Human health risks from textile chemicals: a critical review of recent evidence (2019-2025)

Global textile production, driven by consumer demand, raises significant concerns about exposure to chemicals in clothing and related products. This review synthesizes evidence (2019-2025) on hazardous substances in textiles, including dyes, plasticizers, per- and polyfluoroalkyl substances (PFAS), and metals, and identifies and categorizes their associated human health risks. Emerging evidence highlights microfibers as critical vectors for chemical exposure via inhalation and dermal routes, necessitating updated risk assessments. Focusing on dermal absorption as the primary exposure route, risks to vulnerable populations (e.g., infants, pregnant women) and gaps in regulatory frameworks are highlighted. The current analysis reveals that chronic exposure to chemical mixtures in textiles remains poorly understood, with current safety assessments often neglecting synergistic effects. Key findings include elevated risks from phthalates in infant clothing, PFAS in water-repellent fabrics, and carcinogenic aromatic amines (AAs) from azo dyes. We underscore the urgency of harmonized global regulations, advanced biomonitoring, and sustainable alternatives (e.g., enzymatic dyes, biodegradable finishes). Public awareness initiatives and stricter enforcement of certifications like OEKO-TEX^® or GOTS are critical to mitigating risks. Interdisciplinary collaboration among textile technologists, toxicologists, and public health experts is essential to develop safer textile alternatives and integrate health-centric approaches into sustainability agendas, safeguarding consumers, workers, and ecosystems.