Alden Wicker’s To Dye For is an eye-opening exposé that reveals how our clothing — full of toxins most of us never heard of — may be responsible for a host of medical issues, including cancer, autoimmune diseases, and infertility, among others.

Investigating an industry that is largely unregulated and that is not required to provide ingredient lists (as do foods and beauty products), Wicker creates an engaging and readable account despite the complexity of the subject matter. (A glossary of chemical terms is included.) The average person, she writes, feels “incredulous and confused” upon being told that “each sweater, pair of jeans, socks, or underwear they buy has dozens of different invisible manmade petrochemicals resting quietly on its surface.”

A common reaction is to think, “Chemistry? From fossil fuels? On this cotton T-shirt? Can’t be!” Wicker is here to tell us that it can be, and is. “Chemistry is fashion,” she writes. “Fashion is chemistry.”

The book begins with Wicker, an investigative journalist who specializes in sustainable fashion, being contacted in 2019 about flight attendants who claimed their uniforms were making them sick. The original claims dated back to 2011, when hundreds of Alaska Airlines flight attendants became ill after receiving new uniforms. Over the course of a decade, thousands of flight attendants from three other major airlines “developed rashes, breathing problems, thyroid disease, hair loss, extreme fatigue, and a whole host of debilitating health issues that, in some cases, ruined their lives. And it was all from wearing toxic uniforms.”

Wicker started digging and learned that when the union that represents Alaska Airlines had the uniforms tested, 97 chemical compounds were found, including lead, arsenic, certain restricted disperse dyes known to cause allergic reactions, dimethyl fumarate (an antifungal banned in the European Union), and hexavalent chromium (a carcinogenic heavy metal). Because amounts were below “typical levels that would cause irritation,” nothing was wrong according to the textile industry, which does not take into account any “additive effect.” Since there was no “smoking gun” — no single chemical that was responsible — the airlines were largely unresponsive to complaints, instead blaming the problems on certain employees’ “individual sensitivity.”

After interviewing a number of flight attendants, Wicker started to wonder if their sensitivities to clothing were isolated to their profession or whether they were “just the proverbial canaries in the coal mine” that pointed to a larger problem. She writes:

“The airline attendants are a near-perfect case study because they already operate in a controlled environment with few of the complex variables of an average person’s life. Each airline switched all its attendants into new uniforms simultaneously, and each started receiving complaints not long after from a decent percentage of their attendants. The attendants wear the uniforms for up to twelve hours a day several days in a row and work a set schedule inside near-identical workspaces with few external factors…It’s as close as we’re going to get to a control group — and their exposure levels are high enough, for some, to apparently cause acute and severe illness.”

Wicker then set out to learn “how widespread the acute health issues suffered by the attendants were in the general population. How many people were potentially getting sick from their wardrobes?” The disturbing answer is: a lot, probably more than we can imagine. Take Karly Hiser, a pediatric nurse practitioner in Grand Rapids, Michigan, whose toddler son developed severe eczema that she eventually traced to a sensitivity to his clothing. She started making his clothes from Oeko-Tex-certified fabric purchased from an eco-friendly store and has since gone on to found her own brand of nontoxic children’s clothing.

Then there is Debbie (a pseudonym), of Gloversville, New York, “the erstwhile capital of leather accessories,” where, in the late-19th and into the 20th century, “two million gallons a day of tannery waste, including animal fat and flesh and tanning chemicals, poured directly into the Cayadutta Creek, which changed colors daily according to the dyes used.” Debbie, who played in the colorful water as a child, has been stricken with a number of health issues, including four miscarriages and cervical cancer. Many members of her family also developed various cancers, as well as heart problems, and the community as a whole has high rates of neurological disease, cancer, and respiratory issues.

These are but a couple of the dozens of doctors, parents, researchers, garment workers, fashion professionals, and consumers whom Wicker interviewed in her quest to learn whether our clothes could be making us sick. There is no easy solution. “Fashion products have some of the most complicated and multilayered chemical profiles of any product you or I can buy,” she explains, as “multiple chemical substances are used to manufacture, process, weave, dye, finish, and assemble clothing and accessories.”

At least 40,000 chemicals are used worldwide, “yet only a small percentage of them have been checked for human and animal safety.” What makes tracing the effects of chemicals so difficult is that, in many cases, the exposure is “chronic yet infinitesimally small,” leading to problems without clear causes. In her investigations, Wicker kept seeing the same pattern:

“While a chemical used on a textile might not in itself be dangerous, over time it can break down into its toxic ingredients. So that ingredient — whether it’s formaldehyde in no-iron trousers or an amine in a dyed shirt — might poison garment workers, then contaminate the local community, and then, after a brief sojourn as a harmless performance substance on your fashion, show up again to be breathed in or absorbed by your skin in small amounts, day after day.”

With chapters dedicated to a number of health concerns — endocrine disruptors and fertility, autoimmune diseases, and chemical intolerance (which is poorly understood and is described by a host of terms, including multiple chemical sensitivity, environmental illness, mast cell activation syndrome, and toxicant-induced loss of tolerance) — Wicker shows how the effects of environmental toxins (like those found in our clothing) are potentially more far-reaching and complex than we ever imagined.­­

She concludes her book with a list of practical suggestions both for individual consumers and for larger-scale changes that need to be made to regulate the fashion industry. “You see, what I don’t want to happen as a result of this book is another movement that revolves around guilt-tripping women about their purchasing choices,” Wicker states. “I know that we cannot just shop our way out of this problem.”

Her proposed regulatory changes include implementing tariffs and taxes, requiring chemicals to be registered, expanding the Consumer Product Safety Commission’s reach, banning endocrine disruptors in consumer products, and requiring ingredient lists on fashion products, among others. She concludes with a message of hope:

“If we start tackling this as the interconnected and holistic problem it is, as a war against autoimmune disease, infertility, and chronic poisonings — instead of a series of disparate skirmishes over finishes, dyes, and plastics — I believe we can revolutionize our health, as well as start to reverse the environmental degradation of our planet in the name of fashion.”

In the end, Wicker concedes that many of the links between toxic fashion and health problems are poorly understood and even lie outside of conventional medicine. One doctor she talks to tells her, “I think that you just should be aware that it’s not a conventional view. Maybe that’s why you’re writing a book about it.” Wicke­r leaves us with more questions than answers, but she’s done the important work of paving the way for others to follow.

Early in To Dye For, she mentions Rachel Carson, whose pioneering Silent Spring also challenged the conventional view (and ultimately led to the banning of the pesticide DDT). It is no stretch to imagine that Wicker’s work will galvanize a similar movement to rid ourselves of the toxins that lurk in our clothing.

Yelizaveta P. Renfro is the author of a book of nonfiction, Xylotheque: Essays, and a collection of short stories, A Catalogue of Everything in the World. Her fiction and nonfiction have appeared in Glimmer Train Stories, Creative Nonfiction, North American Review, Colorado Review, Alaska Quarterly Review, South Dakota Review, Witness, Reader's Digest, and elsewhere. She holds an MFA from George Mason University and a Ph.D. from the University of Nebraska.

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