Contact allergies from clothing textiles - is there a cause for growing concern?

Allergic contact dermatitis (ACD) due to chemicals in textiles and other clothing has recently been declared to be of growing concern in Europe. An Annex XV dossier proposing a generic ban of skin sensitisers in these products under the European Chemicals legislation REACH estimated the prevalence of clothing-related ACD in the general population to be 0.8-1.0%. The present study took a critical look at the data basis, the methodological approach and the assumptions underlying the calculation of the burden of disease in the Annex XV report. The reported incidence and prevalence estimates were compared with those obtained by our own analyses of the evidence from clinical epidemiological data of the Information Network of Departments of Dermatology (IVDK) and from morbidity statistics on medical diagnoses of ACD in Germany. Additional evidence was taken from the outcomes of two study projects that aimed to characterise the causal link between ACD and the presence of chemicals, including dyes, in clothing. Based on this data, a further assessment suggests that the Annex XV restriction report overestimates the prevalence of clothing-related ACD in Europe. Therefore, the risk reduction potential of the proposed generic ban is considered to be much lower than predicted. Critical points of the proposed generic ban of skin sensitisers in textiles include, among others, 'regrettable substitutions' of dyes that have proven themselves in practice through their extensive and decades-long use by alternatives that might exhibit a different hazard profile as well as poorer perspiration fastness and/or versatility.