Composting is the process of complete degradation due to biological processes which yields carbon dioxide, water and other inorganic compounds in a defined period of time, without visible, distinguishable or toxic residue (Menstrual Waste Management, n.d.). It is really only appropriate for sanitary napkins without SAP, adhesive wings and other perforated plastic layers as the disposable plastic sanitary napkin is non-biodegradable and thus not compostable. When considering the discourse on compostable sanitary napkins, we need to keep in mind that composting at home is not feasible for most Indian women due to various reasons – discomfort surrounding the idea of manual composting, space constraints in urban areas, social myths and taboos in rural areas, the number of blood soaked sanitary napkins produced in households of more than one menstruating women and the harsh odours it might release. On a parallel note, deep burials pits following the guidelines for deep burials of biomedical waste are also recommended.
According to the Ministry of Drinking Water and Sanitation (MDWS) 2016 report, there are 336 million menstruating women in India, out of which 64 percent use Sanitary Pads, that is, 121 million menstruating women. Assuming that they make use of 8 pads per cycle, the menstrual waste load in India amounts to a whopping 12 billion sanitary pads in a year (Menstrual Waste Management, n.d.). The discourse on Menstrual Hygiene Management (MHM) has gained ground in the last decade due to its collision with the UN laid Sustainable Development Goals (SDGs). A single disposable plastic sanitary napkin takes roughly 500-800 years to decompose. Disposed sanitary products are dumped in landfills and rivers, or incinerated. Incineration brings its own set of problems as incineration technology infrastructure in India is lacking in many respects. Moreover, burning sanitary napkins releases environmental toxins like dioxins and furans which may lead to the impairment of immune, nervous, endocrine, and reproductive systems (“Climate change and health”, 2018). Sustainable steps to contain the environmental toll these products are taking on our ecology involve bio-medical decentralized incineration, recycling, and composting. But these waste management solutions are not without its inevitable concerns either.
With 121 million women using these sanitary pads, it becomes imperative to look into the conditions with which these products are developed so as to reassure ourselves that the environmental cost we bear down on this Earth with our actions is worth the risk. Unfortunately, it is not. Extensive research has been conducted into the raw materials that go into the making of a sanitary napkin and other adjacent products by countries across the world. The results of various studies lead us to the conclusion that these female hygiene products may use residual pesticides, toxic chemicals, and carcinogens. These contaminants and irritants are easily absorbed into the circulatory system of women due to the high permeability of vulvar skin and vaginal mucosa and are thus harmful to women’s endocrine and reproductive systems (Gao & Kannan, 2020). In light of this information, it becomes essential to review those menstrual products in the Indian market that claim to be safe, hygienic, and biodegradable as opposed to the disposable sanitary napkins.
Impact on Women’s Health
While sanitary napkins have existed in the Indian markets since the 1930s, disposable plastic sanitary napkins with adhesives which we use today took hold among the masses in the late 1980s and early 1990s. Some research has been conducted in India in recent years by scientists and NGOs working in the menstrual products and their sustainable alternatives sector to understand the ingredients that go into the making of the disposable sanitary napkin yet the research is quite limited and lacking in many aspects while the scope is quite expansive. Since the standards to certify the quality have not been updated since 1980 by the Bureau of Indian Standards (these standards are now under revision), we cannot rely on the validity of these products based on faith alone. So we look towards research conducted in other countries as the conglomerates and multinational corporations with monopoly over these menstrual products are the same across nations. It is common knowledge in the healthcare world that the vulvar tissue is more permeable than exposed skin and therefore the safety assessment of menstrual hygiene products should keep in mind the heightened level of permeability of the vulvar skin and vaginal mucosa (Farage & Maibach, 2004). Women and adolescent girls belonging to low-income groups often wear disposable sanitary napkins for more than the recommended 4-6 hours due to socio-economic constraints which puts them at risk for medical complications such as reproductive tract infections (RTIs), cervical cancer, and interference with embryonicdevelopment. Thus, the risk assessment for sanitary napkins is necessary as women wear these pads for 3-8 days on average every month for the entire period of their reproductive years.
Sanitary Napkins have undergone immense technological advancement moving from cloth rags to papyrus to sanitary aprons to menstrual belts to the sanitary napkins with adhesive we know today. The disposable sanitary napkins attributes that we have come to value such as fragrances, high absorbent core, “cotton-y soft” feel, and enhanced longevity result from super absorbent polymers (SAPs), phthalates, polycyclic aromatic hydrocarbon (PAHs). Phthalates (also used to add fragrances to sanitary napkins) are a group of chemicals used as a plasticizer found in high concentrations in sanitary napkins which have been known to cause precocious puberty, endometriosis, female genital tumors, and ovulation disorders (Gao & Kannan, 2020). SAPs are added in the core absorbent layer to increase the absorption capacity of the napkin and have been linked to toxic shock syndrome (TSS), a rare but life-threatening condition.
Testing conducted by Women’s Voices for the Earth in August 2014 of Always menstrual pads, manufactured by Procter and Gamble, sold under the name of Whisper in the Indian subcontinent indicates that both scented and unscented Always pads emit toxic chemicals (“Always Pads Testing Results – Women’s Voices for the Earth”, 2020). Our concern increases with the knowledge that several of these chemicals which have been identified as carcinogens, and reproductive and developmental toxins are not disclosed on the product by the manufacturer. These include – Styrene (carcinogen), Chloromethane (reproductive toxicant), Chloroethane (carcinogen), Chloroform (carcinogen, reproductive toxicant, neurotoxin), and Acetone (irritant). Furan is “reasonably anticipated to be a human carcinogen” by the National Institutes of Health (NIH) and various other institutions (National Toxicology Program, Department of Health and Human Services, 2016).
To give our sanitary pads the pristine white look, they have to undergo chlorine bleaching of paper, cotton, and wood pulp, an unwanted by-product of which is dioxins and furans that are generally released into the environment because of incomplete burning in waste incinerators. Dioxin is a carcinogen and its exposure has a range of toxic effects – chloracne; reproductive, developmental and neurodevelopmental effects; immunotoxicity; and effects on thyroid hormones, liver and tooth development (“Dioxins and dioxin-like substances”, n.d.). Furans are present in pesticides that are sprayed on inorganically-grown cotton plantations. Other plasticizing chemicals like BPA and BPS disrupt embryonic development and are linked to heart disease and cancer (Mercola, 2013).
Till today in rural India, the social myths and taboos around menstruation lead to unawareness regarding menstrual management and unhygienic menstrual and sanitation practices (Chanana, 2016). The outcome of using waste synthetic cloth that does not have the absorbency, retention and airflow of cotton cloth is microbial growth and risk of RTIs. Usage and maintenance also plays a big role in the conduction of WASH practices even if the cloth is cotton. Social taboos prevent women and young girls from access to water for sterilization in open spaces and drying and washing the blood-soaked cloth under sunlight (Mahajan, 2019). Thus, the need for state intervention in rural areas to create awareness and implement Menstrual Hygiene Management (MHM) programmes is high.
Impact on the Environment
The Earth is a unique planet and it has sustained human life for about 200,000 years but for the Earth to sustain human life for another 200,000 years, we need to start taking care of this planet. With respect to the matter at hand here, sanitary napkins are a necessary public health right for every woman as part of the international clause put down in Sustainable Goal 6 – WASH (Water, sanitation, and hygiene) – with the aim being to “Ensure availability and sustainable management of water and sanitation for all.” However, improper and inadequate practices of MHM have led to choking the environment. A national estimate puts the amount of menstrual waste created per annum at 113,000 tonnes (Rathi, 2019). The Solid Waste Management (SWM) Rules 2016 clearly dictate that the responsibility of sanitary waste lies with the manufacturers but conglomerates and MNCs like P&G, Johnson and Johnson et al rarely heed to these rules or take any responsibility that goes beyond the perfunctory disclaimer on packages (“Solid Waste Management Rules”, 2016).
The lifecycle of the production of any consumer good negatively impacts the environment at one point or the other in the whole process be it with the pumping out of carbon dioxide by the vehicle transporting the goods to the market or the improper and harmful disposal practices performed by us. Nonetheless, there are ways to minimize our carbon footprint and reducing the global warming potential at almost every stage by making conscious sustainable choices. Waste management for menstrual hygiene products is the most crucial and gamechanging stage for reducing land use and waste as improper waste management is the source of clogged drains, toilets, rivers, sewage backflow, soil pollution and, the creation of mountains of non-biodegradable landfills.
Proper handling of sanitary napkin after disposal is imperative. The plastic layers, adhesive wings, SAPs used to make commercial sanitary napkins are non-biodegradable and take up to 800 years to decompose. If menstrual waste is not segregated, handled separately, and properly wrapped at the household level, the waste collectors have to manually separate these at a later stage making them susceptible to infections and diseases like HIV and Hepatitis. The hazardous and toxic chemicals from the sanitary pads seeps into the soil which leads to emission noxious odours, groundwater pollution and loss of fertility. The waste created is a biomedical hazard for human health, especially for manual scavengers picking out the waste in landfills and cleaning the sewers. The blood in the pads may accumulate pathogens which can infect the soil as well as the water supplies through improperly insulated pipelines in cities and villages.
“According to the Central Pollution Control Board’s guideline on Management of Sanitary Waste, 2018, deep burial, composting, pit burning and incineration (low-cost, smallscale, electric and high temperature biomedical incinerators) are some of the methods that should be adopted to dispose such waste.” (“Is green menstruation possible?”, 2019) According to the data collected by the department of Drinking Water and Sanitation, out of the 12 billion pads being disposed annually, 28% are disposed along with routine waste, 28% are disposed in the open, 33% are buried, and 28% are burnt in the open (Menstrual Waste Management, n.d.).
The Indian government has been promoting the use of mini incinerators in schools, women’s sanitary complexes, primary health centres and any other suitable place in the village to burn sanitary pads (“Breaking the silence on the incineration of menstrual waste – EcoFemme”, n.d.). WHO recommends combustion of health-related waste at high temperatures (above 800℃) to convert waste into relatively harmless gases and incombustible solid waste like ash which are then disposed in designated ash pits or controlled landfills. The major concern around incineration lies in the fact that when incineration occurs in unsafe conditions – such as poorly constructed structures, low burning temperatures, insufficient waste volume, poor emission control, and inappropriate waste or improperly segregated waste – carcinogenic gases like dioxins, furans, and biphenyls are released into the atmosphere (Menstrual Waste Management, n.d.). Thus, there are too many factors to consider when incinerating and the odds of release of toxic chemicals into the atmosphere too high. Constructing incinerators away from inhabited areas would not be a possible solution to minimize the negative impact created as these toxins can travel far from the initial point of emission. Hence, incineration is only appropriate for sanitary napkins without SAPs and bleaching agents.
India needs to focus on developing a circular economy since reusable cloth pads and menstrual cups are not a permanent solution. A circular economy is an economic system aimed at eliminating waste and the continual use of resources. Large scale recycling of all kinds of menstrual products is the best way to handle menstrual waste management. Fater Group in Italy has evolved a technological process of recycling, developed from Fater patents, in which diapers and hygienic pads are separated into their basic components – including plastic, cellulose and SAP – and generated into plastic granules and high quality and completely sterilized organiccellulose material, using steam for eliminating all potential pathogens and odors (Fater Group, n.d.). Thermal Pressure Hydrolysis is another similar recycling method developed by Elsinga Beleidsplanning en Innovatie in the Netherlands to recycle diapers and other incontinence products that may be applicable to menstrual products as well with technological evolution (Odegard, Lindgreen & Broeren, 2018). Similar research and recycling initiatives are being developed around the world. For any initiative like this to work, segregation and collection of waste is the primary and most crucial stage that needs to be implemented across the nation.
The other optimal option is to declare menstrual waste as biomedical waste. This also requires separation as waste collection stage leading to incineration in biomedical incinerators. Biomedical incineration devices are complex and designed to safely dispose of menstrual waste. The waste is first put into primary chamber that reaches temperatures of +850°C and then the gases are processed through a secondary chamber that retains the gases for over 2 seconds. It is
then passed through a number of pollution control systems. This process ensures that no harmful gases are being ejected at the end of the process into the environment (Billingsley, 2019).