Are There 'Forever Chemicals' In Your Clothing?
Key Points
- Exposure to PFAS has been linked to numerous health problems, from allergic reactions to thyroid disease and cancer.
- These toxic chemicals are present in several consumer and industrial goods and the environment.
- Research has found high levels of these "forever chemicals" in clothing, especially workout and outdoor gear.
You may have more than a fashion faux pas to worry about when shopping for a new workout outfit or rain jacket. Research indicates that toxic chemicals, called PFAS, are present in many clothing items, especially those with moisture- and stain-resistant properties.
Itchiness or a rash are just the beginning. Some of these compounds may lead to severe health problems, including hormonal disorders, decreased fertility or cancer.
What does PFAS stand for?
Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a group of chemicals that, according to the Centers for Disease Control and Prevention (CDC), have been widely used in industrial processes and commercial products since the 1940s.
They're known as "forever chemicals" because they don't naturally break down in the environment.
Today, PFAS permeate everything from drinking water and soil to human breast milk and period products. Most people and animals have forever chemicals in their blood.
Are there different types of forever chemicals?
There are thousands of types of PFAS, according to the Wisconsin Department of Health Services, though some are much more common than others.
PFAS, including perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), are the most prevalent and heavily researched, according to the CDC.
The United States and European Union have phased out or banned the production and use of PFOA and PFOS in commercial products, but they continue to linger in the environment. They are still used in some firefighting foams in the United States.
PFOA and PFOS are of particular concern because they can move through solids, contaminate drinking water and accumulate in the bodies of fish, livestock and wildlife, according to the CDC.
The next most common and frequently studied PFAS are perfluorohexanesulfonic acid (PFHxS) and perfluorononanoic acid (PFNA).
PFAS are associated with a range of health risks including the following, according to the CDC and Nicole Deziel, Ph.D., M.H.S., associate professor of Epidemiology (Environmental Sciences) and co-director, Yale Center for Perinatal, Pediatric and Environmental Epidemiology (CPPEE) at Yale School of Medicine in New Haven, Connecticut.
- Elevated cholesterol
- Reduced vaccine effectiveness
- Liver damage
- Cancer
- Decreased fertility
- Thyroid disease
- Asthma
"There's also some evidence linking PFAS exposure to pregnancy complications," said Erika Aragona, D.O., a women's health physician practicing in Boise, Idaho.
"Additionally, breastfeeding women can transfer PFAS compounds to their babies through breast milk, raising concerns for potential infant exposure," Aragona said.
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What are PFAS used for?
PFAS are most often used in the manufacture of fluoropolymer coatings and products that resist oil, grease, stains, heat and water. Various household products contain forever chemicals—everything from sports bras to roofing materials.
"Drinking water is the primary source of PFAs," Deziel said.
Several states and the U.S. Environmental Protection Agency (EPA) have moved to regulate six PFAS levels in tap water, including PFA, PFOA, PFHxS and PFNA.
Other consumer goods likely to contain PFAS include the following, according to Consumer Notice:
- Cleaning products
- Cosmetics
- Fast food packaging
- Firefighting foams
- Freshwater fish
- Nonstick cooking products
- Paints and sealants
- Stain-resistant clothing
- Water-resistant clothing
Although menstrual products are considerably safer than they were a few decades ago, toxic shock syndrome is still an issue and research indicates some menstrual products, including tampons, pads and period pants, contain PFAS.
Do most clothes contain PFAS?
"Nobody knows for sure what percentage of clothing contains toxic chemicals," said Ned Calonge, M.D., M.P.H., associate dean for public health practice and clinical teaching professor at the Colorado School of Public Health in Denver.
Calonge is also chair of a National Academies of Sciences, Engineering and Medicine (NASEM) committee that recently published Guidance on PFAS Exposure, Testing and Clinical Follow-Up.
"Accurate statistics for the percentage of women's clothing that contains PFAS are not available because these chemicals do not readily appear on the labels, and products are not routinely tested for these substances," Deziel said.
"However, several studies have tested a variety of clothing items and found PFAS in many textile samples. Clothing could be an important source of chemical exposure through skin contact."
Most likely, only a small amount of forever chemicals in clothing are absorbed into the body, Calonge noted. Still, considering the risks, many experts believe it's a cause for concern.
What are governments doing about PFAS?
Some local and regional governments have curtailed or eliminated the use of PFAS. Still, there are currently few regulations on forever chemicals in clothing or menstrual products in the U.S. or Europe, according to the American Cancer Society (ACS).
Toxic-Free Future, an environmental research and advocacy organization, tested 60 products, including outdoor apparel, bedding, tablecloths and napkins, to determine PFAS levels. About 35 items contained high levels of fluorine, indicating a high likelihood of PFAS, suggested the 2022 report.
An estimated 75 percent of those 35 products contained long-chain PFAS compounds, which have been banned in the EU and are being phased out in the U.S. due to health risks.
Researchers specifically found PFOA in at least 28 percent of the products.
Federal legislation regulating the use of PFAS has historically focused on older toxic chemicals, such as PFOA, but some new state laws cast a wider net, shared a 2023 report.
California, for example, has moved to end the sale of PFAS-containing clothing from 2025, and Colorado, Maine, Maryland, Minnesota, New York and Vermont have enacted similar legislation.
Earlier this year, the American Apparel and Footwear Association, for the first time, placed PFAS on its Restricted Substances List.
There's also been a recent wave of class-action lawsuits alleging certain brands—including Thinx and REI—marketed their clothing as safe or environmentally sustainable despite toxic levels of PFAS.
What clothing has the highest levels of PFAS?
Research suggests clothing produced by fast fashion brands tends to have higher levels of PFAS than higher-quality garments. That's in part because the synthetic compounds used in their manufacture—including dyes—can be less expensive than toxic-free alternatives.
In recent years, some fast fashion and general goods retailers, including H&M and Lidl, have eliminated PFAS from their clothing, per the Environmental Working Group and Fidra, a Scottish environmental health nonprofit.
Stain- and water-resistant items are also prevalent sources of PFAS in clothing, regardless of price point, quality or material, Mamavation shared.
An estimated 72 percent of these items of clothing contain toxic chemicals, according to a 2022 report from Toxic-Free Future.
Water-resistant clothing
As if high-waisted pants weren't potentially bad enough, now there are new considerations. Rain jackets, boots, gloves, hiking gear, ski gear, yoga pants, sports bras, period underwear and leggings are all examples of moisture-resistant clothing that may contain toxic chemicals.
Often, PFAS—specifically side-chain fluorinated polymers—are used as a moisture-wicking coating. They can also form a membrane or thin layer of fabric that prevents moisture absorption.
"Historically, Gore-Tex was one of the primary sources of PFAS and PFOS in waterproof clothing products," Calonge said.
The brand has replaced PFAS with a new PFAS-free membrane, but many other companies continue to use them.
Stain-resistant materials
Stains occur when a fabric absorbs a substance like coffee, ketchup or lipstick, so stain-resistant materials help keep the fabric from absorbing a substance. Most manufacturers accomplish this feat by applying a coating made with PFAS.
One small 2022 study of children's school uniforms found all products labeled "stain-resistant" contained PFAS, often at much higher levels than in water-resistant outdoor gear.
PFAS were found in flight attendants' uniforms—which are typically stain- and wrinkle-resistant—as a cause of severe illness, shared a 2018 Harvard University report.
How do I know if my clothes have PFAS?
"If a textile is water- or stain-resistant, there's a good chance it contains forever chemicals," Deziel said. "Otherwise, it can be tricky—but not impossible—to tell."
Product labels
"If a label lists the presence of chemicals with names that include 'fluoro' or 'perfluoro,' that's one indicator of PFAS," Deziel said.
However, not all labels explicitly state the presence of PFAS and those that do can be misleading, according to a report by the National Resources Defense Council (NRDC). For instance, some items are advertised as PFOA-free, PFOS-free or PFC-free.
These terms refer to specific types of PFAS but don't indicate the item is entirely toxin-free. When in doubt, the NRDC suggests asking the manufacturer if a product contains forever chemicals.
Online resources
Some websites, such as PFAS Central, Fidra, Mamavation and the Environmental Working Group, list PFA-free products, including apparel. The NRDC's apparel scorecard provides a snapshot of what brands and retailers are likelier than others to have PFAS in clothing.
Retailers and manufacturers committed to producing PFAS-free products may also state this on their websites.
Does washing clothes remove PFAS?
"Forever chemicals are called that for a reason, so it's difficult to remove them," Aragona said. According to Calonge, it's simply impossible.
"Some studies have found that PFAS concentrations in fabrics were significantly reduced after laundering, especially when washed in warm water," Diezel said. "There's just one big caveat."
"Although this could reduce the amount of PFAS potentially absorbed into the wearer's skin, it also means the chemicals released from the material are transported through wastewater into the environment, where they can linger and potentially infiltrate drinking water, soil and more," Diezel said
Use laundry detergents and fabric softeners that don't contain PFAS, as this could diminish the effects of washing, Aragona said.
How can you avoid PFAS?
In the world around us, PFAS contamination is so pervasive that there's no way to eradicate it. However, you can limit your exposure.
"When it comes to finding PFAS-free clothing, natural, untreated materials such as cotton, silk and wool and synthetics such as polyester and nylon tend to be the safest bets," Aragona said.
Also, purchasing higher-quality, longer-lasting items and secondhand products can help to reduce clothing-related PFAS contamination in the environment.
Look for brands that complete product safety compliance through companies such as Bluesign or Oeko-Tex that set restricted substance limits on products based on international regulations such as EU's REACH.
Perhaps more important than clothing, don't forget a potential pathway for PFAS contamination is the source of water you drink.
"To determine if your drinking water is contaminated, contact your water department, local or state health department," Calonge said.
Deziel noted that filters that have activated carbon or use reverse osmosis can effectively reduce your exposure.
"If you live in an area with high PFAS concentrations in the water, you work in manufacturing PFAS, your work involves firefighting foam or some other PFAS-containing product, or you live by a military base where exercises with firefighting foam have taken place, consider asking your care provider about serum testing," Calonge said.
Blood tests are available to detect levels of PFAS. Anything less than 2 nanograms per milliliter (ng/mL) is acceptable, per the CDC. There is the potential for adverse effects between 2 and 20 ng/ML, and anything over 20 ng/ML requires immediate attention.
The bottom line
PFAS are unavoidable, but taking certain precautions can help reduce potential risks.
If you're concerned about how toxic chemical exposure could affect you or your family, talk to your local health department or a doctor to determine the best course of action.
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