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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.

Wearing dry and wet cloth and disposable diaper materials has certain effects on the degree of skin wetness. These, in turn, affect the coefficient of skin friction, the skin's susceptibility to abrasion damage, its permeability, and its support of microbial growth. These effects were explored using an adult model wearing forearm patches. The adult model was validated by comparisons of skin wetness and friction values for infants and adults determined under similar conditions. Skin wetness was proportional to diaper wetness. With increased skin wetness, there were increased coefficients of friction and increased abrasion damage, skin permeability, and microbial growth. Cloth diaper material produced wetter skin than did disposable diaper material at equivalent loadings.

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treatment with P-glucuronidase the urine was adjusted to pH 4.7 and again extracted with ether. The major metabolites in this ether extract were 3-chlorophen01,~ 4-chlorophenol, and 4-chlorocatechol. Two minor metabolites were 2-chlorophenolg and an 0-methyl ether of 4-chlorocatechol.g Strong acidification of the remaining urine and further ether extraction led to the isolation of 4-chlorophenylmercapturic acid (S-4chlorophenyl-N-acetylcysteine). The deuterium retentions observed in all the metabolites isolated are presented in Table I. The same three monophenols benzenediol has been isolated from the urine of rabbits t o which 4-deuteriochl~robenzene~ had been administered. Eleven New Zealand white female rabbits (-1 kg) were injected intraperitoneally with 2.0 g each of 4deuteriochlorobenzene applied in a 1 : 1 emulsion with water containing 0.25% each of oleic acid and triethanolamine. Urine was collected for 48 hr and adjusted t o pH 8. The ether extract provided about 4 mg (0.014 %) of 6-deuterio-5,6-dihydroxy-3-chloro-1,3cyclohexadiene (VI) as a crystalline solid (mp 129-130", lit.4 129-130" for the hydrogen compound) containing exactly 1.0 deuterium atom. The stability of this glycol t o acid4s6 and triacetyl~smate~ suggests the trans configuration VI (only one antipode is pictured arbitrarily).About 1 mg of the glycol VI was dehydrated with 1.0 N HC1 at 100" for 10 min. The phenolic products were methylated with dimethyl sulfate in oxygen-free 1 .O N NaOH at 80" for 2-3 min, conditions under which no appreciable exchange occurs. The resulting chloroanisoles were examined by combined glpc-mass spectrometry with Carbowax columns operating at 115-130". The mixture consisted of 99% 4-and 1 % 3chloroanisole. The 4-chloroanisole contained 0.23, and the 3-chloroanisole approximately 0.84 deuterium atom per molecule. When the dehydration was conducted at room temperature in 1.0 N HC1 for 4 days, the isolated p-chloroanisole contained 0.19 deuterium atom per molecule. The retention of 19-23% deuterium in the 4-chlorophenol (XVI) by acid-catalyzed dehydration of the glycol VI compares with 54% retention in vivo where the phenol XVI is probably formed directly (I -I11 ---t IV -+ V) rather than via the glycol I1 or VI.The relatively slow aromatization of the trans-glycol VI suggests a cationic transition state XI11 rather than a concerted (cis) elimination. This migration, concomitant with dehydration, is reminiscent of pinacol rearrangements in which the migratory group is hydrogen.7 Migrations of hydrogen are known to occur enzymatically in the dehydration of aliphatic pinacols where they are then subject to stringent steric and mechanistic requirements.s These results allow two conclusions: (i) retention of deuterium in the dehydration of the glycol VI involving cationic intermediates, such as XIII, is significant; (ii) the nonenzymatic formation of a 3-chlorophenol (isolated as 3-chloroanisole), from the glycol VI with 16% of the deuterium lost, suggested initially that hydrogen underwent migration by pathway IX ...