Breathing the Cost of Fast Fashion: A Review of Airborne Exposures and Respiratory Health Across the Textile Supply Chain

The fashion industry is a recognized source of water and soil pollution, yet its contribution to air quality across the garment lifecycle has received comparatively less attention. Building on prior work linking fast fashion to chemical exposure in textiles to the industry’s sustainability challenges, this review traces airborne exposures and respiratory health from production to disposal. In manufacturing, decades of epidemiolocal evidence document occupational respiratory disease, including byssinosis and lung function decline, driven by cotton dust, volatile organic compounds, and finishing agents, with the burden concentrated in low- and middle-income countries where production has relocated and enforcement is limited. At the disposal end, the open burning of discarded garments releases particulate matter, dioxins, furans, and polycyclic aromatic hydrocarbons, with an estimated 10 to 20 million metric tons of textile waste burned annually across 137 countries, though community-level health outcomes remain largely unquantified. As a result of fast fashion, accelerating production amplifies exposures at both ends. The review maps the available evidence, identifies gaps, most notably the absence of community respiratory data at disposal sites, and examines regulatory frameworks and interventions with demonstrated potential to reduce exposure. Throughout, those most exposed are largely not those wearing the garments.