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

Development of Polyampholyte Cellulose-Based Hydrogels for Diapers with Improved Biocompatibility

Non-biodegradable superabsorbent polymers (SAPs) in personal care products (PCPs) pose significant environmental and health concerns despite their high absorption capacity. The aim of this study was to develop cellulose-based hydrogels as a sustainable alternative to those conventional SAPs, taking advantage of cellulose properties such as biocompatibility, biodegradability, and hydrophilicity. A synthesized allyl cellulose (AC) derivative was copolymerized with unusual monomers used in the production of SAPs, and the influence of monomer ratios, crosslinking density, and the ratio of cellulose to monomers on the absorption capacity was investigated and optimized. The most promising hydrogels were fully characterized for the proposed application and compared with a commercial SAP extracted from a baby diaper. The cellulose-based hydrogels showed promising absorption capacities in synthetic urine (~15 g/g), and a high centrifuge retention capacity (12.5 g/g), which was only slightly lower than the commercial SAP. These new hydrogels exhibited excellent biocompatibility and outperformed the established commercial diaper SAP. This study represents a more sustainable alternative to conventional SAPs, potentially reducing health risks while increasing the bio-based content of PCPs. Further optimization of these hydrogels could transform the hygiene product industry, by providing a balance between performance and environmental sustainability.

The history of diapers and their environmental impact

IMPACT

This article examines diaper practices around the world throughout history. This article reviews the innovation of the modern diaper and the environmental effects of disposable diapers.

Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies

Although humans are highly dependent on plastics from infancy to adolescence, these materials can degrade into ubiquitous microplastics (MPs) that affect individuals at every stage of life. However, information on the sources, mechanisms, detection techniques, and detrimental effects of MPs on children's health from infancy to adolescence is limited. Hence, here we identified and reviewed original research papers published in 2017-2023 across 11 database categories in PubMed, Google Scholar, Scopus, and Web of Science to improve our understanding of MPs with a focus on pediatric well-being. These studies found that milk and infant formulas are common sources of MP exposure in infants. Infant formula is the dominant source of MPs in babies, while plastic toys are a common source of MPs in toddlers. Adolescents are frequently exposed to MPs through the consumption of food contaminated with MPs and the use of plastics in food packaging. Water and air are sources of MP exposure in children from infancy through adolescence. This study thoroughly summarized how MP exposure in children of all ages causes cell damage and leads to adverse health effects such as cancer. With appropriate authorization from the relevant authorities, small amounts of human biological samples (10 g of feces) were collected from volunteers to assess the amounts of MPs in children with the aim of promoting pediatric well-being. The samples were then treated with Fenton's reagent, stored in glass jars, and filtered through nonplastic filters. Finally, MPs in children were quantified using stereomicroscopy and characterized using micro-Fourier transform infrared spectroscopy.

Environmental concerns on water-soluble and biodegradable plastics and their applications - A review

Water-soluble polymers are materials rapidly growing in volume and in number of materials and applications. Examples include synthetic plastics such as polyacrylamide, polyacrylic acid, polyethylene glycol, polyethylene oxide and polyvinyl alcohol, with applications ranging from cosmetics and paints to water purification, pharmaceutics and food packaging. Despite their abundance, their environmental concerns (e.g., bioaccumulation, toxicity, and persistence) are still not sufficiently assessed, especially since water soluble plastics are often not biodegradable, due to their chemical structure. This review aims to overview the most important water-soluble and biodegradable polymers, their applications, and their environmental impact. Degradation products from water-insoluble polymers designed for biodegradation can also be water soluble. Most water-soluble plastics are not immediately harmful for humans and the environment, but the degradation products are sometimes more hazardous, e.g. for polyacrylamide. An increased use of water-soluble plastics could also introduce unanticipated environmental hazards. Therefore, excessive use of water-soluble plastics in applications where they can enter the environment should be discouraged. Often the plastics can be omitted or replaced by natural polymers with lower risks. It is recommended to include non-biodegradable water-soluble plastics in regulations for microplastics, to make risk assessments for different water-soluble plastics and to develop labels for flushable materials.

A Disposable Diaper Collection Project in Langa, Cape Town, South Africa: A Pilot Study

In developing countries, there is currently no established waste management plan that includes resource recovery from used disposable diapers (DDs) apart from incineration and landfilling. In low-income areas with limited storage space, the complex composition and odour of used DDs make it impossible to manage properly if not supported by effective waste management systems. In the absence of effective waste management, DDs are dumped in open spaces, burned or buried. These actions pose threats to the safety and health of humans, animals and the environment. Separation and collection of DDs are critical preliminary steps to landfilling, recycling or beneficiation. In this article, we describe a case study of two pilot collection projects in Langa township in Cape Town, South Africa, to determine whether and how a source-separated collection system can work in low-income, resource-constrained areas. The lessons learned highlighted the following: The eagerness of parents to participate for the benefit of their own and their children's health; the complementarity of the two pilot collection models to serve the needs of the community; the important role non-government organisations play in the implementation of waste management projects; the significance of the possible job creation opportunities and the unintended benefits of enhancing social cohesion. The financial sustainability of these projects needs further exploration.

Recycling of diaper wastes for a triboelectric nanogenerator-based weather station

Escalating concerns over waste management and the need for sustainable energy have prompted innovative solutions at the nexus of resource recycling and self-powered applications. This study presents a novel approach to recycling super-absorbing polymer (SAP) gels from waste diapers and discarded baking sheets to fabricate a diaper waste-based triboelectric nanogenerator (DW-TENG). The DW-TENG, resembling a maraca, demonstrated superior electrical performance with a voltage output of 110 V, a current of 9 μA, and a power of 259.15 μW. It was successfully integrated into a self-powered weather station for real-time monitoring of wind speed, humidity, and temperature. This research underscores the dual benefits of waste management and energy generation, representing a promising step toward a circular and sustainable future.

Novel 3D printed polysaccharide-based materials with prebiotic activity for potential treatment of diaper rash

Diaper rash, mainly occurring as erythema and itching in the diaper area, causes considerable distress to infants and toddlers. Increasing evidence suggests that an unequal distribution of microorganisms on the skin contributes to the development of diaper dermatitis. Probiotic bacteria, like Staphylococcus epidermidis, are crucial for maintaining a healthy balance in the skin's microbiome, among others, through their fermentative metabolites, such as short-chain fatty acids. Using a defined prebiotic as a carbon source (e.g., as part of the diaper formulation) can selectively trigger the fermentation of probiotic bacteria. A proper material choice can reduce diaper rash incidence by diminishing the skin exposure to wetness and faeces. Using 3D printing, we fabricated carbon-rich materials for the top sheet layer of baby diapers that enhance the probiotic activity of S. epidermidis. The developed materials' printability, chemical composition, swelling ability, and degradation rate were analysed. In addition, microbiological tests evaluated their potential as a source of in situ short-chain fatty acid production. Finally, biocompatibility testing with skin cells evaluated their safety for potential use as part of diapers. The results demonstrate a cost-effective approach for producing novel materials that can tailor the ecological balance of the skin microflora and help treat diaper rash.

Perception and Disposal Practices of Toddler Feces by Mothers in Suburban Area of Kendari, Indonesia

Unsafe child feces disposal (CFD) is another form of open defecation and can pose a risk of disease in children. More than 30% of Indonesian households practice unsafe CFD, yet, its determinants are unknown. This study aims to identify the contextual and behavioral determinants of CFD through the lens of the Risk, Attitude, Norm, Ability, and Self-regulation (RANAS) framework. The cross-sectional study was conducted in 349 households in the suburbs of Kendari City, Southeast Sulawesi Province, Indonesia, in mid-2023. About 64% of the respondents practiced unsafe CFD. Most respondents used diapers that were immediately thrown into the trash without cleaning (i.e., 60.2%). Logistic regression analysis found two significant contextual factors associated with safe CFD: having received sanitation-related information and toddler age, i.e., children below 5 years old. Perceived severity was the most influential psychological factor behind the CFD practice, followed by knowledge. This study suggests that informing caregivers about the negative health effects of practicing unsafe CFD, especially on their children, can be a positive trigger for them to practice safe CFD. In addition, the promotion of early toilet initiation and recycling programs for used diaper waste should also be conducted to ensure comprehensive CFD management.

Beach litter occurrence along the shoreline of Mabini Protected Landscape and Seascape, Davao de Oro, Philippines

This study aimed to assess the occurrence of marine litter on selected beaches in Mabini Protected Landscape and Seascape, Davao de Oro, Philippines, where records have not been published yet. Beach litter was collected during low tide from four beaches in June 2023. Results revealed that plastics were the most abundant type of litter at 82.22 %. Most plastic materials sampled were plastic fragments and packaging at 37.72 % and 18.24 %, respectively. An independent t-test showed that rocky beaches had significantly higher litter density at 1.38 items m-2 than sandy beaches at 0.45 items m-2, t(10) = 4.281, p = 0.001. The present results indicated that the actual cleanliness of the Mabini coast is low, suggesting that clean-up strategies from various stakeholders are needed.

A novel multi-scale pressure sensing hydrogel for monitoring the physiological signals of long-term bedridden patients

For long-term bedridden patients who need to wear diapers, the timely replacement of diapers is very important to ensure their quality of life. Therefore, it is urgent to develop a pressure sensor that can monitor the physiological conditions of patients in real time. Inspired by the multi-scale network structure of the multi-fiber protein in the muscle, a multi-scale hydrogel as a pressure sensor was prepared by introducing micron-scale hydrogel microspheres as physical crosslinking agents. Compared with the traditional polyacrylamide hydrogel (0.17 MPa of compressive strength), the multi-scale hydrogel showed a higher compressive strength of up to 1.37 MPa. Meanwhile, the hydrogel exhibited better pressure sensitivity (0.59 kPa-1) than the existing hydrogels (0.27-0.40 kPa-1). The sensor prepared by this hydrogel could monitor the patient's physiological condition (urine outflow and urinary filling) in real time through the conductivity response to ion concentration and pressure, and then transmit the signal to the caregivers in time to avoid skin damage. This multi-scale hydrogel provided a great convenience for the physiological monitoring of long-term bedridden patients by acting as a pressure sensor.

Open defaecation by proxy: Tackling the increase of disposable diapers in waste piles in informal settlements

Disposable diapers are becoming increasingly popular and present an emerging challenge for global waste management, particularly within LMICs. They offer a cheap and convenient way for caregivers to manage child excreta; however, insufficient understanding of safe disposal methods, combined with limited access to waste management services results in hazardous disposal. Used diapers are being increasingly found dumped in the open environment, including in water bodies and in open fields, leading to faecal contamination of the environment and an enhanced risk of transmission of faecal-oral diseases such as cholera and typhoid. United Nations SDG 6 aims to end open defaecation globally by 2030; however, improper disposal of used diapers will hamper progress towards reaching this goal. In this review, we identify current trends in use and subsequent disposal of single use disposable diapers in LMICs, and critically discuss the environmental and public health impacts of current practices, and potential solutions to address these challenges. Contemporary methods for managing the disposal of single use diapers for communities in LMICs tend to be cost prohibitive with few alternative options other than dumping in the environment. Modern cloth diapers offer a low waste alternative to disposable diapers but often carry an unaffordable high upfront cost. Here, in addition to advocating improved efforts by governments to upgrade access and quality of waste management services, we recommend the design and implementation of intervention schemes aimed to increase awareness of safe and hygienic disposal practices for disposable diapers.

Delayed elimination communication is a crucial factor in disposable diaper dependence in Chinese preschool-aged children

PURPOSE

Elimination communication (EC) is considered to be a milestone in a child's development. Nowadays, a trend toward an older age at EC initiation has been observed globally, probably due to the convenience of disposable diaper use in daily life. The study aimed to identify potential risk factors for disposable diaper dependence (DDD) and evaluate whether an early/proper EC can reduce the risk of DDD among children in China.

METHODS

A cross-sectional study was performed on 13,500 children in mainland China from October 2019 to March 2020. An anonymous questionnaire was used to collect information including the sociodemographic characteristics, details about DDD and EC, and the effect of DDD on the quality of life of children. Data were analyzed by SPSS and R software.

RESULTS

The overall prevalence of DDD was 4.17% (4.31% in boys; 4.02% in girls) and decreased with age, from 8.71% at 2 years to 0.73% at 6 years (χ ² _trend  = 210.392, P < 0.001). In univariable analysis, age, location or EC were associated with DDD. Four independent factors-age, location (urban), caregivers with high education levels (junior college or above) and delayed EC (after 12 months of age)-were identified to be significantly associated with DDD risk in logistic regression model. Compared with EC onset after 12 months of age, EC onset before 12 months of age was associated with a 79.6% (model 2) reduction in DDD. Four independent factors were selected to establish the nomogram for DDD based on the results of logistic regression analysis. The C-index (0.770) and the AUC (>0.7) indicated satisfactory discriminative ability of the nomogram. The calibration diagrams showed favorable consistency between the prediction of the nomogram and actual observations.

CONCLUSION

Our findings indicate the joint contribution of age, location, caregivers' education level and EC to DDD in Chinese preschool-aged children. Timely cessation of the use of disposable diapers and early/proper EC may help to reduce the risk of DDD in children.