Clothes factories often make garments by adding various chemicals, some of which might be toxic and even carcinogenic. According to Chao Ming-wei, a certified toxicology expert from the American Society of Toxicology and associate professor of the Department of Biotechnology at Chung Yuan Christian University in Taiwan, there are ways to identify clothing containing toxins and lessen its health risks.

In 2024, the German professional publication “Oekotest“ (ecological test) conducted random testing on 21 clothing items from mainland China’s e-commerce platform Shein. These items ranged from baby shoes to teen dresses and adult faux leather jackets. The test results showed that two-thirds of the items failed to meet safety standards, and some of them, including baby clothing and sandals, were found to contain toxins such as antimony, lead, cadmium, dimethylformamide, and phthalates, among others.

What Dangers Do These Toxins Pose?

Chao said during an interview on NTD’s “Health 1+1” program that the clothing mentioned above is not suitable for people to wear because the toxins can lead to health issues:

• Antimony: This silvery-white metal can be found in the Earth’s crust. It exacerbates immune system problems and causes skin allergies. According to the U.S. Agency for Toxic Substances and Disease Registry, antimony oxide is added to textiles and plastics to make them fire-resistant. However, antimony can hurt the heart, blood vessels, gastrointestinal system, liver, and respiratory tract and affect developmental health.
• Lead: This heavy metal affects the nervous system and can cause anemia and kidney damage.
• Cadmium: The National Cancer Institute states that cadmium and its compounds are highly toxic and can cause cancer, including lung, prostate, pancreatic, breast, and bladder cancers. It can also cause lesions and kidney damage.
• Dimethylformamide: Accumulation of this chemical in the liver may cause liver poisoning.
• Phthalates: Phthalates damage the reproductive system, resulting in smaller sexual organs in boys, precocious puberty, and early menstruation in girls. Gary Ginsberg, a lecturer at the Yale School of Public Health, said that phthalates, one of the plasticizers in personal products, can disrupt natural hormones, inhibit testosterone, and enhance estrogen, which can lead to improper development of baby boys.

Why Are There Chemicals in Clothing?

Why are there so many toxic chemicals in substandard clothing? Chao said that the following toxic substances come primarily from these sources during the garment-making process:

• Plasticizers: Plasticizers are often added to waterproof clothing to enhance water resistance.
• Fluorescent agent: Light-colored clothes may contain fluorescent agents, added to make them look whiter, more colorful, and brighter. If the clothing is reflective under UV light, it indicates the presence of fluorescent agents.
• Bleaching agents: One of these is formaldehyde, which is used to prevent white clothing from yellowing, provide mildew resistance and wrinkle-free properties, and make the fabric stiffer.
• Dyes: Dyes are added for color and may contain heavy metals.
• Pesticides: These may be added to prevent mold on pure cotton clothing and to protect against pests.

How Toxins Enter the Body

Chao said that toxic substances mainly enter our bodies through three pathways: eating, inhalation, and skin contact. Although the likelihood of poisoning via skin contact is low, long-term exposure can still cause problems.

In 2011, flight attendants at Alaska Airlines reported health symptoms after they were given new uniforms. Many experienced itchy or inflamed skin, rashes, itchy eyes, hair loss, blurred vision, nasal congestion, earaches, sore throat, cough, hoarseness or loss of voice, shortness of breath, and other problems. These symptoms were believed to be related to harmful chemicals in the new uniforms.

Chao said that flight attendants who wear such problematic uniforms for extended periods not only have skin contact with toxins, but also absorb them through the respiratory system. This can lead to respiratory inflammation and sore throat. Additionally, contact with these toxins can cause itchy eyes with redness and may indirectly affect the immune system.

Airborne Chemicals

Sometimes, when you buy new clothes, you may notice a pungent odor as soon as you open the packaging. Does this mean the fabric contains toxic substances? Chao said that people generally cannot detect heavy metals in clothing through smell unless the concentration is exceptionally high. He mentioned two types of chemicals that do have a detectable odor: formaldehyde and plasticizer.

White clothes are typically treated with a surface layer of formaldehyde to preserve whiteness. Some manufacturers might use excessive amounts of formaldehyde. If the clothing isn’t properly washed before wearing, it can lead to inhalation of the chemical, resulting in discomfort and health issues.

Formaldehyde has a pungent odor, and the larger the skin contact area with formaldehyde-containing clothing, the more of the substance the body absorbs. Formaldehyde can cause symptoms such as itchy eyes and skin, sore throat, and shortness of breath.

Plasticizers help make dyed colors appear more vivid. Although they exude unpleasant scents, such as the smell of high-adhesion glue, some people still like the aesthetic. Newly renovated houses may also emit the scent of plasticizers.

Wash New Clothes Before Wearing

Chao noted three situations in which toxic substances in clothing are more likely to enter the body: wearing clothes for an extended period, wearing them close to the skin, and wearing clothing when it is wet from rain or sweat. This is especially true for new undergarments; if they are worn without being washed first, the chemicals on them can stick to the skin. When sweating occurs, these toxic substances can dissolve in the sweat and then penetrate the skin.

Chao said that newly purchased clothes must be washed before wearing them. It is best to use a little more detergent than usual. Consider washing them several times to remove the most harmful substances and minimize any damage to the skin.

As for whether clothes that have faded badly after washing are suitable for wearing, Chao said: “This is a mixed situation. The fact that the dye is coming out in the water means that harmful substances are being washed away. Those substances would be transferred to our skin if they weren’t washed. However, this indicates that the quality of the clothing is poor, and it’s advisable not to choose such manufacturers.”

Beware of PFAS

Many waterproof garments on the market contain per- and polyfluoroalkyl substances (PFAS). One 2024 study pointed out that PFAS can penetrate the skin barrier and reach the bloodstream, posing serious health hazards, such as cancer, weakened immunity, and hormone disruption.

The International Agency for Research on Cancer (IARC) has classified two common PFAS, perfluorooctanoic acid and perfluorooctanesulfonic acid, as chemical carcinogens.

PFAS are ubiquitous. For example, Teflon nonstick cookware is made from these substances. They can potentially enter the body through food, especially if the surface of the cookware is scratched. Chao said that when using Teflon cookware, it is essential to avoid using hard utensils to prevent scratching the surface, which can release these harmful substances.

In terms of clothing, many windproof, waterproof, and snowproof garments have outer layers made from PFAS due to their excellent waterproof and thermal insulation properties. Chao said that PFAS typically do not leach out if the structure is intact. However, if the garment is damaged, these substances can come into contact with the skin and enter the bloodstream.

Chao said that when buying clothes and footwear, any strange odor detected is a good indicator that they might contain toxic substances. Bright-colored clothes that bleed easily may have unsafe dyes, and materials with a peculiar texture may not be safe either. Shoppers should exercise caution to avoid buying low-quality products that could harm their health.