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Background: Enzymes have been safely used in laundry products for many years. The risk of developing adverse responses to enzymes in laundry detergents among consumers in countries where hand laundry predominates is expected to be low., Objectives: To understand how consumers in hand laundry markets used detergent products; to show that use of enzyme-containing detergents did not lead to sensitization in an atopic population with compromised skin; and to show that enzyme detergents did not have an adverse effect on skin condition., Methods: Women in the rural Philippines were chosen since they do hand laundry for several hours a day, every day. The skin prick test (SPT) tested for the presence of IgE antibody to common aeroallergens and to enzymes in detergent product. Atopic women used enzyme-containing laundry bars for hand laundry and personal cleansing. They also used enzyme-containing laundry granules for hand laundry. All subjects were evaluated by SPT with enzymes over 2 years. Hand and body skin conditions were also evaluated., Results: None of the 1,980 subjects screened for eligibility into the 2-year study were SPT positive to enzymes, including 655 women who used enzyme-containing detergent for up to 1 year. None of the subjects in the study developed IgE to the enzymes. Enzymes had no adverse effect on skin condition or on the development of erosions on the hands., Conclusions: The 2-year study confirms that enzymes are safe for use in laundry products at or below levels tested in the study even when used by atopic consumers under extremely harsh conditions.