From the Massachusetts Nurse Newsletter
April 2006 Edition
Common health effects from exposure to synthetic fragrance
According to the Environmental Protection Agency, the following health problems have been associated with fragrance exposure: asthma, Reactive Airway Disease (RADS), difficulty breathing, coughing, fatigue, eye irritation, sinusitis, rhinitis, inflammation of mucous membranes, skin problems including dermatitis, immune system damage, nausea, vomiting, abdominal pain, changes in blood pressure, cancer, and even death in severe cases due to respiratory failure.
Effects on the brain and nervous system include: convulsions, headaches/migraines, depression, dizziness, irritability, confusion, panic attacks, anxiety, memory loss, impaired concentration, drowsiness, insomnia, impaired vision, ataxia, stupor, spaciness, giddiness, slurred speech, twitching muscles, tingling in the limbs, and loss of muscular coordination. 1991 EPA Study by Larry Wallace. “Identification of Polar Volatile Organic Compounds in Consumer Products and Common Microenvironments.”
Fragrance chemicals and their related health problems
Acetone-dryness of the mouth and throat; dizziness, nausea, lack of coordination, slurred speech, drowsiness, and in severe cases coma; it acts primarily as a CNS depressant. Benzene-irritation of the eyes and respiratory system; decrease in white blood cells, headaches. impaired judgment, and menstrual disorders. Phenol-eye, nose, and throat irritation, abdominal pain; cardiac arrhythmias and failure, cardiovascular collapse, chromosomal aberrations and damage; cold sweats, collapse, confusion, headaches, hemolytic anemia, profuse sweating, and ringing in the ear. Toluene-skin, eye, and respiratory irritant, CNS depressant, liver and kidney disorders, and toxic brain dysfunction. Benzyl acetate-skin, eye, respiratory and gastrointestinal irritant, vomiting, diarrhea, tissue damage, and abnormal EEG’s. Limonene-skin and eye irritant and sensitizer; stomach irritant, albumin and blood in urine; and many CNS effects. 1,2
Policy: Knowing that fragrance use significantly compromises indoor air quality and prevents access for some individuals, it is the policy of (name of your health care facility) to restrict the use of fragrance and fragrance products. This policy applies to all who use this facility including staff, patients, and visitors.
Definitions: Fragrance refers to a scent that is perceptible by others. It includes but is not limited to personal caret products such as perfume, cologne, aftershave products, hair care products, soaps, lotions, powders, deodorants; laundry products such as detergents and dryer sheets; cleaning products; and, air “fresheners” that contain fragrance. Fragrance products: any product that contains fragrance or scent.
Procedure: All staff will attend a brief training on the adverse health effects of fragrance. Staff will have an opportunity to share concerns and ask questions.
A pamphlet describing the issue and stating acceptable fragrance free personal care, laundry and cleaning products will be distributed. Health concerns that arise from infractions of the policy are to be directed to health services. Noncompliance issues are to be directed to the appropriate administrator.
Patients and visitors: Patients and visitors will receive a pamphlet explaining the reasons for and how to comply with the fragrance free policy. Signage that reads “Welcome. This is a Fragrance Free Health Care Environment. For the health and comfort of all who use this facility, kindly avoid using fragrance” will be posted at all entrances. Noncompliance issues are to be directed to the appropriate administrator.
Brigham and Women’s Hospital in Boston, all hospitals in Halifax, Nova Scotia and many other health care facilities throughout Canada restrict fragrance use. Other policies that can serve as models are on web sites listed at the end of the article.
(Name of your health care facility) is considering having a policy that reduces the use of fragrance. By answering this short survey, you can help us in this decision.
Staff _______ Patient ______ Visitor_____
1. Do you experience any ill effects from fragrance? Yes ____ No_____
2. If yes, please describe briefly _________________________________________
3. If you are a staff member, has your ability to work ever been affected by fragrance in your work area? Yes ______ No _______
4. If yes, please describe briefly _________________________________________
5. What do you think about a fragrance policy?
Thank you for taking time to help us make your health care facility healthier!
Jane Doe, MD
Director, Health Services
Anderson, R. & J. Anderson. “Acute Toxic Effects of Fragrance Products.” Archives of Environmental Health March-April, 1998. 53 (2), 138-146.
Anderson, R. & J. Anderson. “Toxic Effects of Air Freshener Emissions.” Archives of Environmental Health Nov-Dec, 1997. 52 (6) 433-438.
Anderson, R. & J. Anderson. “Respiratory Toxicity of Fabric Softener Emissions.” Journal of Toxicology and Environmental Health Part A 2000. 60:121-136.
Jackson, N. ANA’s Green Meeting Guide 2004 www.ana.org
Kosta, L. Fragrance and Health 1998. Human Ecology Action League. Atlanta, GA.
Kosta, L. “Fragrance control and health care facilities: An interview with Marlene Freeley, R.N., M.S., Director, Occupational Health Services, Brigham and Women’s Hospital, Boston, Massachusetts.” The Human Ecologist Winter, 2002, 13-17.
Pitts, C. Get A Whiff Of This. 2003. Self published ISBN: 1-4140-0845-7
Pontus, C. Powerpoint Presentation on Fragrance and Health. Massachusetts Nurses Association. Christine Pontus, RN, MS, COHN-S, Associate Director, Massachusetts Nurses Association, firstname.lastname@example.org
Sattler, B. and Jane Lipscomb, eds. Environmental Health and Nursing Practice NY: Springer, 2003