Fragrances are among the most frequent and potent symptom triggers for people who report developing chemical intolerances following an acute or chronic exposure such as to pesticides or indoor air pollutants. Sometimes specific formulations (air fresheners, fabric softeners, etc.) or brands are especially problematic, with individuals reporting headaches, impaired concentration, confusion, sudden mood changes, fatigue, etc.

Anne Steinemann at the University of Washington and her colleagues recently analyzed 25 top-selling fragranced consumer products. The paper, which can be accessed here, is an eye-opener. Using GC/MS (gas chromatography/mass spectrometry), Steinemann found that these products contain an average of 17 chemicals each, almost all of which do not appear on any label, and many of which are known to be toxic. A single fragrance may contain 100 or more VOCs. This strongly suggests that we need to find unscented alternatives for cleaning our homes, our laundry and ourselves.

Q: Why don’t the names of these chemicals at least appear on the product labels? A: Manufacturers are not required to disclose fragrances in cleaning supplies, air fresheners or laundry products. These are regulated by the Consumer Product Safety Commission. Likewise, the Food and Drug Administration, which regulates personal care products, does not require listing of ingredients used in fragrances, “even though a single “fragrance” in a product can be a mixture of up to several hundred ingredients.” Ms. Emily Sohn, writer for Discovery News, asked me to comment on the significance of this new study. Read the article here.

As an allergist, I know that individuals’ responses to exposures vary widely. The problem is, we can’t know a priori whether or in whom a scent is going to cause nasal congestion, a headache or impair the ability to concentrate-at home, at work, at school or while driving. We do know that a sizable percentage of the population responds adversely to various fragrances and other low-level exposures.

Fortunately, there is something we can do. We can stop buying fragranced products, instead choosing those that are clearly labeled “fragrance-free.” Tell the managers at places you and your family frequent, from the grocery store to restaurants to your child’s school, that you want fragrance-free products used because of the hazardous chemicals found in many fragranced products. There is no way to know how toxic a specific fragranced product may actually be, and as Steinemann found, simply choosing products that are “green” or “natural” is no guarantee of their safety. Fragranced “green” products, she reported, also emitted volatile organic compounds (VOCs) which can irritate the airways and cause multi-system symptoms in susceptible individuals.

Individuals with chemical intolerances can benefit greatly from fragrance-free policies at school or work and from eliminating fragrances at home. Unfortunately, while fragrance-free policies can help protect building occupants and custodial staff from harmful chemicals, one of the greatest sources of fragrances indoors is other people. Many people start off their day by applying a variety of fragranced products, which then volatilize into the air throughout the day. This personal “out-gassing” is worst in the morning, and it can be debilitating for chemically intolerant individuals if they must start their day sitting next to someone at a meeting or in class, inhaling complex mixtures from fabric softeners, personal care products, and cologne.

Fragrance intolerance may be an important sentinel symptom for Toxicant-induced Loss of Tolerance (TILT). There is a close anatomical relationship between the nose and the limbic (mood and memory) part of the brain. People tend to notice when a fragrance that was once loved now makes them feel ill. In my work with Gulf War I veterans, I met a soldier who sent his spouse their favorite fragrance while still he was overseas. After he returned from Iraq, she went to pick him up from the airport wearing that special scent. During the several-hour drive back home, he became so sick that he begged her never to wear it again.

I firmly believe that “Your right to wear fragrance ends at my nose,” a phrase adapted from the days when smoking indoors was still common. But, regardless of who is right, the best strategy when seated next to a heavily fragranced person is to move. It is tiresome to feel you are “on the run,” from invisible vapors of fragrance, but as more people gently explain that fragrance causes headaches, asthma, burning eyes, or nausea, perhaps both policies and personal choices will change.

One woman I know has recently been trying a new approach. When she sits next to individuals who aren’t wearing discernible fragrances, she thanks them, saying, “I want to thank you for not wearing fragrance. I often have to get up and move because other people’s perfume and laundry products can give me a headache.”

It’s a great conversation starter.

Remember: Fresh air is the best air freshener, and the best smell is no smell!