Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
Eunice Kennedy Shriver National Institute of Child Health and Human Development, Epidemiology Branch, Bethesda, MD, USA.
Environ Health. 2019 Feb 11;18(1):11. doi: 10.1186/s12940-019-0452-z.
Tampons are used by up to 86% of US women and are a rarely considered potential source of pesticide and metal exposure. Tampons may be of particular concern given the likely higher absorption that occurs in the vagina. Our objective was to examine the potential associations between tampon use and metal concentrations, and biomarkers of inflammation and oxidative stress among healthy women.
We used information from a prospective cohort of 259 regularly menstruating women, aged 18-44, followed for two menstrual cycles. Tampon use was assessed using information provided in participant study diaries. Metal concentrations were measured from a blood sample collected at enrollment. Oxidative stress and inflammation biomarker concentrations were determined from blood samples collected at up to 8 clinic visits for each cycle. Linear regression models were used to estimate associations of tampon use with metal exposure, and linear mixed models to estimate associations of tampon use with inflammation and oxidative stress biomarkers at different times during the menstrual cycle.
We observed non-significantly higher mean levels of mercury for tampon users compared to non-tampon users (exp(β) = 1.25, 95% CI = 0.93, 1.68). We found no evidence of an association between tampon use and inflammation biomarkers. We observed consistently higher isoprostane levels, an oxidative stress biomarker, among tampon users compared to non-tampon users (e.g. exp.(β) = 1.05, 95%CI = 0.96, 1.16, for the average isoprostane during the menstruating week); however, these results were not statistically significant.
While our results are not statistically significant, we observed suggestive associations between tampon use and elevated levels of mercury and oxidative stress biomarkers. Although our finding should be interpreted in light of our limitations, they indicate that tampons may be a source of exposure to metals and chemicals that have been largely ignored, and any related health effects are an important public health concern.
卫生棉条的使用率高达 86%，是美国女性中使用较少但可能导致农药和金属暴露的产品。由于在阴道中更易被吸收，卫生棉条可能会引起特别关注。我们的目标是研究卫生棉条的使用与金属浓度之间的潜在关联，以及健康女性中炎症和氧化应激的生物标志物。
我们使用了一个前瞻性队列的 259 名 18-44 岁定期来月经的女性的数据，对她们进行了两个月经周期的随访。使用参与者研究日记中提供的信息来评估卫生棉条的使用情况。在入组时采集血液样本，测量金属浓度。在每个周期的多达 8 次就诊时，采集血液样本，以确定氧化应激和炎症生物标志物的浓度。线性回归模型用于估计卫生棉条使用与金属暴露之间的关联，线性混合模型用于估计卫生棉条使用与月经周期不同时间点的炎症和氧化应激生物标志物之间的关联。
与非卫生棉条使用者相比，卫生棉条使用者的汞平均水平略高（exp(β)=1.25，95%CI=0.93，1.68），但没有统计学意义。我们没有发现卫生棉条使用与炎症生物标志物之间存在关联。与非卫生棉条使用者相比，卫生棉条使用者的异前列腺素水平（一种氧化应激生物标志物）始终较高（例如，在月经期内，平均异前列腺素的 exp.(β)=1.05，95%CI=0.96，1.16）；然而，这些结果没有统计学意义。
虽然我们的结果没有统计学意义，但我们观察到卫生棉条使用与汞和氧化应激生物标志物水平升高之间存在提示性关联。尽管我们的发现应考虑到我们的局限性，但它们表明卫生棉条可能是金属和化学物质暴露的来源，而这些来源在很大程度上被忽视了，任何相关的健康影响都是一个重要的公共卫生问题。
