A California jury decided that the clothing company behind American Airlines' uniforms should pay more than $1 million to four flight attendants, who blamed chemicals in the clothes for rashes, headaches and breathing problems.1 “I would wake up and my eyes would be completely swollen. I looked like I had been in a boxing match,” said Tracey Silver-Charan.1 She also recalled: “I was unable to breathe. I often felt like I was going to pass out on the job.”1
Their lawsuit claimed the uniforms contained traces of formaldehyde, toluene and other toxic chemicals.1 For years, resins containing formaldehyde have been put into fabric to keep clothes wrinkle-free and help them last.1,2 That is the link to your own wardrobe: a “wrinkle-free”, “non-iron” or “easy care” claim on cotton often describes a chemical finish, not just the way the fabric behaves.
The health risk of greatest concern from formaldehyde in clothing, US government investigators found, is allergic contact dermatitis, which comes from contact with the skin.3 In everyday words, that is a skin allergy: a red, itchy rash where the trigger touches you. YAN's view: a crease you can iron out is a better trade than a finish you cannot see, so for babies, bedding and anything worn against the skin we choose plain cotton without an easy-care claim, and we read the lack of recent tests as a gap, not an all-clear.
What you need to know
- The wrinkle resistance comes from formaldehyde resins that form chemical bonds with the fibres in the fabric.4
- The main concern is a skin allergy, and once someone is allergic they may continue to react.3,5
- Nothing on the tag tells you: clothing labels do not identify items treated with formaldehyde.3
- Wash new clothes and bedding before first use, and for babies and anyone with eczema, choose plain cotton with no easy-care claim.
What the jury decided
The jury found the uniforms were a “substantial factor in causing harm” to the four flight attendants.1 It also said the maker was not negligent in designing the garments, nor in failing to recall them when complaints began to pour in.1 The companies argued that the uniforms had been tested for formaldehyde and met all applicable safety standards.2
Testing ordered by the flight attendants' union, the airline and the uniform maker had found formaldehyde in some of the shirts and suiting.6 So a jury accepted that work clothes harmed these four people, but the verdict did not settle which chemical was to blame.
Why would a shirt need a chemical to stay smooth?
Cotton creases; anyone who has pulled a shirt out of the washing machine knows it. In the mid-1920s, formaldehyde was brought into the textile industry to help fabrics such as cotton resist wrinkling during wear and washing.7 The resins form tight chemical bonds with the cotton fibres and hold them in place, which is what keeps the creases out.4
Dr Perryman, who practises in Colorado, says the resins are used on blends of synthetic and cotton fibres and on bed sheets.8 “In general, formaldehyde is found on everyone in this room in two different places: preservatives in skin care products and in a lot of our clothing,” she said.8 Some of her patients bring their own bedsheets to hotels so they don't get flares from the hotel's sheets.8
Not every “wrinkle resistant” or “permanent press” item has been treated, she cautions, but those are the claims to watch.8 Better finishes do exist: “Newer formaldehyde textile resins have less formaldehyde release, but they may be more expensive, and some industries may not use them,” she said.8
How it reaches your skin
Some of the resin may never bond fully, and chlorine bleach can then break it down and release formaldehyde.4 The resin can also split apart under warm moist conditions, letting formaldehyde out.4 Skin under a collar, a cuff or a sheet you sleep in is warm and often damp, which is why the finish matters most in things worn close and for long hours.
At a meeting on contact dermatitis, Dr Ryan Carlson described a woman who became allergic to formaldehyde from a disinfectant used at her workplace and later reacted to a formaldehyde resin in her lab coat.9 The condition cleared up when she stopped wearing the coat.9 Another patient got a rash on his forehead from a baseball cap with formaldehyde resins in the lining.9
“Clinically, you have to have a high index of suspicion whenever anyone comes in with a chronic eczematous rash,” Carlson said.9 In plain words: when a patch of eczema keeps coming back, clothing belongs on the list of suspects.
How big is the risk?
Sixteen years ago, US government investigators had 180 items tested, and most had less formaldehyde than the strictest national limit the clothing industry could name.3 A study comparing eco-friendly and regular garments found formaldehyde in some samples, all below the legal limits, and its authors judged the health risk acceptable.7
Those test results point to who should care most: anyone who is already allergic to the finish, or who becomes allergic over time. If that is you or someone in your home, look out for clothing and bedding sold as crease-proof or non-iron.
Does washing get it out?
The same study found no formaldehyde in clothes that had been washed, and its authors call washing before first use a safe and simple practice.7 US government investigators found that washing clothes before they are worn often reduces formaldehyde levels but is not always successful.3 But in a small test of fabrics from one local shop, most showed no drop in formaldehyde after the first and second washes.4
This investigation continues below.
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So washing is free and worth doing, but it is not a guarantee. If a rash keeps coming back, avoiding clothing that contains formaldehyde is typically effective at preventing it and relieving symptoms, the US investigators found.3
What the labels and the rules tell you
At the time of the US report, formaldehyde levels in clothing were not regulated in the United States, though several other countries had limits.3 In the EU, the REACH chemicals rules now set a formaldehyde limit for the products they cover, according to a testing company's summary of the European Commission's guide.10
Japan limits formaldehyde in textile products for infants, including nappies.11 So at least one country singles out babies' clothes for a formaldehyde rule of their own, and that is where we are strictest too.
Green labels are no shortcut: in that garment study, the eco-friendly clothes held more formaldehyde on average than the regular ones.7 As its authors point out, organic cotton refers to how the cotton was grown, not to the chemicals added during manufacture.7
What we still don't know
The US investigators said their results could not be projected to all clothing sold in the United States.3 The small shop test that found formaldehyde surviving two washes is more than twenty years old. None of these sources tells us how common the finish is on non-iron shirts and sheets sold in the UK today, or exactly how a “non-iron” label relates to the resin.
A fresh test of non-iron shirts and sheets on sale now, before and after washing, would show whether the finish still matters; until then we take the cautious path, because no recent evidence of harm is not evidence of safety.
What to choose
Start with the free habits.
- Wash new clothes, sheets, pillowcases and baby things before first use.
- Skip chlorine bleach on non-iron and easy-care items.
- If a rash keeps appearing where clothes or sheets touch, stop using the newest crease-proof item and see whether it clears, and mention your clothes to your doctor.
When you buy, read the claim on the tag or the product page: on cotton for babies, bedding and everyday shirts, skip “wrinkle-free”, “non-iron”, “easy care”, “permanent press” and “crease resistant”. If you are not sure, ask the seller once: “Has this fabric been given a wrinkle-free or easy-care resin finish?”
Formaldehyde is also added to fabrics as a flame retardant, to resist stains and to keep colours from running.6 That is why we prefer plain, undyed cotton with no easy-care claim, for babies and bedding above all; an organic label is welcome, but on its own it does not rule out a finish.
A cotton-polyester blend is no way round it, because blends are among the fabrics the resin is used on. In the small shop test, the fully synthetic clothes were free from formaldehyde.4 Even so, we would not swap cotton for polyester to avoid it: polyester is a plastic fibre, and our standard favours natural fabrics you can wear for years and recycle.
If you can't replace non-iron sheets or shirts you already own, keep using them while nobody reacts, wash them before use, and keep them off a baby's cot.