Formaldehyde in Clothing Boosts Dermatitis and Cancer Risk
Reducing your risk of cancer and skin irritations including dermatitis may be as simple as avoiding clothing containing formaldehyde.
Many assume this problem can simply be removed by washing the clothing before wearing it. Not so fast. Read on.
But clothing sources of formaldehyde exposure can be even more toxic than these sources. Why? Because these make direct contact with our skin. Further, our clothing can become a source of chronic exposure as they gradually out-gas.
Formaldehyde exposure from clothing is real. Recently, for example, I purchased a hooded jacket. When I got it home, I noticed the hood had a very toxic smell. The main fabric panel said the jacket was made of polyester. The hood looks like a wrinkle-free cotton blend. But the smell was unmistakable: Formaldehyde.
Melamine-formaldehyde resin is used for many hard-surface applications such as counter-tops and flooring. But a significant amount of clothing – especially clothing from China – is made with urea-formaldehyde. Why? Some manufacturers believe it is the best way to achieve a wrinkle-free piece of clothing.
Formaldehyde has been used for decades to achieve wrinkle-free clothing. Typically it has been used on cotton fabric or cotton/polyester blends. More recently, fully synthetic fabrics or blends can also contain formaldehyde.
Formaldehyde in Chinese clothing
Because synthetic fabrics don’t wrinkle as easily, formaldehyde isn’t necessary. Still some manufacturers are using formaldehyde in their synthetic clothing, especially when it is blended. While formaldehyde is being used by clothing manufacturers in other countries, testing has indicated that some Chinese clothing manufacturers in particular are using extremely high levels of formaldehyde.
In 2007, New Zealand’s Ministry of Consumer Affairs investigated tests funded by a NZ program called Target. The company had some Chinese clothing tested by a third-party laboratory. The fabric tests found that the easy-care fabrics had up to 900 times the levels of formaldehyde considered safe in clothing.
The program director, Candace McNabb, commented on the testing results:
“The laboratory we spoke to was really surprised at the results and actually went back and double-checked that they’d done everything right because our results were so high.”
In 2010, the U.S. Government Accountability Office submitted a report to Congress on formaldehyde in clothing.
The research accounted a laboratory test of 180 clothing articles purchased in the U.S. Ten of the articles had formaldehyde levels above the 75 parts per million. Three of the top five formaldehyde-containing articles came from China.
The highest levels were found in a dress shirt (100% cotton) from China – at 206 parts per million.
This was followed by:
• A hat (100% cotton) from China, at 192 ppm
• Pillow cases (60-40 cotton/polyester) from Bahrain at 189 ppm
• Khakis from India at 169 ppm
• Another dress short from China at 95 ppm
Nine of the top ten items were articles worn by children. Their research also found that 34 percent of clothing purchased in the U.S. was made in China.
Yes, urea-formaldehyde does help achieve wrinkle clothing. It bonds with clothing materials to create a stiff fabric. As for being fire retardant, think again. Yes, when bound with urea it can form a heat-resistant barrier. But formadehyde is flammable when released as a gas. As urea-formaldehyde off-gasses – you guessed it, formaldehyde gas.
The central issue: Formadehyde is toxic.
As the U.S. GAO review of the research reported, in the short-term, formaldehyde in clothing is linked with nausea, irritation to the eyes, nose and throat; and asthmatic attacks. In the longer-term, formaldehyde has been linked with contact dermatitis, cancer, and neurological damage. Let’s take a look at some of the evidence.
Formaldehyde can cause dermatitis
A 2016 study from Australia’s Occupational Dermatology Research and Education Center conducted a 22 year review of occupational skin disease. Nearly 80 percent of patients contracted contact dermatitis. And formaldehyde releasing materials such as rubber gloves were among the leading causes for the dermatitis conditions.
Another 2016 study from Sungkyunkwan University School of Medicine showed similar findings. Here, 41 patients with atopic dermatitis were compared healthy patients. They found that contact exposure to formaldehyde caused dermatitis-producing skin dysfunction in both the healthy people and the dermatitis patients.
The multi-center North American Contact Dermatitis Group Patch study added formaldehyde to dermatitis allergens in 2016. Their research also found a positive link between dermatitis and formaldehyde.
In a laboratory study, those exposed to just 1.2 parts per million of formaldehyde concentration in the air showed atopic dermatitis responses within the skin. And this was with airborne gas – not skin contact.
Formaldehyde is carcinogenic
Laboratory studies since the 1970s have been linking formaldehyde with cancer. As this research has matured, the link has become more convincing. In 2011, the U.S. National Toxicology Program – part of the Department of Health and Human Services, officially classified formaldehyde as a human carcinogen. This is in addition to it causing neurological damage.
In the flooring article, we discussed other evidence showing that formaldehyde is a carcinogen. Calculations by the U.S. Centers for Disease Control showed that airborne formaldehyde causes up to 30 cases of cancer in 100,000 people.
The statistic was developed from meta-analyses of multiple studies. The most prevalent cancers from airborne formaldehyde include leukemia, lung cancer, oral and nose cancers.
Clothing is even more concerning. Yes, urea-formaldehyde can off-gas formaldehyde and are linked with these sorts of cancers.
Contact with formaldehyde is carcinogenic. A study from Italy’s University of Eastern Piedmont studied tested formaldehyde exposure on human skin cells in the laboratory.
They found that even low concentrations of the chemicals significantly increased the activation of what is called ERK (extracellular signal-regulated kinase) expression. ERK expression has been linked with the development of multiple forms of cancer.
A study from Brazil’s University of São Paulo took skin cell samples from 17 volunteers. They were anatomy students, who had air contact with formaldehyde during their anatomy courses. The researchers found that the students had significantly increased levels of mutagenicity among their skin cells. Cell death also increased.
Mutagenicity means the skin cells showed mutations. Mutations within cells means an increased risk of skin cancer.
Researchers from the Medical University of Innsbruck calculated that airborne exposure of 0.1 to 0.5 ppm (parts per million) for three days can have significant toxicity, and cause increased cell death among skin cells. They also stated:
“Formaldehyde toxicity can affect all organ systems in particular those which get into direct contact. The exerted effects range from carcinogenicity to irritation and allergy and depend from the concentration, the duration and the route of exposure.”
The CDC’s National Institute for Occupational Safety and Health began studying formaldehyde exposure in garment plants since the early 1980s. They found that garment worker deaths from leukemia were significantly higher than in the rest of the population. They also found leukemia deaths were twice the rest of the population in people with ten or more years of exposure. The researchers concluded:
“Results support a possible relation between formaldehyde exposure and myeloid leukemia mortality.”
Numerous other studies have collectively linked formaldehyde exposure to cancer. And with direct contact as in clothing and furniture, formaldehyde produces both a long-term and immediate effect.
Doesn’t formaldehyde come out in the wash?
Not necessarily, and not readily. A 2004 study from India’s Kasturba Medical College tested 20 pieces of clothing purchased commercially. Of the 20 articles, 11 tested positive for formaldehyde using a chromotropic acid testing procedure. Only the cotton or cotton-polyester blends contained formaldehyde.
The researchers proceeded to wash and dry the formaldehyde-containing clothes. After washing and drying the clothes twice, some of the blends showed reduced formaldehyde. But the researchers found no reduction in formaldehyde content among many articles after washing and drying twice. They wrote:
“Polyester cotton and organdy showed reduced formaldehyde content after washing. The other textiles showed no reduction in the intensity of the red purple to violet color after the first and second washes.”
The intensity of the red purple to violet is part of the chromotropic acid test. This result means little or no reduction in formaldehyde.
In a 2013 study, the San Francisco-based Cardno ChemRisk laboratory also tested formaldehyde in 20 articles of clothing.
Here, the researchers found that only 3 of the 20 had significant formaldehyde levels. However, two of these three had extremely high formaldehyde concentrations: 3,172 parts per million and 1,391 ppm. These were up to 40 times the limit of international textile regulations.
Then the researchers purchased additional versions of these two articles. They washed and dried them using hand-washing and machine washing methods. They also tested air drying and machine drying methods.
They found that the washing and drying only reduced the formaldehyde levels by between 26 and 72 percent. And the washing or drying method didn’t significantly change the reduction of formaldehyde in the clothing.
The researchers also tested whether ironing the clothing would further reduce the formaldehyde levels: It didn’t.
The take away (or take off)
Some of the research discussed above illustrate that many types of clothing will not contain formaldehyde. This is particularly true of non-wrinkle-free fully synthetic fabrics like polyester.
However, it is apparent that clothing from China should be approached with caution. Especially if it is labeled as easy-care or wrinkle-free. A whiff-sniff test prior to purchasing could be warranted. A whiff-sniff is when you hold your nose about a foot away and fan in some air next to the article. This avoids sticking your nose right into the questionable article and getting further contaminated.
Such a whiff-sniff test could result in a little formaldehyde exposure. But better to be exposed for a second than for the next few months or more as you wear the article.
Yes, it is certainly best to wash and dry new clothes before wearing them. But from the two studies above we find that washing once may not eliminate the formaldehyde content. Even multiple washings may only reduce the formaldehyde content but not eliminate it. Vinegar and/or baking soda might be a consideration, but there’s no evidence these will remove it any faster.
Probably better to not purchase clothing that has a strong chemical smell in the first place. Or, as in my case with the jacket, return it as soon as you can. Regardless of how well it might fit.
Another strategy is to wear recycled clothing. Recycled clothing comes with some additional out-gassing from wearing and washing by the original owner. Plus it’s cheaper and better for the environment.
Higgins CL, Palmer AM, Cahill JL, Nixon RL. Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014. Contact Dermatitis. 2016 Oct;75(4):213-22. doi: 10.1111/cod.12616.
DeKoven JG, Warshaw EM, Belsito DV, Sasseville D, Maibach HI, Taylor JS, Marks JG, Fowler JF Jr, Mathias CG, DeLeo VA, Pratt MD, Zirwas MJ, Zug KA. North American Contact Dermatitis Group Patch Test Results: 2013-2014. Dermatitis. 2016 Oct 21.
Kim J, Han Y, Ahn JH, Kim SW, Lee SI, Lee KH, Ahn K. Airborne formaldehyde causes skin barrier dysfunction in atopic dermatitis. Br J Dermatol. 2016 Aug;175(2):357-63. doi: 10.1111/bjd.14357.
Han RT, Back SK, Lee H, Lee J, Kim HY, Kim HJ, Na HS. Formaldehyde-Induced Aggravation of Pruritus and Dermatitis Is Associated with the Elevated Expression of Th1 Cytokines in a Rat Model of Atopic Dermatitis. PLoS One. 2016 Dec 22;11(12):e0168466. doi: 10.1371/journal.pone.0168466.
Dean AM, Secrest AM, Powell DL. Contact Urticaria From Occupational Exposure to Formaldehyde. Dermatitis. 2016 Jul-Aug;27(4):232. doi: 10.1097/DER.0000000000000194.
Donovan S. NZ tests find formaldehyde in Chinese-made clothes. ABC News. Aug. 2007.
United States Government Accountability Office. Report to Congressional Committees. Formaldehyde in Textiles. August 2010 GAO-10-875.
Gostner JM, Zeisler J, Alam MT, Gruber P, Fuchs D, Becker K, Neubert K, Kleinhappl M, Martini S, Überall F. Cellular reactions to long-term volatile organic compound (VOC) exposures. Sci Rep. 2016 Dec 1;6:37842. doi: 10.1038/srep37842.
Lorenzoni DC, Pinheiro LP, Nascimento HS, Menegardo CS, Silva RG, Bautz WG, Henriques JF, Almeida-Coburn KL, da Gama-de-Souza LN. Could formaldehyde induce mutagenic and cytotoxic effects in buccal epithelial cells during anatomy classes? Med Oral Patol Oral Cir Bucal. 2017 Jan 1;22(1):e58-e63.
Pinkerton LE, Hein MJ, Stayner LT. Mortality among a cohort of garment workers exposed to formaldehyde: an update. Occup Environ Med. 2004 Mar;61(3):193-200.
National Cancer Institute. Formaldehyde and Cancer Risk. Accessed Jan. 11, 2017
Rizzi M, Cravello B, Renò F. Textile industry manufacturing by-products induce human melanoma cell proliferation via ERK1/2 activation. Cell Prolif. 2014 Dec;47(6):578-86. doi: 10.1111/cpr.12132.
de Groot AC, Maibach HI. Does allergic contact dermatitis from formaldehyde in clothes treated with durable-press chemical finishes exist in the USA? Contact Dermatitis. 2010 Mar;62(3):127-36. doi: 10.1111/j.1600-0536.2009.01581.x.
Novick RM, Nelson ML, McKinley MA, Anderson GL, Keenan JJ. The effect of clothing care activities on textile formaldehyde content. J Toxicol Environ Health A. 2013;76(14):883-93. doi: 10.1080/15287394.2013.821439.
Rao S, Shenoy SD, Davis S, Nayak S. Detection of formaldehyde in textiles by chromotropic acid method. Indian Journal of Dermatology, Venereology and Leprology 70(6). 2004 Nov.