“Are diapers with synthetic material (infant and adult) allowed in the Monoplace hyperbaric chamber, pressurized with 100% oxygen?”
Thank you for your question. The UHMS HBO safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the Medical Director and Hyperbaric Safety Director of your facility.
The UHMS Hyperbaric Safety Committee understands the advantage that absorbent diapers offer to the patient and the caregiver. Regarding the allowance of synthetic materials in Class A or Class B chambers, one must weigh the risks carefully and consider any opportunity for risk mitigation. For guidance concerning risk assessment and mitigation, we refer you to the National Fire Protection Association® (NFPA) 99, Health Care Facilities Code, 2018 Edition, which contains a section regarding textiles (220.127.116.11.4) offering guidance on the decision process for textiles, garments and wound care products.
We suggest that you know the types of materials commonly used to manufacture these products and their potential flammability. Typically, disposable diapers contain several layers of material Consisting of::
- The inner layer or top sheet rests against the skin of the wearer and can be made from polypropylene material. Some top sheets include a skin-care lotion, which can protect the skin from overhydration and reduce irritation.
- The absorbent core layer is designed to hold fluids. To enhance absorbency, most disposable diapers include a matrix of fluff material and a chemical compound known as Super Absorbent Polymer (SAP) that holds up to three hundred times its weight. This material forms into a gel as it absorbs fluids, and is known by other names, including hydrogel, sodium polyacrylate, polyacrylate absorbents, or Absorbent Gel Material (AGM).
- The fluff in the absorbent core is usually made from wood pulp and may include wheat/corn-based materials. It is designed to distribute fluid across the diaper surface, while the SAP is intended to absorb and lock liquids in its core.
- The waterproof outer shell is most often a petroleum-based plastic or polyethylene-treated material.
- Bands made of elastic Lycra® or spandex to keep the diaper close to the wearer.
- Non-woven refastening tape which holds the diaper in place and allows for adjustment.
We suggest the Hyperbaric Safety Director initiate a risk assessment. The risk assessment found in section A.18.104.22.168.4.3 is written for hyperbaric wound dressings, but the process is useful for other items as well. The Hyperbaric Safety Director should consider using this risk assessment when deciding which materials may be allowed in the hyperbaric environment. Furthermore, section 22.214.171.124.4.4 calls for written approval by the (Hyperbaric) Safety Director and Medical Director for prohibitive items to be allowed. The Safety Committee suggests that this code applies to the acceptance or disapproval of diapers.
You may wish to review these safety factors that impact your decision:
- The increased oxygen atmosphere in the chamber and the need to limit combustibles
- Silk, wool and synthetic textiles are prohibited unless approved by the Medical Director and (Hyperbaric) Safety Director based on sound and safe reasoning
- Avoid static producing materials
- Closed-cell materials, such as some synthetics may retain oxygen after decompression, presenting an additional risk once the treatment has been concluded. Patients must avoid contact with any naked flames for approximately 30 minutes after therapy.
- Although most codes regarding textiles are not written for 100% oxygen environments, garments are required to comply with UL requirements and A Guide to the Undited States Apparel and Household Textiles Compliance Requirements; NISTIR 8115, https://nvipubs.nist.gov
- The Safety Committee is aware of practices that have utilized cotton towels to fashion a cloth diaper as well.
- Confirmation of the continuity of ground between the patient and the chamber before each therapy.
- Consider placing a damp cotton towel over the garment to lessen static capacity.
Please let us know if we can provide any additional guidance or information.
The UHMS Safety Committee
Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet. If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility. Information provided on this forum is for general educational purposes only. It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.