To the Editor.
—Since 1987, the Seattle-King County Nurses Association's Diaper Decision Group has followed issues related to diapering methods and has attempted to raise awareness about diapering choices. We are a nonprofit association with no financial ties to either the cloth or disposable diaper industries. From our work, a number of issues can be raised about the article by Van et al.1 Although no financial support or affiliations were disclosed, Dr Pickering appeared in a 1990 Procter & Gamble videotape about reducing illness in child-care settings.Readers should be cautioned that the results of the study are applicable only to disposable diapers with absorbent gelling material and cannot be generalized to all types of disposable diapers. The use of the term paper diapers was misleading. Paper diapers are composed of 65% wood-pulp fibers, yet the remaining nonbiodegradable materials include polyethylene plastic, tape, and superabsorbing crystals.It is possible
Primomo J. Diapers and Day Care. JAMA. 1991;266(17):2372. doi:10.1001/jama.1991.03470170059016