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PubMed1987

A comparison of the amount of dust produced by disposable and cloth diapers in incubators.

Disposable diapers are now being used in incubators, raising questions concerning the amount of dust they produce during diaper change, and the subsequent effects on premature infants. This study compares the amount of dust produced during change of disposable diapers and during change of cloth diapers. The disposable diapers tested were Pampers (premature baby size, sterilized), manufactured by the Procter & Gamble Company. Cloth diapers tested included diaper covers. Results of the study indicated that disposable diapers produce far less dust than cloth diapers. Thus, disposable diapers can be satisfactorily used in incubators for premature infants. The difference in results between the two types of diapers might stem from their different structures: cloth diapers have a monolayer structure, whereas disposable diapers have a double cover over the refined pulp they contain, which might otherwise tend to generate dust.

Clothing↗

PubMed1993

Comparison of stool containment in cloth and single-use diapers using a simulated infant feces.

Single-use diapers and cloth diapers with vinyl pants were compared for their relative abilities to contain stool within the diaper. Artificial feces with carbon black as an additive allowed a quantitative measure of fecal containment by image analysis in 60 infants. This method showed complete containment of feces in the diaper in 50% of the single-use diapers whereas only 10% of the cloth diapers showed complete containment. In infants where the border of the vinyl pants was used as the boundary of containment with the cloth diapers, complete containment occurred only 33% of the time. Fluorescein dye ratings for containment/leakage in 69 infants showed that 83% of single-use diapers and 30% of the cloth diapers were rated as having no or minor leakage of feces. Cultures were taken of laundered vinyl pants that had previously been used over cloth diapers to determine microbial contamination. Thirty-nine percent of the pants contained Gram-negative, lactose-fermenting bacilli indicating fecal contamination. This study comparing single-use and cloth diapers for containment of artificial feces by use of image analysis and fluorescein dye ratings showed better containment by single-use diapers. The study also raises the question of possible spread of feces-borne pathogens by the vinyl pants used over cloth diapers, particularly in a day-care center.

Bacteria↗

PubMed1987

Clinical studies with disposable diapers containing absorbent gelling materials: evaluation of effects on infant skin condition.

Disposable infant diapers with absorbent gelling material (cross-linked sodium polyacrylates) incorporated into the core were clinically evaluated for their effect on infant skin condition. Absorbent gelling materials tightly hold water and provide pH control by a buffering capacity as well as by helping to segregate urine apart from feces. Four clinical studies were conducted with each following a rigid protocol that controlled for variables of diet and age in addition to the diaper material that may influence the development of diaper dermatitis and helped to control for any inherent bias in the study. This allowed for the controlled assessment of skin condition with respect to diaper type. Absorbent gelling material-containing disposable, conventional (100% cellulose core) disposable, and home-laundered cloth diapers were test products. In these studies 1614 infants were initially enrolled with 522 of them assigned to absorbent gelling material disposable, 738 to conventional disposable, and 354 to home-laundered cloth diapers. Objective measurements of skin wetness (transepidermal water loss) and skin pH, as well as double-blind grading of diaper dermatitis, were the measures of skin condition. Absorbent gelling material disposable diapers were associated with significantly reduced skin wetness, closer to normal skin pH, and lower degrees of diaper dermatitis when compared to conventional disposable or home-laundered cloth diapers. The results are consistent with the hypothesis that better control in the diaper area of skin wetness, skin pH, and the prevention of the mixing of urine and feces produces a better diaper environment.

Acrylic Resins↗

PubMed1987

Clinical and microbial effects of cloth, cellulose core, and cellulose core/absorbent gel diapers in atopic dermatitis.

Atopic dermatitis (AD) is an inherited cutaneous inflammatory condition which may affect 10% of infants. Persons with this diathesis are more susceptible to irritants and to superficial infections. Little is known about diaper rash and diapering materials in AD. In this study we set firm criteria to identify a large group of infants with AD for comparison with a nonatopic, normal control group in terms of severity of diaper dermatitis; relationship of diaper dermatitis to diaper materials; and influence of modifying factors (bacterial and candidal colonization/infection, diarrhea, antibiotics, other illnesses, food allergy or intolerance). Babies with eczema were recruited and, from a group of 2,443 respondents, 87 satisfied carefully defined criteria for atopic dermatitis. A similarly sized (90) control group matched for age, sex, and weight was selected for absence of features of atopy or familial atopic history. Infants were assigned into balanced subgroups wearing cloth diapers, conventional cellulose diapers, or diapers containing cellulose and absorbent gelling material (AGM). Assessment of grading for atopic parameters showed statistically significant differences between the AD and normal groups at every visit. Mean diaper rash grades, as assessed by the same physicians at each visit, were significantly higher in the AD group wearing cloth diapers compared with those in AGM subgroups at five of eight visits. There was significant correlation between AD severity and diaper rash scores overall and in the AD cloth group, but not in other subgroups. Quantitative total bacterial plate counts were significantly lower in AGM than cloth diaper areas on three of eight sampling periods in the AD group.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellulose↗

PubMed2004

Diapers and skin care: merits and demerits.

Diapers have been used for care of babies since decades to prevent soiling and for social convenience. However, the use of diaper poses a risk of developing diaper dermatitis. Recent innovations in diaper technology have led to development of superabsobent disposable diapers, emollient delivering diapers and breathable diapers. These newer types of diapers reduce the incidence of diaper dermatitis. The non-biodegradable material used in superabsorbent diapers is, however, a matter of serious concern because of its toxic effects and environmental pollution. The different type of diapers, recent advances in them and their environmental concerns are discussed in this article.

Diapers, Infant↗

PubMed2000

Continuous topical administration of a petrolatum formulation by a novel disposable diaper. 2. Effect on skin condition.

BACKGROUND: Diaper dermatitis is a common childhood affliction. Aiming to help reduce the prevalence of this problem, we have developed a novel diaper to deliver to the skin dermatological formulations intended to help protect the skin from overhydration and irritation. OBJECTIVE: To determine the clinical benefits of a novel disposable diaper designed to deliver a petrolatum-based formulation continuously to the skin during use. METHODS: Two independent, blinded, randomized clinical trials were conducted, involving an aggregate total of 391 children, 8-24 months of age. All comparisons were done versus a control diaper, identical to the test product except for the absence of the petrolatum formulation. The studies determined the effects of the novel diaper on skin erythema and diaper rash. RESULTS: Use of the formulation-treated diaper was associated with significant reductions in severity of erythema and diaper rash compared to the control product. CONCLUSIONS: The results demonstrated the clinical benefits associated with continuous topical administration of a petrolatum-based formulation by this novel diaper. We anticipate that this advance in diaper design will contribute significantly to further reduce the prevalence and severity of irritant contact dermatitis in the diaper area.

Administration, Topical↗

PubMed1987

Clinical correlates with diaper dermatitis.

Three types of clinical studies were carried out to better understand diaper dermatitis in a general infant population. In 'snapshot' clinical studies, skin condition under the diaper was evaluated at a given point in time across a large base of infants. Correlations were sought between diaper dermatitis incidence and severity and a number of factors, including sex, diet, maturity, type of diaper, history of allergy, contact with fecal matter, presence of Candida albicans, and diaper change frequency. Severe diaper rash correlated strongly with the presence of C. albicans, and the frequency of rash correlated with duration of contact with feces and inversely with diaper change frequency. Diaper rash peaked at ages 9-12 months and was lower for breast-fed than for formula-fed infants. Exclusive use of disposable diapers correlated with lower rash levels than when some or all cloth diapers were used. In a longitudinal study, infants were observed daily for 50 days in order to determine the frequency and duration of rash episodes. In this study, the tendency for some infants to be rash-prone was clearly indicated. In a third type of study, over 10,000 infant visits to physicians' offices were used to record skin condition. Results showed a three-to fourfold increase in diaper rash if the child had diarrhea during the previous 48 h.

Candida albicans↗

PubMed2000

Continuous topical administration of a petrolatum formulation by a novel disposable diaper. 1. Effect on skin surface microtopography.

BACKGROUND: Cutaneous problems are commonly associated with the use of diapers. Aiming to help reduce them, we have explored the use of the inner layer of diapers as a means to deliver to the skin dermatological formulations intended to help protect it from overhydration and irritation. OBJECTIVE: To determine the feasibility of using the inner layer of the diaper as a vehicle for topical delivery of a petrolatum-based formulation and to determine its impact on skin surface microtopography. METHODS: Two independent, blinded, randomized clinical trials were conducted, on children 16-24 months of age. All comparisons were done versus a control diaper, identical to the test product except for the absence of the petrolatum formulation. The studies determined the effects of the novel diaper on transfer of formulation to the skin and skin surface microtopography. RESULTS: During normal diaper use, formulation transfer from the diaper to the skin occurred in a cumulative, time-dependent manner and use of the formulation-treated diaper was associated with significant reductions in skin surface roughness compared to the control diaper. CONCLUSIONS: The results demonstrated the feasibility and skin surface benefits associated with continuous topical administration of a petrolatum-based formulation by this novel diaper. This unprecedented dosimetric approach offers new avenues to reduce further the dermatological problems commonly associated with diaper use.

Administration, Topical↗

PubMed1994

[Composting facilities. 1. Microbiological quality of compost with special regard to disposable diapers].

At three different composting facilities, co-composting of used panty diapers with an addition of 10% (weight) to the usual plant input was investigated for various hygienic and microbiological parameters. In nearly any case, a sufficient degree of germ reduction above 99.9% could be observed by determination of reduction rates of B. subtilis spores. The concentrations of "total microorganisms" ranged from 3.9 x 10(5) to 3.3 x 10(11) colony forming units per gram compost (CFU/g) in composts without and from 3.3 x 10(5) to 4.7 x 10(9) CFU/g in composts with panty diapers in the input. The concentrations of "gram-negative bacteria" ranged from 3.3 x 10(4) to 1.3 x 10(9) CFU/g (without panty diapers) resp. from 3.3 x 10(5) to 3.5 x 10(8) CFU/g (with panty diapers), the concentrations of "fecal streptococci" from 1.7 x 10(3) to 7.7 x 10(7) CFU/g (without panty diapers) resp. from 1.4 x 10(4) to 1.4 x 10(8) CFU/g (with panty diapers). Facultatively pathogenic microorganisms showed a broad variety, but no common trend in composts with and without panty diapers in the input. Statistical validity of the determination of contents of microorganisms in compost samples was guaranteed by the collection and analysis of 20 parallel samples with an average sample mass of 10 to 15 kg. From the analyzed quantitative and qualitative hygienic-microbiological parameters, it can be concluded that no negative hygienic-microbiological effects, caused by the addition of 10% (weight) of used panty diapers in the input, have to be expected. Under the aspects of epidemiologic hygiene, composting of used panty diapers together with usual input materials seems to cause no increased risks under the tested conditions. Under the aspect of consumer protection, there is no increase in the risk of infection when using compost produced with addition of panty diapers, compared to compost produced without panty diaper addition to the input.

Bacillus subtilis↗

PubMed1987

History of diapering in Japan.

A review of the history of diaper use in various countries reveals a number of difficulties that have been confronted. These difficulties seem to be associated with both climatic and traditional factors in each country. In Japan, for example, because of the hot and humid summers, there was a need to make diapers both leak- and 'stuffiness'-proof. At first the use of natural fiber diaper covers met this need, but the recent development of disposable diapers seems to even better solve these problems. Yet disposable diapers still make up only 25% of the diaper market in Japan. This is because the Japanese view of baby care and the country's economy have worked against acceptance of disposable diapers, despite their merits. The slower trend toward disposable diaper use in Japan is in contrast to their rapid acceptance in Western Europe and the United States. Western acceptance probably stems from the perception that disposable diapers are a convenient and practical alternative to cotton diapers. Japan is moving in the direction of greater acceptance, but will do so according to Japanese customs and thought.

Climate↗

PubMed1987

Investigation of the age of release from the diaper environment.

The use of disposable diapers in Japan is increasing. It has been observed, however, that, because their dry touch prevents infants from feeling wetness, disposable diaper use may prolong the time of wearing diapers or delay toilet training. A study of the periods during which diapers were required was conducted on two groups, one using conventional cotton diapers and the other, disposable diapers. In addition, the same study was performed with identical twins, one sibling using cotton, and the other, disposable diapers. Results of the study revealed that the time to stopping diaper use was the same in both groups: the average was 27 months (6 months longer than the average 20 years ago). Among identical twins, no difference was observed as to notice before discharge, notice after discharge, or period of use. Therefore, there was no evidence that the dry feel of disposable diapers resulted in prolongation of diaper use.

Age Factors↗

PubMed2002

Scrotal temperatures do not differ among young boys wearing disposable or reusable diapers.

BACKGROUND/AIMS: This study investigated the effect of specific, commonly used diaper types on scrotal temperatures in normal healthy, young boys. These included both modern disposable and reusable diapers as well as various types of protective outer coverings that are in common use in both North America and Europe METHODS: Scrotal and skin surface temperatures were continuously monitored in healthy, young males using a computerized data-logging system based on temperature probes specifically designed for paediatric studies. These systems could be used either tethered to the PC or made completely portable depending upon the age and activity of the child being measured. Based on our results from several pilot studies, it became clear that the best way to determine if disposable and reusable diapers differ with regard to their impact on scrotal temperatures is to run these comparisons under controlled laboratory conditions where "diaper type" was the primary variable. A 2-h time period was chosen to ensure that sufficient time had elapsed for thermal equilibrium to be established under the diapers. We also felt it necessary to study the impact of urination and simulated this condition over the last 15 min using standardized methods. In addition to the skin surface temperatures, we also measured the temperature of the tympanic membrane using an infrared thermometer as an estimate of "core" temperature for each individual at various times during the session. RESULTS AND CONCLUSIONS: In this study, we have clearly shown that scrotal temperatures are the same whether the child is wearing disposable or reusable cloth diapers with a protective cover. The only situation in which scrotal temperatures were found to be lower is when the cloth diaper is used alone without a protective cover but this is not representative of how these products are actually used. We also found that on average scrotal temperatures are significantly lower than core for each diaper type. Occasionally, we did see individuals in which the maximal scrotal temperatures approached core temperatures but in every case the thermal sensors were soiled by a bowel movement. We also found that skin surface temperatures increased not only when covered by a diaper but also due to the thermal insulation provided by outer garments and blankets.

Body Temperature↗

PubMed1986

Diaper dermatitis: frequency and severity among a general infant population.

The frequency and severity of diaper dermatitis was measured among a midwestern suburban population of 1089 infants ranging in age from 1 to 20 months. No diagnosis of specific etiology was made. Fecal samples were collected and analyzed for Candida albicans, and information on family characteristics, infant diet, general health, history of rash, and diapering habits and practices was collected by questionnaire. The distribution of the severity of observed diaper rash can be described as a logarithmic-normal function, implying several multiplicative causative factors. Within the total severity range, there appear to be three subcategories of diaper rash, differing in some manner, perhaps reflecting different etiologies. The frequency of observed diaper rash was a function of the maturity of the infant, reaching a maximum around 9 to 12 months of age. The prevalence of severe rash correlated with the presence and level of fecal C. albicans. Infants diapered exclusively in disposable diapers showed less rash (P less than 0.001) than those diapered exclusively or sometimes in cloth diapers.

Age Factors↗

PubMed1990

Diaper performance: maintenance of healthy skin.

Skin wetness is proportional to diaper wetness, and with increased skin wetness, the potential for diaper dermatitis is increased. This study evaluated a wide range of infant diaper products. Eighty healthy volunteers wore 2-inch wetted diaper patches on their volar forearm for two hours. An evaporimeter was used to measure excess skin wetness attributed to the patches. The amount of moisture retained in the patch was also calculated. We found that superabsorbent (SA) disposable diapers kept the skin drier and retained more synthetic urine than cloth reusable and conventional disposable brands, and thus have the greatest potential for helping prevent diaper dermatitis. The SA brands evaluated did an equally adequate job in keeping the skin dry and in retaining moisture. Conventional disposable diapers were less able to keep the skin dry than SA diapers and were not superior to cloth products in most instances. Cloth diapers' performance depended on their composition. Those with several layers of the same fabric were less successful in keeping the skin dry than ones that contained middle layers of different nonwoven components.

Diaper Rash↗

PubMed1988

Urine output determination from superabsorbent and regular diapers under radiant heat.

The rate of water evaporation from diapers was determined by sequential weights of open and closed regular diapers and of open superabsorbent diapers in three different environments--radiant heater at 100% heater output, radiant heater at 50% heater output, and room air. In all three environments, evaporation was greatest with open regular diapers, less with open superabsorbent diapers, and least with closed regular diapers. Evaporation was greatest under the radiant heater with 100% heater output, less under the radiant heater with 50% heater output, and least in room air. An open, regular diaper under 100% heater output lost 45% of its water after one hour and 85% had evaporated after two hours. Smaller volumes of water demonstrated a larger percentage of evaporation than larger volumes. Recommendations are made for the use of (1) either open, superabsorbent diapers or closed, regular diapers, (2) prompt weights after urination, and (3) accurate and precise scales.

Clothing↗

PubMed1995

A novel method for isolating and quantifying urine pathogens collected from gel-based diapers.

BACKGROUND: Given that children often present to physicians with a wet gel-based diaper, a method for using this diaper for a urine specimen was studied. METHODS: A blinded clinical laboratory trial was conducted in the microbiology laboratory. The sampling technique involved the use of oval gynecologic forceps as a template and sterile scissors to cut out samples of diapers. Each diaper sample was then vortexed in 20 mL of sterile saline and the supernatant quantitatively cultured. Diaper sample supernatant cultures with simulated infected urines (suspensions of Escherichia coli) were used. RESULTS: Weight measurements of the diaper samples soaked with 20 mL or more of saline yielded reproducible results (0.703 g; 95% confidence interval [CI], 0.52 to 0.88 g). Culture results (colony-forming units per liter [CFU/L] of supernatant) from diapers soaked with 25 mL of various concentrations of E coli (10(6), 10(7), 10(8), 10(9) CFU/L) showed excellent correlation with the inoculum used, and no effect of a 2-hour delay in culturing the wet diapers. CONCLUSIONS: Our technique provides accurate and reliable estimates of bacterial concentrations in the usual range for infected urine from gel-based diapers soaked with solutions of E coli. Further evaluation of clinical implementation is needed.

Escherichia coli↗

PubMedDate not supplied

Diapering choices: a critical review of the issues.

Careful consideration is needed to determine which diapering system may be best suited to an institution's or individual's needs. A critical review of five issues--skin care, infection control, other health-related concerns, environmental and safety aspects, and time/cost issues--reveals that: (a) superabsorbent paper diapers reduce the incidence and severity of diaper dermatitis and control the spread of infection in caregiving surroundings; (b) cloth and paper diapers have different effects on the environment and neither type of diaper is clearly superior to the other; and (c) the cost of disposable diapers and reusable commercial-laundered diapers may be comparable, although home-laundered diapers are least expensive if the caregiver's labor is not considered.

Cost-Benefit Analysis↗

PubMed1987

Classification of diaper dermatitis: an overview.

Several types of diaper dermatitis are discussed: generic diaper dermatitis is most common and involves a simple erythema and mild scaling of the gluteal crease, buttocks, thighs, and lower abdomen. Candidal diaper dermatitis involves clinically significant infection with Candida albicans and presents as a sharply marginated area of erythema with significant involvement of the anterior thighs, genital creases, abdomen, and genitalia. Noduloulcerative diaper dermatitis may develop in a small percentage of patients who have chronic diaper dermatitis, as large, raised erosions with rolled margins. The lesions are most noticeable on the prominent body parts-genitalia, abdomen, thighs, and buttocks. Infantile seborrheic dermatitis involves a distinctive pattern of inflammation that usually begins beneath the diaper as a sharply marginated area of erythema with satellite lesions. Within 1-2 weeks, lesions develop on the scalp, cheeks, arms, legs, and intertriginous parts of the body. Impetigo is common in the diaper area, particularly in the first 6 months of life and during the warmer summer season. The lesions are usually bullous and represent infection by Staphylococcus aureus. Folliculitis appears as small, perifollicular erythematous papules and pustules, usually on the buttocks, thigh and lower abdomen. It is common in the warm summer months and is usually caused by bacteria such as S. aureus. Intertrigo categorizes disease that does not fit into the above categories. Often the patient presents with simple erythema of the folds without pustules or induration. This probably represents irritation and low-grade infection. It is important for the clinician to be aware that many other diseases can have manifestations in the diaper area.(ABSTRACT TRUNCATED AT 250 WORDS)

Candidiasis, Cutaneous↗