One morning in a Florida RV park, Tonya Osborne woke up before dawn to drive to the Orlando airport. She was catching a flight to Dallas. It was Nov. 20, 2018, and she had a meeting with Southwest Airlines, where she had worked as a flight attendant for two decades.

But this was no routine trip. Osborne was trying to discover what kind of chemicals were in her uniform – which she says caused her to break out in a rash, irritated her eyes and nose, and left her with scarring. Months after the symptoms first appeared, she underwent two skin biopsies, got a skin patch test, and requested approval for an alternative uniform to the one that was bothering her.

Her dermatologist put it this way, according to a medical form Osborne submitted to Southwest that September: If she "continues to wear the uniform, she will continue to have a severe rash that may reduce her ability to perform her duties.”

Over the last decade, flight attendants at several major airlines have said their uniforms are making them sick. They have reported the issues to labor unions, discussed symptoms among one another in a private Facebook group, and laid out their claims in lawsuits. In New York and Wisconsin, suits are pending against Lands’ End, maker of Delta’s “Passport Plum” uniform. In Illinois, American Airlines faces a proposed class-action suit, brought by flight attendants and pilots, which the company has asked a federal judge to dismiss.

So far, three air carriers have agreed to replace their uniforms, after complaints. American Airlines, which dominates travel at Philadelphia International Airport, started using new uniforms this month for more than 50,000 employees, and Alaska Airlines is rolling out a new uniform collection this year as well. Delta said in January that it, too, will seek a replacement uniform.

Flight attendants at Southwest are also experiencing symptoms they say are linked to uniforms, according to interviews and documents reviewed by The Inquirer. One person was so alarmed about the uniform’s effects on her body that she had a garment tested for heavy metals and toxins by a private lab. Southwest has held at least two meetings for a handful of flight attendants to speak with a toxicologist at corporate headquarters.

The union that represents Southwest’s 17,000 flight attendants says that “hundreds” of its members have reported uniform-related health concerns, including skin reactions, localized swelling, headaches, and difficulty breathing.

Chad Kleibscheidel, a spokesperson for Transport Workers Union Local 556, declined to provide specific figures, but said more people have reported symptoms to the union than to the company directly. He said it’s possible that flight attendants are underreporting the health issues to Southwest, because they fear “being targeted,” worry about missing work, or are daunted by the process of getting an alternative uniform approved.

“There have been hundreds of people who have had an issue or a problem," Kleibscheidel said. "Some flight attendants have moved through the process swiftly and successfully, and others have not, and that poses a problem.”

The union is in the final stages of developing an online reporting system to collect more data from workers on “any issues or problems they may be experiencing,” he said. “Our role as safety professionals begins the moment we put our uniform on,” Kleibscheidel said. “It must be safe for everyone who wears it.”

Osborne had a rash from her uniform after a flight in July 2018.
Courtesy Tonya Osborne
Osborne had a rash from her uniform after a flight in July 2018.

In interviews with nine flight attendants, workers said they had experienced hair loss, rashes, fatigue, and shortness of breath. They also voiced frustrations with Southwest’s response. “We don’t know what’s in the uniform," one employee said, "and they want you to tell them what you’re allergic to” in order to get permission to wear an alternative. Eight of the people spoke on condition of anonymity, citing concerns that they could lose their jobs by talking to the media.

Southwest informed employees in a September 2018 email that the company had all uniform pieces tested, and the results “confirmed that employees are not subject to health hazards when wearing the uniform garments and accessories.”

Osborne continued to press for details about the testing, and was invited to meet with company officials and a doctor in Dallas in November 2018.

Several aspects of the meeting disturbed her. Osborne and two other flight attendants were shown a “pass-fail” chart that listed chemicals, dyes, and allergens, she says. Some items listed on the chart were marked as “fail,” but a company official said not to worry about that, Osborne recalled. She was not allowed to keep a copy of the chart.

“To me, they’re hiding something, if we couldn’t even bring home that sheet,” Osborne says. Company officials have not shared the contents of any broader toxicology report, she says.

According to Osborne, a company executive said that neither Southwest nor the uniform’s maker wanted to lose $11 million on the uniform contract – and Cintas, the supplier, would not offer new pieces until the current stock had been depleted.

In response to detailed questions from The Inquirer, a Southwest spokesperson provided a statement saying that the company regrets that Osborne “experienced issues with her uniform items as the safety and wellbeing of our employees is at the center of everything we do at Southwest Airlines.”

More than 20,000 flight attendants, customer-service agents, and operations agents wear pieces from the collection.

The company “has established programs to provide uniform accommodations – including paying for alternate uniform pieces made of different materials, which can be sourced by the company or selected by the employee from a retailer of their choice,” according to the statement.

Southwest also commissioned a lab to analyze the uniforms “to support employees with any concerns,” and “multiple meetings were held to share the independent lab results with employees," the company said. “Unfortunately, the statements cited from this meeting by other sources contain both mischaracterized comments and comments that are not in context with what was shared during that good-faith effort to provide transparent information.”

Cintas said the test results were assessed by independent professionals, who concluded that the uniform pieces “do not pose a health risk to Southwest employees,” according to a company statement. "Additionally, the test results are entirely consistent with what would be expected if similar off-the-rack retail garments were tested.”

The uniform’s maker said that in a population of thousands, some employees “may be sensitive to certain textiles or materials,” and Cintas is committed to working with the airline to provide alternate uniform pieces to employees “who may have a sensitivity."

Osborne, who’s 62, spent five months going back and forth with the company to find an alternative. Afterward, other medical issues kept her out of work, as well. “They know there’s a problem,” she says, “and they’ve known for a long time.”

Why uniforms cause reactions

Judith Anderson works as an industrial hygienist for the Association of Flight Attendants (AFA), a union that represents 50,000 workers at 20 airlines. Before 2011, she’d never come across anything like physical reactions to uniforms.

But that year, AFA started fielding reports that flight attendants at Alaska Airlines were reacting to their new uniforms. The union has since worked on the issue with flight attendants at American Airlines’ regional carriers and at Delta — systematically collecting reports from workers, having uniforms tested for allergens and irritants, and negotiating for replacement uniforms.

A host of factors could explain why these reactions have surfaced in the last 10 years. One is a demand for “performance fabrics” that are resistant to stains and wrinkles. And with globalization, “there has been a shift to source clothes from multiple mills overseas that don’t have enough quality control to prevent this problem,” Anderson said.

When the garments are shipped, they may be treated with chemicals to prevent mold growth. Then the uniforms are distributed to workers who are required to wear them, all while logging hours in a confined space that can get hot.

On top of that, the United States does not regulate chemicals in clothing, beyond some exceptions about lead in children’s apparel. “Generally speaking, there’s no rules,” Anderson said. “It’s whatever’s cheap.”

When it comes to testing uniforms for chemicals, Anderson said, there are “low hanging fruit” to look for. The AFA’s testing, for instance, has found formaldehyde, a carcinogen, along with sensitizers, which cause allergic reactions, and endocrine disruptors, which can mimic hormones and signal to the body to stop making hormones like estrogen.

But it’s also possible, experts say, that multiple chemicals interact to produce symptoms. Yet there are no U.S. standards to measure the harm of chemicals in combination, let alone how much of any individual chemical in a piece of clothing is safe. The creation of standards has largely been left to private companies.

A recycled polyester label from one of Osborne's Southwest Airlines uniform pieces. (Photo/Willie J. Allen Jr.)
Willie J. Allen Jr.
A recycled polyester label from one of Osborne's Southwest Airlines uniform pieces. (Photo/Willie J. Allen Jr.)

“It’s a very unregulated and un-researched exposure," said Irina Mordukhovich, an epidemiologist who works on Harvard’s Flight Attendant Health Study. "There’s not really a framework for interpreting the laboratory results to begin with.”

The Harvard research group documented a relationship between skin and respiratory reactions and the new uniforms at Alaska Airlines in 2011. Mordukhovich said she’d like to "be able to answer the question of how the chemicals might interact synergistically” — that is with one another, with the aircraft environment, and other conditions, such as whether the person is sweating.

After one Southwest flight attendant started losing her hair, and wondered what else could be happening inside her body, she sent a uniform dress off for lab testing. A toxicologist’s analysis of the results found that the cloth contained benzyl alcohol, a skin and respiratory irritant, as well as “elevated” levels of 14 heavy metals, such as aluminum, chromium, arsenic, mercury, and lead.

“The levels found of these compounds will cause severe allergic reactions to the individual wearing the clothing,” the toxicologist wrote, including “asthma, bronchitis or even chemically-induced pneumonia.”

Graham Peaslee, a physics professor at Notre Dame, has studied toxins such as a fluorinated compounds — or PFAS — in everyday products like fast-food packaging. Recently he has run tests on flight attendant uniforms, and found PFAS, which can be used for stain resistance, as well as metals used as antimicrobials that supposedly keep clothes from smelling.

He has concerns about how such chemicals are affecting flight attendants — and potentially consumers more broadly.

Apparel is "a wide open field. You can put anything you like in it, and everyone is trying to distinguish themselves with something new,” Peaslee said. "And we should probably be double checking that.”

‘I have to work’

In 2016, Southwest announced that Cintas would produce the airline’s first uniform redesign in 20 years. The pieces were rolled out to the workforce in 2017, costing Southwest $25 million, according to the local NBC affiliate in Dallas. (Southwest said it could not confirm a current total cost.) In terms of safety, Sonya Lacore, vice president of inflight operations, told the news station that Southwest assembled its own team "to go over and verify the fabrics” in Asia.

“There are just some people who are allergic to some fabrics, and we’ve ensured that if that is the case with an employee, then we have an option for them to wear 100% cotton,” Lacore said at the time.

By early 2018, Osborne says she started experiencing health problems. That February her cornea tore — she doesn’t know why — and she had migraines and sinus infections. In May, she broke out in a rash and her primary care doctor diagnosed her with hives and prescribed her steroid treatment.

Later that summer, her dermatologist performed the two skin biopsies, and the patch test showed that Osborne had an allergy to a mix of two types of blue dyes.

“I get horrible rashes, blisters and areas that appear and feel burned,” she wrote to the company in her first request for an alternative uniform in September 2018. “I have to work,” she went on. “This is becoming costly due to many doctor visits, days unable to work.”

She pointed out that other people were having symptoms, too. “I would like to see all our [uniform] pieces changed, as I know I’m not the only one with these reactions,” she said on the form.

Two weeks later, Sonya Lacore assured employees that the uniform pieces had been tested, and that flight attendants “are not subject to health hazards,” according to a Sept. 25, 2018, email to employees. “As a reminder,” Lacore said, “if accommodations are required, we have a process in place for providing alternative uniform pieces.”

While Osborne tried to work through that process, she found the company was only offering three pieces — two tops and cargo pants — that stuck out sorely from the regular uniform, and would require alterations to fit her properly.

Osborne also kept asking questions. “I am curious where the testing was done, and what chemicals and dyes were found in them,” she wrote to Lacore and others on Oct. 8. “I do believe further steps need to be taken, because I don’t think anyone realizes how bad the reactions are, and how many of us are having them.”

To avoid using up her sick leave, Osborne paid other flight attendants to pick up her scheduled flights. She spent hundreds of dollars giving away her trips, and was living off her 401(k). She’d gone to live in the RV temporarily, and was still hoping to move out once she got back to work.

Tonya Osborne in the doorway of her RV. (Photo/Willie J. Allen Jr.)
Tonya Osborne in the doorway of her RV. (Photo/Willie J. Allen Jr.)

When the company offered to fly her to Dallas to discuss the uniform testing in person, Osborne didn’t understand why she wouldn’t be paid for a workday, since the issue was tied to her job. “I was told in order to find out what the report shows, I had to have a meeting,” she emailed a manager that October.

The night before the November meeting, Osborne was reading up on chemicals so she’d have a better idea what to ask about. She was also babysitting her 8-year-old grandson. He stayed the night with her and she’d bought a plane ticket for him to fly Dallas, too. At Southwest headquarters, her grandson played a video game outside the glassed-in conference room as the hours-long meeting unfolded.

Osborne, two other flight attendants, and a union representative met with Mike Sims, senior director of inflight operations, along with John Andrus, director of occupational safety, another Southwest official, and a toxicologist who said he was not being paid by the airline.

Osborne had the impression that a thick stack of papers on the table represented the results of the toxicology testing, but the flight attendants were shown only the pass-fail chart, listing components of the uniform. She emailed the union rep afterward that she felt as though “a lot of questions were unanswered or danced around.”

She thought there was more they should have been told "than what was presented to us on that one little card,” Osborne wrote in late November 2018. The toxicologist “never answered what was in the ‘dyes and other stuff’... or allergens, and ‘other allergy stuff.’ ”

During another exchange in the Dallas meeting, Mike Sims said that $11 million remained on the uniform contract, and neither Southwest nor Cintas wanted to lose that money, according to Osborne. Sims also said that the alternative uniform’s pieces were treated with the same chemicals as the regular uniform, Osborne recalled, and he said Southwest was trying to get new alternative pieces made of cotton.

In the meantime, Osborne says, one Southwest official in the meeting suggested that the flight attendants use up their uniform allotment, and give those pieces away to coworkers to deplete the current stock faster. Osborne worried that if she took that advice, she could make her colleagues sick.

When another flight attendant at the meeting suggested the company send a memo, making the workforce more aware of the reactions some were experiencing, the idea was rejected, Osborne says. Sims said that it would create more problems and that not enough flight attendants had complained of symptoms to warrant such a memo.

In the weeks and months after the Dallas meeting, Osborne broke out in a rash after trying on an alternative blouse sent to her by Southwest. Her dermatologist also wrote a letter to Mike Sims in early January 2019, requesting to know what kind of chemicals were in the uniform. Osborne sent a copy of the doctor’s letter to Southwest’s accommodations team, requesting approval for two shirts she’d found on her own. “This has been going on for months and I really need to work,” she wrote.

A coordinator for the accommodations team thanked Osborne for her patience. “We had a meeting with our uniform committee today, and they are currently working on a letter and more in-depth information to send to your health care provider,” the coordinator said in an email.

That letter never came, Osborne says.

Once she received an approval for two other pieces, she still felt apprehensive about being near the uniform at work. She’d run into a colleague in the uniform one day, and Osborne broke into a rash after they hugged. Unrelated to the uniform, she started seeing doctors last spring for problems with her knee and her hand, leading to several surgeries in summer 2019 and last month.

She is stressed about her finances and health issues, still living in the RV and disappointed that a career she loved has come to this.

“I just wish something could happen to make them open their eyes, and realize, you’re not taking care of your employees, you’re taking care of your pocketbook.”