The clothes we wear can serve as an outward reflection of our personalities and values. In recent years, the fast fashion industry has come under scrutiny for environmentally unsustainable practices, leading many of us to think about the impact of our outfits on the health of the planet. But how many of us stop to consider how our clothing choices influence our personal health?
The transformation of textile fibers into wearable clothing is a complex, and chemically intensive process. Thousands of chemicals are used in the manufacture of clothing. Approximately 10% of these chemicals have been shown to be potentially hazardous to humans and may negatively impact the brain [1]. However, the toxicity profile for the vast majority of these chemicals has not been established, so the number of potentially toxic chemicals in an item of clothing may be even higher. Additionally, neurotoxic heavy metals and other potentially hazardous trace elements are often used in the dyeing process and can become embedded in clothing [2].
Since we are exposed to a variety of potentially hazardous chemicals during the course of our everyday lives, it can be difficult to attribute a particular health effect to any one source. Many of these substances are generally tolerated in small amounts, but can start to elicit reactions with higher levels of exposure. As a result, evidence regarding the potential health risks associated with clothing primarily comes from those working in the textile manufacturing and fashion industries, as these individuals are repeatedly exposed to high levels of textile toxins [3; 4]. Individuals who are required to wear uniforms made of highly chemically treated performance fabrics may also be more vulnerable to clothing-related health effects.
Performance fabrics contain the highest levels of chemicals associated with harm to human health. The chemical treatments are designed to confer desirable properties such as water resistance, stain resistance, and flame retardancy.
Per- and polyfluorinated substances (PFAS) are often referred to as ‘forever chemicals’ for their propensity to accumulate in the body and environment for long periods of time [5]. These are largely used to confer water or stain resistance. Though, it should be noted that not all water-resistant clothing contains PFAS, as there are some naturally water repellant fibers, such as wool. PFAS have been associated with a variety of negative health effects, including metabolic and immunological dysfunction. Some particularly toxic forms of PFAS, namely, perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), have been phased out of production, but our understanding of the safety risks regarding the hundreds of other PFAS is incomplete. Therefore, PFOA- and PFOS-free products containing some of these lesser known PFAS are not necessarily non-toxic.
Polybrominated diphenyl ethers (PBDEs) are used as flame retardants [6]. This class of chemicals does not bond to the fabric fibers, thus it can get released into the body and blood of the wearer. PBDEs can interfere with metabolic function and promote inflammation.
Azobenzene disperse dyes are able to penetrate the skin, and are the most allergenic class of textile dyes [7]. They are used to dye synthetic fabrics, such as polyester, nylon, and acrylic, and have been found to be a common component of household dust. Bright colors, including orange, yellow, red, and blue have been shown to be the most triggering.
Some individuals are especially sensitive to these chemicals, such that reactions can be triggered by low level exposure [8]. Although symptoms vary, neurological symptoms such as headache and brain fog are among the most common [9]. This sensitivity occurs most often in those with a low tolerance to oxidative stress [10], suggesting that these chemicals may be inducing low level metabolic damage, even in the absence of overt symptoms. Notably, oxidative stress damage and metabolic dysfunction are prominent features of dementia and other neurodegenerative diseases. As a result, it may be particularly important for sensitive groups to avoid exposure to heavily chemically treated fabrics.
WHAT YOU CAN DO
The chemical burden is highest in newly manufactured clothing, therefore, washing clothing prior to wearing is a critical step in reducing exposure to potentially hazardous textile toxins. For delicate fabrics, it is preferable to handwash or utilize an eco-friendly dry-cleaning service, such as wet cleaning or liquid carbon dioxide cleaning since traditional dry cleaning will add to the chemical load of the garment.
Natural fiber fabrics, such as cotton, wool, linen, and silk tend to have a lower chemical burden than synthetic fabrics, particularly with respect to dye-related toxins. For plant-based fibers, such as cotton and bamboo, seeking out organic varieties will help ensure that the fabrics do not contain herbicides and pesticides, which can be difficult to remove by washing.
A variety of retailers have pledged not to use chemicals known to be hazardous to human health in their products. An easy way to identify products that adhere to these standards is to look for the OEKO-TEX® STANDARD 100 Label. This label ensures that the garment has been tested for a list of both regulated and non-regulated potentially toxic substances and exceeds international standards.
Taking these steps can help you to make fashion choices that reflect your personal style without compromising the health of your brain and body.
Betsy Mills, PhD, is a member of the ADDF's Aging and Alzheimer's Prevention program. She critically evaluates the scientific evidence regarding prospective therapies to promote brain health and/or prevent Alzheimer's disease, and contributes to CognitiveVitality.org. Dr. Mills came to the ADDF from the University of Michigan, where she served as the grant writing manager for a clinical laboratory specializing in neuroautoimmune diseases. She also completed a Postdoctoral fellowship at the University of Michigan, where she worked to uncover genes that could promote retina regeneration. She earned her doctorate in neuroscience at Johns Hopkins University School of Medicine, where she studied the role of glial cells in the optic nerve, and their contribution to neurodegeneration in glaucoma. She obtained her bachelor's degree in biology from the College of the Holy Cross. Dr. Mills has a strong passion for community outreach, and has served as program presenter with the Michigan Great Lakes Chapter of the Alzheimer's Association to promote dementia awareness.
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