Sensitivity to (personal) fragrances can be a concern for visitors and patients as well as staff members

By Evelyn I. Bain, M Ed, RN, COHN-S, Associate Director/Coordinator, Occupational Safety and Health Specialist

Note: Betty Bridges is a member of Health Care Without Harm and has worked extensively on education and awareness issues related to exposure to personal fragrances and pesticides.

The following is a note Betty sent to HCWH members while her son was hospitalized following an auto accident. It is reproduced here, with permission, to promote awareness among readers of this newsletter of the frequency of exposure as well as the effects many persons experience when exposed to personal fragrances.

As some of you already know, my 19 year old son was seriously injured in an auto accident on May 16th. This has given me an up close experience with fragrance use and exposure in the hospital setting. My own severe respiratory sensitivity to a specific fragrance chemical makes me acutely aware of the presence of fragrance. Further the chemical I am sensitive to is a known skin sensitizer and can cause skin allergy.

Patient care kits contain scented soap*¹, lotions, shampoo, etc. The body wash, deodorant, baby powder which were not a part of the patient kit, were scented as well*². In ICU, as a rule, the staff did not seem to use perfume or cologne, though some did use scented detergents, deodorants, lotions, shampoos, etc. My son's chart was flagged*³ to indicate no scented products and I provided unscented toiletries.

I helped with his bath one morning before I had an opportunity to obtain unscented products. Dial soap causes me no problems. When I washed his face using the soap, he stated it made his lungs feel funny. He has no sensitivity to fragrance normally. But he had been on the ventilator for 4-5 days and his left lung was bruised in the accident. So scented products can be a problem for those with compromised lung function from injury as well as those with asthma and respiratory diseases.

He was moved to a regular room on Monday. The patient care kits and body wash were the same used as in ICU. Though his chart was still flagged not to use scented products they were in his room and had been used. The unit secretary wore a very strong perfume*⁴. I encountered air freshener being sprayed in the hall to cover odors.

He was moved to spinal rehab on Wednesday. I have not been able to assess the use of fragrance on that floor. The staff I have encountered so far seemed odor neutral.

I do know products to clean floors, surfaces, etc also contain fragrance as they trigger my respiratory symptoms, though they seem to have little inherent odor*⁵. The purpose of the fragrance is probably to mask odors rather than to impart a scent. So even products without a strong odor may still contain fragrance chemicals including skin sensitizers. Products used by staff to wash hands also contained fragrance. There seemed to be several different types. I did not encounter any fragrance emitting devices in any bathrooms that I remember. I do not know if this is hospital wide or just not used in certain areas.

From my experience (Betty Bridges):
*¹Scented products containing known skin sensitizers are routinely used in hospital settings.
*²Patient care items are scented.
*³Flagging a patient's chart does not ensure scented products will not be used on and around the patient.
*⁴Scented products are frequently used by staff on their person.
*⁵Products to clean the environment are scented.