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Background: Disperse dyes are common sensitizers, but are not currently included in the European baseline series., Objectives: To justify the inclusion of a textile dye mix in the European baseline patch test series., Methods: A survey of the reported frequencies of contact allergy to textile dyes and textile dye mixes was performed by searching PubMed (http://www.ncbi.nlm.gov.ludwig.lub.lu.se/pubmed, last accessed 14 December 2014). The results from a multicentre study performed within the European Environmental Contact Dermatitis Research Group (EECDRG) and published in 2014 formed the final basis for the recommendation., Results: The EECDRG study performed in Europe and the United States showed that 2.1-6.9% of consecutively tested dermatitis patients reacted to a 6.6% wt/wt textile dye mix consisting of eight disperse dyes. The clinical relevance was ascertained in >30% of the positive cases. A high frequency of simultaneous sensitivity to Disperse Orange 3 (DO 3) and p-phenylenediamine (PPD) was seen. Active sensitization to the mix was not noted., Conclusions: It is recommended to include a 6.6% textile dye mix consisting of eight disperse dyes in the European baseline series, even though one component, DO 3, may be superfluous, owing to its frequent cross-reactivity with PPD. Removal of DO 3 from the mix would need further study., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

As part of our ongoing mortality surveillance program for the US man-made vitreous fiber (MMVF) industry, we examined mortality from malignant mesothelioma using data from our 1989 follow-up of 3478 rock/slag wool workers and our 1992 follow-up of 32,110 fiberglass workers. A manual search of death certificates for 1011 rock/slag wool workers and 9060 fiberglass workers revealed only 10 death certificates with any mention of the word "mesothelioma." A subsequent review of medical records and pathology specimens for 3 of the 10 workers deemed two deaths as definitely not due to mesothelioma and one as having a 50% chance of being caused by mesothelioma. Two other deaths, for which only medical records were available, were given less than a 50% chance of being due to mesothelioma. Eight of the 10 decedents had potential occupational asbestos exposure inside or outside the MMVF industry. We also estimated the mortality risk from malignant mesothelioma in the cohort using two cause-of-death categorizations that included both malignant and benign coding rubrics. Using the more comprehensive scheme, we observed overall deficits in deaths among the total cohort and fiberglass workers and an overall excess among rock/slag wool workers. The excess in respiratory system cancer is largely a reflection of elevated lung cancer risks that we attributed mainly to confounding by smoking, to exposures outside the MMVF industry to agents such as asbestos, or to one or more of the several co-exposures present in many of the study plants (including asbestos). The second scheme, which focused on pleural mesothelioma in time periods when specific malignant mesothelioma coding rubrics were available, classified only one cohort death as being caused by malignant mesothelioma, compared with 2.19 expected deaths (local county comparison). We conclude that the overall mortality risk from malignant mesothelioma does not seem to be elevated in the US MMVF cohort.

Part I of this study explores whether clothing today contains formaldehyde levels likely to cause contact allergy in formaldehyde-allergic patients. Part II of this study examines whether current reactions to textiles may be due to allergy to textile resins and whether individuals with formaldehyde-related textile allergy will react to the newer low formaldehyde resins used in the textile industry. Part I: free formaldehyde was measured in 16 fabric specimens produced in the US and overseas. Additionally, since the textile industry has moved to the use of newer methods for measuring fabric formaldehyde content, the newer methodology was compared with the older methods used in the medical literature. Part II: 10 subjects with known textile contact allergy were patch tested to available Chemotechnique textile resins and 6 new low-formaldehyde resins used by the textile industry. Part I: 8 fabric specimens yielded no detectable formaldehyde and 7 specimens yielded <200 ppm free formaldehyde, using Schiff's reagent and Merck testing methods. 1 specimen showed approximately 2000 ppm formaldehyde, as measured by the Merck test, but only 24 ppm free formaldehyde when retested by the method described in Japanese Law #112. Part II: all subjects reacted strongly to formaldehyde and DMDHEU (the predominant resin currently used in textiles). 6 subjects reacted to EUMF. 2 subjects had mild reactions to the newer low-formaldehyde resins and 1 to the non-formaldehyde Fixapret NF. Our results suggest that most clothing today yields free formaldehyde levels unlikely to cause contact allergy in formaldehyde-allergic individuals. Japanese method #112 is the recommended methodology to measure free formaldehyde in future studies. DMDHEU may now represent the main cause of textile allergy and may be a better screen than EUMF for this problem. Newer resins yielding fabrics with <75 ppm free formaldehyde may cause occasional reactions, but are more likely to be tolerated by individuals with textile contact allergy. Treatment of these individuals should be directed at identification of reliable sources of garments utilizing these newer resins.

The author describes the discovery of a cluster of cases of interstitial lung disease among employees of a textile manufacturing plant and the difficulties he and his university-hospital occupational medicine team encountered in attempting to identify the cause of the disease. At first accepted in a consultant capacity by the plant's management, the team met increasing resistance to its efforts as it uncovered evidence of a work-related cause of the disease and attempted ientists to communicate findings important to the health of the public, and the physician's overarching professional responsibility to his or her patients.

Cases of textile-related dermatitis reported in the medical literature after the mid-1980s are reviewed. Part I focuses on cases in which textile resins, fiber additives, or fibers were the causal agent. Studies which provide insight into understanding fabric-induced prickle and itch are included.