Updated: Nov 6
Clothing can serve as a means for exposure through phthalates directly or indirectly. Phthalates may be used in clothing, especially those that are imprinted with iron-ons, adhesives, or printing inks. The indirect exposure to phthalates is alarming. Cotton, more so than polyester, can adsorb phthalates from the environment. This means that phthalates can attach to cotton and increase the risk of dermal absorption from outside sources. Polyester does not directly contain phthalates. Read more...
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What are phthalates?
Phthalates are chemicals used as plasticizers, to make plastics more flexible, soft, and durable. Exposure tends to be through items exposed to plastics but can also be airborne. According to the CDC, there appears to be widespread exposure to phthalates in the United States as they are found in the urine of most people tested. Women tend to have higher exposures than men, possibly owing to exposure via personal care products such as shampoos, conditioners, skincare products, and accessories.
Phthalates can enter the body through ingestion, inhalation, and through dermal absorption through the skin. Once they enter the body, they are metabolized and can impact our health. The health impacts noted according to this article that compiled data from numerous resources include:
Type II Diabetes
Thyroid dysfunction and thyroid cancer
Increased Systolic Blood Pressure
Impaired male development and semen quality
Pregnancy loss, preterm birth, low birth weight
Impacts levels of Luteinizing Hormone and Sex Hormone Binding Globulin
Given the paucity of studies and data available, it is truly difficult to know the true impact of phthalate exposure in clothing on our overall health. However, given the fact that dermal absorption of phthalate contributes to our overall exposure and that clothing tends to accumulate and be a source of phthalates over time, it is important to maintain appropriate laundering practices.
Why are phthalates in clothing?
Clothing can serve as a means for exposure through phthalates directly or indirectly.
Phthalates may be used in clothing, especially those that are imprinted with iron-ons, adhesives, or printing inks. Some sites report that they may be used in workout clothing, although this could not be confirmed through medical studies available. A report from Marketplace found that certain items such as totes and princess dresses contained phthalates.
The indirect exposure to phthalates is alarming. Cotton, more so than polyester, can adsorb phthalates from the environment. This means that phthalates can attach to cotton and increase the risk of dermal absorption from outside sources. Polyester does not directly contain phthalates. This is commonly misunderstood given the name of the fibers used to make polyester.
A study evaluating phthalates in new clothing purchases for preschool children found phthalates in all garments studied with concerns raised to the risk of exposure based on the body surface area covered by the clothing.
Interestingly, clothing can serve to protect the skin from exposure to phthalates in the environment. A study evaluating exposed skin for phthalates versus skin covered by clothing did find that there were higher concentrations of phthalates on exposed skin. However, over several days of wearing the same clothing item, phthalates increased in the clothing.
Another study evaluating absorption of phthalates through the skin was significantly increased with clothing that contained phthalates contributing to a significant source of phthalate exposure for humans.
Which clothing is most at risk for phthalates?
Cotton clothing adsorbs phthalates easily. This means that phthalates tend to adhere to the textile.
Some surprising studies have evaluated the phthalate concentrations in clothing. The results are particularly shocking in light of the exposure noted from infant and children's clothing.
There is a study evaluating infant clothing which tends to be made of cotton and found that high concentrations of phthalates as well as traditional laundering are not capable of removing most completely.
Clothing items with a soft plastic element or imprinted inks can also serve as a source of exposure.
Can phthalates be removed from clothing?
Laundering does tend to reduce the phthalates in clothing. This is a reminder, especially for infant and children's clothing, to wash before wearing to reduce children’s exposure to these chemicals and others. Although all may not be gone after one wash, repetitive washes will continue to reduce the phthalate content while also reducing the phthalates that may accumulate in clothing over time.
Do phthalates in clothing cause skin sensitivities or allergic reactions?
A review of the medical literature for phthalates as a trigger for allergic contact dermatitis in the skin did not yield many results, however, there is an interesting connection to cutaneous disease of which we are just starting to develop an understanding. A study in 2021 revealed that patients with Atopic Dermatitis had an increased excretion of phthalate metabolites in their urine compared to those without the disease. This study is fascinating in that it suggests a relationship between phthalate exposure and an increased tendency towards atopic dermatitis and even points to the possibility that excess phthalate exposure could be a risk factor for developing atopic dermatitis. Far more research and studies are needed to really understand this correlation however it does demonstrate that those manifesting atopy appear to have had a higher risk of exposure to phthalates.