Cheap clothing, made from low-quality materials, often produced under exploitative conditions and contributing to the rapid evolution of the environmental crisis, comes at an even steeper price for the long-term health of the people who make and wear it.

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“Some reports in recent years have shown the presence of lead, per- and poly-fluoroalkyl substances [aka, PFAS], and phthalates in some fast-fashion clothing,” says John W. Downs, MD, MPH, FACP, FACOEM, of Virginia Commonwealth University (VCU) Health and Director of the VCU Poison Center.

While these chemicals are unlikely to cause immediate illness, except in cases of allergic reactions, their potential long-term health effects deserve attention. Let’s take a look at the top three fast-fashion toxins linked to cancer and other serious health conditions.

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Are your clothes making you sick?

According to Nicole Deziel, PhD, MHS, an associate professor of Epidemiology (Environmental Health Sciences) at the Yale School of Public Health and a member of the Yale Cancer Center, “Fast fashion can potentially contribute to chemical exposures in consumers who wear the garments, due to the possible presence of [PFAS], flame retardants, dyes, pesticides, phthalates, microplastics, or formaldehyde.” She notes the link between these chemicals and health issues such as respiratory issues, reproductive problems, and certain cancers.

Dr Downs has a differing opinion, however. “In clinical toxicology, illness is a function of the dose received,” he says. “The higher the dose received, the more likely illness to develop.” He says it would be unlikely that such significant amounts of these substances as to induce an acute illness would be absorbed from general clothing wear, particularly since most individuals don’t wear the same clothing daily.

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Lead

Many agencies in the US and around the world have reviewed studies on the link between lead and cancer, leading them to declare that lead is likely to cause cancer in humans, according to the Agency for Toxic Substances and Disease Registry.[2]

In addition, “Lead exposure has been associated with developmental delay as well as lowered cognitive and academic performance in children,” according to Dr. Downs.[3] “Typically, this is seen with recurrent accidental ingestion of other household lead sources, such as chipping paint. More extreme cases can result in more overt neurologic dysfunction, including seizures,” he clarifies.  

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PFAS, aka 'forever chemicals'

PFAS are chemicals widely used in many ways, including making items like nonstick cookware, carpets, and pizza boxes. These chemicals are in the water, air, fish, and soil and can also be found in people’s blood.[4]

“Some older forms of PFAS, specifically PFOA and PFOS, have been associated with the development of kidney and testicular cancer, thyroid dysfunction, ulcerative colitis, high cholesterol, and high blood pressure during pregnancy in humans,” according to Dr Downs.[4][5] He also notes that the human health effects secondary to other forms of PFAS are less clear, but the science is ongoing and evolving.  

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Phthalates

“Phthalates are a class of chemicals used to make synthetic materials more durable. The primary route of exposure to phthalates has been ingestion from water or food sources,” says Dr Downs. Items that touch plastics, whether when they are being made, packaged, or delivered, have them.[6] Think anything from toys, hair products, food packaging, water bottles, and toothbrushes to medical devices.

“Experimental studies have suggested alterations in hormone production and possible changes to reproductive organs in animals exposed [to] some phthalates,” says Dr Downs, noting a 2019 study published in the International Journal of Environmental Research and Public Health.[7] He also adds that there may be some association between phthalates and the development of obesity as well. However, “it is less clear if these conditions occur with the degree of exposure humans receive.”

“Though dermal contact with garments that contain these chemicals could contribute to exposures, this is generally not considered a major pathway,” explains Dr. Deziel. “The larger concerns about exposure and health risks from fast fashion are to those who make the clothing, which predominantly occurs in low- and middle-income countries.” She explains that the workers may experience much higher levels of exposure to toxic chemicals and harmful fibres, as well as musculoskeletal issues from repetitive motions.

Another significant concern she highlights is that “laundering these garments can release chemicals and fibres into waterways, affecting the ecosystem.” Additionally, items from the fast fashion industry are designed to be produced and worn quickly, making recycling many of the fabrics difficult. As a result, discarded clothing generates substantial waste, further harming the environment.

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Reducing exposure

If individuals want to reduce their exposure to chemicals from clothing, Dr Deziel recommends buying clothing from more sustainable materials like organic cotton and flax/linen. Dr Downs affirms this advice, adding that purchasing clothing made with natural fibres such as cotton, wool, and silk is the way to go.

For those who can’t avoid clothing made with synthetic fibres, washing the item before its first wear can reduce the amount of residual dyes and chemical treatments the fabric may have, says Dr. Downs. “Washing won’t eliminate them, though.”

Dr Deziel also recommends buying used clothing and wearing clothing longer to reduce exposure. “Some of these chemicals would be reduced over time, partly because they are removed via laundering and then entering the environment.”

Shoppers concerned about PFAS should avoid clothing labelled “water-resistant” or “stain-resistant” or with labels that indicate the presence of chemicals with names that include “fluoro” or “perfluoro.” Dr. Deziel repeats that exposure to clothing is not considered the major source of PFAS: “The main source is drinking water.”

Developing skin irritation after wearing a piece of clothing could mean the person has an allergy to something in that piece of clothing, whether natural or synthetic, Dr Downs says. In that case, the cloth shouldn’t be worn again. 

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Disclaimer: This story is contributed by Frances Gatta and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.