THE tampon industry is big business - selling more than one billion tampons a year.

Peter Stephenson is the former managing director of Tambrands, which make Tampax, and is now the director general of the Absorbent Hygiene Products Manufacturers Association.

He told The Northern Echo that the number of cases of TSS associated with tampon use was declining.

Mr Stephenson is also involved in the Toxic Shock Syndrome Information Service, which offers advice about the condition.

He said: "Every year we put out 250,000 leaflets about TSS to raise awareness. And the manufacturers have spent millions of pounds on research into TSS.

"The industry has been instrumental in setting up information services on TSS, and Tambrands set one up in 1993.

"The awareness levels of TSS today are higher than ten or 20 years ago."

He said manufacturers send nurses into thousands of schools every year to speak to both boys and girls about menstruation and TSS.

TSS was identified as a condition in 1978, and between 1979 and 1980 there were 300 cases across the US.

Mr Stephenson said: "At that time a new brand had been introduced which was extremely absorbent, and there were problems with women leaving them in too long. When that brand was taken off the market, the numbers of cases dropped dramatically."

Mr Stephenson said that all tampon manufacturers had entered into a voluntary agreement to provide a warning on packs and have information leaflets inside the packs.

He said: "These voluntary agreements have been in place since 1984 and are very closely monitored. But there are some countries which do not have these in place.

"In Britain we provide the warnings and the information, but we cannot make people read the information.