visual changes in the patient's diaper in the evaluation of post circumcision bleeding?

Background: The most common complication of circumcision is bleeding. Monitoring bleeding by visual assessment of the diaper can cause errors due to the high absorbency of diapers. The patient may have had significant problems before the visible changes. The amount of liquid that wets the cloth does not necessarily lead to a visual change consistent with the amount, and the nature of the liquid contaminating the diaper may cause difficulties in terms of visual evaluation. Making a decision based on the visual changes in the patient's diaper cannot be considered as reliable. Methods: We planned to evaluate the visual changes that are caused by liquids of various volumes and contents that wet the diaper, according to measurable criteria. We aimed to emphasise the importance of the subject in circumcision practices of diapered children. Wetting of diapers with different volumes and variable blood load was performed utilising blood with different haematocrits and fluids. One hundred and sixty different diapers in four groups were moistened utilising the drip method. Visual changes in the soaked diapers were evaluated with the colorimetric method and five different colour criteria. The saturation and lightness values, which indicate the colour value, were obtained by using the numerical equivalents of the three main components, red, green and blue. Analysis was carried out by subjecting statistical evaluation within and between groups. Results: There was a significant difference between the control group and the study group. It was observed that visual changes caused by the moistened cloths with linear increase did not make the same linear interaction. There was not a significant difference between Group II and Group IV, which were soaked with the same amount of blood and different volume of fluid. In Group III, colour saturation changes were found to have a parabolic effect instead of a linear change. In two different analyses of moistened diapers in terms of volume and blood load; it was not determined that the expected linear changes between the groups were not observed. Conclusion: Visual changes in diapers related to volume or blood load effects of fluids may not be compatible with the amount of bleeding. Mistakes may occur when super absorbent wipes are used when determining the amount of bleeding from the use of colour changes in the diaper. Visual changes should not be relied on in bleeding due to circumcision. Rather, vital signs follow-up and measurable laboratory tests should be used as a basis.

Model for projecting the generation of used disposable diapers in the era of depopulation and aging in Japan.

Japan has entered a period of depopulation and aging ahead of any other country. One concern in an aging population is increases in the generation of used disposable diapers. The use of disposable diapers, which are largely composed of plastic, can be an important issue as we work towards building a carbon-free society and break away from using fossil-derived plastics. This study aimed to develop a model to project the future generation of used disposable diapers in each municipality in Japan through 2045 and to identify the effects on municipal solid waste (MSW) management. We revealed the per capita generation of used disposable diapers, distinguishing disposable diaper products, urine and faeces in an online survey of 2000 respondents. The generation of used disposable diapers was estimated to increase in general, but the amount was projected to decrease in rural areas where the population of elderly people would decline. The proportion of used disposable diapers in combustible waste was projected to increase by 2045 in almost all municipalities of Mie Prefecture. Based on the scenario in which disposable diaper products would become lighter in the future because of technical improvements, we concluded that the impact of the decrease in the lower heating value (LHV) of used disposable diapers on the incineration process cannot be ignored in the future.

Health Risk Assessment of Dermal Exposure to Polycyclic Aromatic Hydrocarbons from the Use of Infant Diapers.

In September 2021, the European Chemicals Agency evaluated a dossier for restricting polycyclic aromatic hydrocarbons (PAHs) in infant diapers and concluded that risks were not demonstrated, because of inconclusive exposure data. To fill this gap, we measured the 16 priority PAHs of the U.S. Environmental Protection Agency in the diaper core of four brands and in the sheets and fastening tapes of six brands of commercially available diapers. Health risks were conservatively assessed by assuming that dermally absorbed PAHs can cause both local (skin cancer) and systemic critical effects (neurobehavioral changes). Total concentrations of PAHs in the diaper core and top sheet, the only significant contributors to skin exposure, averaged 26.5 µg/kg and 66.6 µg/kg, respectively. Excess skin cancer risks and hazard quotients for neurobehavioral effects calculated with the daily dose of total PAHs from the combined diaper core and top sheet averaged 1.44 × 10-7 and 1.19 × 10-2, respectively. The median daily doses of total PAHs and of its benzo[a]pyrene-equivalent from breast milk estimated worldwide are 171 and 30 times greater than that from the combined diaper core and top sheet, respectively. Altogether, these findings indicate that trace levels of PAHs found in infant diapers are unlikely to pose health risks.

End-of-life management of single-use baby diapers: Analysis of technical, health and environment aspects.

Single-use baby diapers belongs to an important group of products used in the parenting journey because of their high performance and convenience. Single-use baby diapers are normally thrown away after one-time use, resulting in a waste management problem. The goal of this paper was to better understand main environmental concerns of different types of diapers and address how to reduce them, with a special consideration of waste management strategies and user behaviour practices. Furthermore, health and environmental hazards potentially associated with materials included in diapers, or substances formed from diapers during the waste treatment stage, are also analysed (e.g., phthalates, pesticides, dioxins, pesticides). Three main types of baby diapers have been analysed: single-use baby diapers, reusable baby diapers, and biodegradable single-use diapers. Each type of diaper comes with technical characteristics and environmental concerns and challenges, which are discussed in this paper to support the development of measures for the safe(r) and sustainable design, use and end of life management of baby diapers.

Use of Cotton Balls in Diapers for Collection of Urine Samples Impacts the Analysis of Routine Chemistry Tests: An Evaluation of Cotton Balls, Diapers, and Chemistry Analyzers.

OBJECTIVE: To evaluate the suitability of urine samples collected with cotton balls placed into diapers for routine laboratory chemistry analyses. STUDY DESIGN: Twenty pools of residual unpreserved urine samples were separated into control and treated aliquots. The treated samples were absorbed into 2 different brands of cotton balls, wrapped in 3 different brands of diapers, and incubated at 37°C for 1 hour. The urine-soaked cotton balls were placed into a syringe and expressed via plunger depression. Urine sodium, potassium, creatinine, urea, calcium, magnesium, inorganic phosphorus, albumin, and total protein were measured on all samples on 5 automated clinical chemistry platforms: Ortho Vitros 4600, Siemens Dimension Vista 500, Beckman Coulter AU5822, Roche Cobas 6000, and Abbott Architect c8000 at 5 separate hospital laboratories. Criteria used to exclude the presence of significant effects of urine from presoaked cotton balls in a diaper on the measurement of chemistry laboratory tests were R2 >0.95, slope of 0.9-1.1, and mean bias within ±10%. RESULTS: Albumin and total protein measurements demonstrated significant negative bias in urine from both brands of presoaked cotton balls with all brands of diapers on all 5 chemistry platforms compared with the control urine. We did not observe a significant effect of presoaking urine in cotton balls in a diaper on the measurement of sodium, inorganic phosphorus, and urea. The remaining tests demonstrated significant effects when measured in urine from presoaked cotton balls and/or diapers that were specific to the chemistry analyzer platform or diaper. CONCLUSIONS: Diaper and cotton ball-based urine collection significantly impacts the measurement of several common chemistry assays.

Effect of wearing diapers on toddler's gait.

Gait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant's motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers' gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.

Extraction and measurement of urinary tetranor-PGDM in disposable diapers.

Urinary tetranor-PGDM is a useful diagnostic biomarker for food allergy which often affects infants. We attempted to extract and measure urinary tetranor-PGDM absorbed in polymer of diapers. We applied CaCl2 to the collected polymer, determined the adequate time length of shaking the polymer to release urine, and measured tetranor-PGDM in the extracted urine. This procedure provided high linearity and recovery rate in tetranor-PGDM measurement. We also found that urinary tetranor-PGDM was stable for 24 h at 4°C in diapers. This method can be useful to monitor the food allergic condition of non-toilet trained children.

Does the development and use of modern disposable diapers affect bladder control? A systematic review.

INTRODUCTION AND OBJECTIVE: During the last decades, the development of the modern disposable diaper (DD) has changed the way we diaper our children, as they are safe, easy to use, comfortable and easy to dispose, compared to cloth diapers used earlier. Concurrently, the age of initiating toilet training (TT) is rising. We aimed to investigate the connection between DD usage and the tendencies seen in TT and childhood urinary incontinence, with specific interest on studies evaluating the effect of diapering on enuresis. STUDY DESIGN: A literature search was conducted in PubMed and Embase. A systematic literature search was conducted, revealing 309 studies in Embase and 269 studies in Pubmed. After removing duplicates, 400 studies were eligible for screening. All abstracts were screened, and 12 relevant abstracts where identified, but only eight studies were eligible. No prospective intervention studies specifically evaluating the effect of diaper on enuresis were identified. Literature on TT and diapers in general was identified using the respective search terms on both databases. RESULTS: The eight studies identified showed a tendency towards diaper use being related to a delay on obtaining continence in children, but no secure conclusions can be made, as the literature is inadequate. DISCUSSION AND CONCLUSION: Based on the available literature no secure conclusions can be drawn although an association is suggested. In order to evaluate the effect of diapers on incontinence, prospective randomized studies are needed.

Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status.

BACKGROUND: Infant diaper dermatitis (DD) is a prevalent condition due to multiple, interactive factors including increased skin hydration, irritant exposure, and increased skin pH. We examined diaper dermatitis vs within diaper and non-diaper controls over time and characterized the association of skin color and texture relative to skin barrier integrity, hydration, and pH. MATERIALS AND METHODS: The prospective study included 46 infants with DD at well-child visits. Skin integrity was evaluated over 15 days, including visual skin condition, rate of stratum corneum transepidermal water accumulation, hydration, pH, and skin color and texture from high-resolution digital skin surface images. Effects by site and time were evaluated with general linear models. RESULTS: Six distinct texture patterns were observed. All three sites differed significantly for texture class frequency. Normal dermatoglyphics were more frequent for non-diaper vs both within diaper and rash sites. Dermatoglyphics with marked furrows or lines (class 3) were common within diaper vs rash but not for non-diaper vs within diaper. Streaks were highest for DD and lowest for non-diaper. Flat regions were more frequent DD. Barrier integrity, that is, moisture accumulation rate, was lower for normal dermatoglyphics than streaks or flat texture. DD severity decreased over 15 days. Barrier properties of within diaper and non-diaper areas were not well-differentiated. CONCLUSION: The incidence of streak texture in the within diaper high magnification images was high despite being visually normal. This finding suggests that it is an "early indicator" of skin damage and may be clinically useful for early detection and treatment.

Characterization of the microbiome in the infant diapered area: Insights from healthy and damaged skin.

It has been recognized for nearly a century that human beings are inhabited by a remarkably dense and diverse microbial ecosystem, yet we are only just beginning to understand and appreciate the many roles that these microbes play in human health and development. Establishment of the microbiome begins at birth, but many previous studies on infant skin health have focused on Candida species. Little is known on the full microbial composition across different areas and even less is known on how these communities change during disease/inflammatory states. In this clinical study, infants were recruited during periods of diaper dermatitis (DD) and health to characterize the skin microbiome in these two states. Substantial shifts in the skin microbiome were observed across four sites in the diapered area (genitals, intertriginous, buttocks and perianal), as well as during periods of DD. As DD scores increased, there was a shift in relative abundance that demonstrated higher community percentages of faecal coliforms, such as Enterococcus, and lower percentages of Staphylococcus strains. In high-rash samples, the predominant Staphylococcus species is S aureus, potentially implicating S aureus as a DD aetiological agent. This study provides new information related to the microbiome on infant skin in the diapered area and provides insights into the role of the microbiome in the development of DD.

Diaper Need Is Associated with Pediatric Care Use: An Analysis of a Nationally Representative Sample of Parents of Young Children.

OBJECTIVE: To examine the possible association between diaper need, difficulty affording an adequate amount of diapers, and pediatric care visits for urinary tract infections and diaper dermatitis. STUDY DESIGN: This cross-sectional analysis using nationally representative survey data collected July-August 2017 using a web-based panel examined 981 parents of children between 0 and 3 years of age in the US (response rate, 94%). Survey weighting for differential probabilities of selection and nonresponse was used to estimate the prevalence of diaper need and to perform multivariable logistic regression of the association between parent reported diaper need and visits to the pediatrician for diaper rash or urinary tract infections within the past 12 months. RESULTS: An estimated 36% of parents endorsed diaper need. Both diaper need (aOR 2.37; 95% CI 1.69-3.31) and visiting organizations to receive diapers (aOR 2.14; 95% CI 1.43-3.21) were associated with diaper dermatitis visits. Similar associations were found for diaper need (aOR 2.63; 95% CI 1.54-4.49) and visiting organizations to receive diapers (aOR 4.50; 95% CI 2.63-7.70) for urinary tract infection visits. CONCLUSIONS: Diaper need is common and associated with increased pediatric care visits. These findings suggest pediatric provider and policy interventions decreasing diaper need could improve child health and reduce associated healthcare use.

A novel screening method for pediatric urinary tract infection using ordinary diapers.

Urinary tract infection (UTI) is one of the most common bacterial infections in children. The symptoms of UTI in young children are nonspecific, therefore urine should be examined whenever UTI cannot be ruled out. In clinical settings, however, collecting urine from children who are not toilet trained is sometimes difficult, presenting a challenge in UTI management. Here, we developed a "diaper UTI test", which enables the quick detection of pyuria in ordinary diapers, and investigated its sensitivity and specificity in a clinical study. The diaper UTI test is based on a leukocyte esterase reaction. Reagent was prepared in liquid form so that it can be absorbed by disposable diapers, where it will produce a violet color in the presence of pyuria. For the clinical study, we enrolled children younger than 3 years with potential UTI who underwent bladder catheterization for urine culture and urinalysis. Of the 65 children included, 21 were diagnosed with UTI. The sensitivity and specificity of the diaper UTI test were 90.5% (95% CI 69.6-98.8) and 93.2% (95% CI 81.3-98.6), respectively. Because of its convenience and good sensitivity, the diaper UTI test may be useful in the screening of pediatric UTI.

Disposable diaper overuse is associated with primary enuresis in children.

This research investigated the association between prolonged disposable diaper (DD) wearing in infancy and primary enuresis (PNE). As a case-control study, we collected data from 376 children with enuresis and 379 healthy children who were sex- and age-matched at three tertiary care institutions in mainland China from August 2017 to July 2018. The results of adjusted logistic regression showed the odds ratios (95% confidence intervals) for PNE across the categories of age of daytime DD use cessation were as follows: ≥ 25 months: 1.00, 18-24 months: 0.25 (0.17-0.37), and ≤ 17 months: 0.11 (0.06-0.20), independent of age, mother education, residence, toilet training approach, breastfeeding duration, UTI, constipation, anaphylactic disease and family history. After a similar multivariable adjustment, increased age of daytime DD use (per-month) had a positive correlation with PNE, OR = 1.17, 95% CI 1.13-1.20 and non-linear relationship was detected, whose point was 21 months (the effect sizes and the 95%CI on the left and right sides of inflection point were 1.04 (0.99-1.10), P = 0.131 and 1.25 (1.18-1.31), P < 0.001). Subgroup analysis found that the effect of duration of disposable diaper exposure for each additional month, those children had accepted assisted infant toilet training/elimination communication (AITT/EC) practice had a lower risk of PNE (OR = 1.08, 95% CI 1.04-1.12), compared with those without AITT/EC practice (OR = 1.20, 95% CI 1.14-1.27), P for interaction < 0.001. In conclusion, the children diagnosed with primary enuresis after age 5 stopped using disposable diapers at daytime later than the control group. Association between duration of DD exposure and the risk of childhood enuresis is modified by AITT/EC practice. Timely cessation use of disposable diaper and practice AITT/EC may shorten the time to nocturnal continence, and the prospective cohort studies are needed to verify the discoveries.

An Exploratory Study of Adult Baby-Diaper Lovers' Characteristics in an Italian Online Sample.

BACKGROUND: Knowledge of the Adult Baby-Diaper Lovers (ABDL) phenomena is quite recent and there are, of yet, few studies on this phenomenon. AIM: This study was conceived to investigate the functions of ABDL behaviours and the characteristics of ABDL in an online Italian community sample. We hypothesized that ABDL phenomena were associated with general psychological maladjustment and with an experience of parental rejection during childhood. It was also assumed that there would be differences in ABDL profiles based on the age of appearance of their first Adult Baby-Diaper Lover (ABDL) fantasies. METHOD: An internet-based study was conducted and it involved 38 adults aged between 18 and 74 years (M = 34.95; SD = 12.25). Participants were first given an ad hoc questionnaire, which was devised to obtain information about the anamnestic variables related to ABDL. Then, the participants filled out the Cognitive Behaviour Assessment 2.0 battery to obtain anamnestic information regarding their psychological, medical, and personal history and to evaluate primary psychological dimensions in clinical practice. Finally, they filled out the Adult Parental Acceptance-Rejection Questionnaire, to evaluate their recollections of parental perceived rejection, and the Personality Assessment Questionnaire, to evaluate the primary psychological aspects related to parental rejection. RESULTS: The data indicated that adults with ABDL showed the presence of anxious traits and recollections of parental rejection during childhood. Moreover, associations were observed between current or previous ABDL phenomena enuresis and negative mood states. CONCLUSION: Specific kinds of parental modes, anxiety traits, and enuresis seem to be the source of ABDL interests. Moreover, ADBL behaviours seem to assume different functions and meanings.

The Reliability of Iodine Concentration in Diaper-Retrieved Infant Urine Using Urine Collection Pads, and in Their Mothers' Breastmilk.

Mild to moderate iodine deficiency is common among women of childbearing age. Data on iodine status in infants are sparse, partly due to the challenges in collecting urine. Urinary iodine concentration (UIC) is considered a good marker for recent dietary iodine intake and status in populations. The aim of this study was to investigate the reliability of iodine concentration measured in two spot-samples from the same day of diaper-retrieved infant urine and in their mothers' breastmilk. We collected urine and breastmilk from a sample of 27 infants and 25 mothers participating in a cross-sectional study at two public healthcare clinics in Norway. The reliability of iodine concentration was assessed by calculating the intraclass correlation coefficients (ICC) and the coefficient of variation (CV). The ICC for infants' urine was 0.64 (95% confidence interval (CI) 0.36-0.82), while the ICC for breastmilk was 0.83 (95% CI 0.65-0.92) Similarly, the intraindividual CV for UIC was 0.25 and 0.14 for breastmilk iodine concentration (BIC). Compared to standard methods of collecting urine for measuring iodine concentration, the diaper-pad collection method does not substantially affect the reliability of the measurements.

Diaper Need Met Among Low-Income US Children Younger Than 4 Years in 2016.

Objectives. To document the collective effort of diaper banks in the United States and to estimate the percentage of low-income children whose diaper need is met through these efforts.Methods. For each state, we compared the number of children younger than 4 years in families living at or below 200% of the federal poverty level with the number of children served by diaper banks in each state. We collected data reporting all 2016 activities from diaper banks (n = 262) via survey from January to March 2017.Results. In each state, the percentage of children experiencing diaper need that received assistance from a diaper bank ranged from 0% to 16% per month.Conclusions. The findings from this study highlight that a small proportion of low-income families accessed diapers through the existing community-based safety net provided by a national network of nonprofit diaper banks.Public Health Implications. Policies at the federal, state, and municipal level are needed to alleviate this consequence of poverty for children and their families.

Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior.

OBJECTIVES: To compare prevalence and severity of diaper dermatitis (DD) in infants and toddlers (babies) across three countries (China, USA, and Germany), including diapered skin measures and caregiver practices. METHODS: A cross-sectional study of 1791 babies (~600 from each country) was recruited at each clinical site. Based on regional toilet-training habits, exclusively diaper-wearing infants were recruited between ages 2-8 months in China and 2-18 months in the USA and Germany. DD was measured, as well as skin pH, transepidermal water loss (TEWL), and relative humidity (RH) in the diapered region. Caregiver habits were collected via a questionnaire and included information on hygienic practices. RESULTS: Diaper dermatitis was highest in the perianal area, followed by the intertriginous, genital, and buttock regions. In general, DD was significantly lower in babies in China, highest in Germany, and intermediate in the USA. This rank ordering of DD by geography was also observed in baby age 2-8 months. The lower DD observed in China was associated with lower skin pH and TEWL on diapered skin and decreased RH in the diaper. Chinese caregivers had the highest rate of prophylactic topical product usage, the most robust cleaning of the diapered area, lack of cleansing after urine-only diaper changes, and Chinese infants spent the least time in an overnight diaper. CONCLUSIONS: These data suggest caregiver behaviors including prophylactic use of topical products, thorough cleaning after stooling and reduced time in an overnight diaper are associated with less DD, lower superficial skin pH, and enhanced skin barrier.

The shape of disposable diaper affects spontaneous movements of lower limbs in young infants.

This study examined the characteristics of young infants' lower limb spontaneous movements based on differences in shape of diapers. Twenty-seven healthy infants (103 ± 16.3 days old) were enrolled in this study. We measured the spontaneous movements of their lower limbs in four conditions (Naked, wearing Normal type diapers, wearing Type A diapers, and wearing Type B diapers). The Normal diaper has a wider waist belt than the Type A diaper, and the Type B diaper has a narrower crotch area than the Type A diaper. We observed them in seven indices (the velocity of lower limb movements, the trajectory area of knee movement in the sagittal plane and the frontal plane, the distance between both knees and between side of abdomen and knee, and correlation of velocities between side of abdomen and knee and between left and right ankles). The results showed that the velocity of the lower limb movements in the Naked condition was higher than when wearing Normal diapers. The value for the trajectory area of knee movement in sagittal plane, which reflects the range of lower leg lifting movements and closeness of such movements to the trunk, for the Type B diaper condition was higher than that for the Normal diaper condition. This result indicates that the shape of the diaper affects the spontaneous movements of the lower limbs of young infants.