Archive for the ‘Fragrances’ Category.

Asking Safeway: Who Will Mind the Store?

Yesterday, I gladly joined the Safer Chemicals, Healthy Families campaign to ask retailers to do a far better job of screening their products for hazardous chemicals. The group has developed a list of 100 plus chemicals identified by scientists or regulators as hazardous, including such substances as triclosan, which was featured in the recent Dateline piece, and parabens.

Photo of Laura MacCleery

Guest blogger Laura MacCleery, pictured with Safeway manager David, writes about the “Mind the Store” campaign to persuade retailers to get tough on toxic products. Laura is a lawyer, mother and self-described “squeaky wheel in search of a spoke.” She writes commentary at Laura’s Rules. Her post first appeared there in April.

Before work, I ventured out with my friend, Molly Rauch of Moms Clean Air Force, who writes about our visit eloquently here, to check out products and deliver a letter to the local Silver Spring, Md., Safeway store manager, to make the case that people in their own community care about getting rid of toxics. When we got to the store, we perused the aisles, looking at labels with their tiny print, and trying to figure what, exactly, was in what.

We had a hard time with many product categories — cleaning products, for example, don’t actually have to say what’s in them. For example, here’s one that is clear as mud:

Yet all the overwhelming smells of the fragrances and perfumes (that could be harmful pthalates, as Dateline explained) in that aisle actually made me a bit dizzy.

We did find some products with triclosan, clearly labeled, including the Hello Kitty hand soap Dateline identified — which is particularly upsetting given its cutesy child-appeal marketing — as well Dial Complete, another cleanser, which (dubiously) promises a “Healthier You.”

In addition, through careful scouring, we were able to spot some products with parabens in them, including this antacid called “DiGel:”

It was difficult, even with a list of chemicals, to decipher everything. Molly put it well in her great post:

We felt lost in a thicket of chemical names, tiny fonts on tiny labels, and terms we didn’t understand.

And we were aware that we weren’t able at all to figure out packaging concerns like the Bisphenol-A (a chemical which acts like hormones in the body and has been linked to numerous damaging health impacts) that is in most can linings and on receipts.

After wandering the aisles for half an hour with our brows deeply furrowed, Molly and I approached the store manager to present a letter asking Safeway to do this kind of work on behalf of consumers. The letter was an invitation for retailers to get ahead of the consumer wave that I truly believe is coming — which will demand that products we use in our everyday lives not damage our health.

Retailers — who have everything to lose when customers vote with their feet — also have tremendous power over what they sell. They could be major drivers for change, if they saw it as part of their job. So our job is to make them see the appeal of changes that would drive their supply chains to do better — not just for products with niche appeal to organo-Moms like me, but for all the millions of Moms, Dads and others who don’t compulsively read labels on everything they buy and really shouldn’t have to.

David, the store manager, was welcoming about our message and received our letter and the list of 100+ hazards with warmth, promising to pass it along. He even let us take a picture, which spoke volumes for the people managing retail stores like Safeway, who want an authentic connection to their communities and customers. There would truly be nothing better than if a retailer like Safeway were to take this letter seriously and work through its supply chain to remove these toxic chemicals from its stores.

This action was fun, easy and made me happier all day long. Even if you don’t have a great partner like Molly, it’s easier than you think to speak a little truth to power while you are shopping. So go to the campaign website and register, then empower yourself to be bold, friendly and clear about your priorities next time you go to pick up groceries — it only takes two minutes to let the store manager know where you stand and what matters to you.

And let us know how the conversation goes with tweets and posts! I’ve been very inspired by the other mom bloggers and activists who’ve joined in the campaign:

See you out there!

Hospitals Need a ‘No-Fragrance’ Rule

My 85-year-old mother recently had to go to the hospital emergency room for a subdural hematoma. She’s very sensitive to fragrances. Members of her bridge club and singing group know this and respect her wish for no fragrances. Otherwise her eyes and nose water, she gets headaches and has difficulty breathing.

Hospital personnel wheel gurney

Hospitals need to enforce rules because fragrances can aggravate the conditions of patients. Photo: U.S. Navy.

At the ER, a nurse who was very friendly smelled so strongly that I asked him not to come close. It was the beginning of the shift. He apologized and washed it off, thankfully, but he needed to hear this from a patient’s mother who is also a doctor! I do plan to contact the director of nursing services.

People who are pregnant, get migraines or other headaches, or have asthma often need to avoid fragrances. Many hospital staff members themselves are very sensitive because they have been previously TILTed.

– Related Post: How to Thank People Who Wear No Fragrances

TILT is short for Toxicant-induced Loss of Tolerance. It affects people who have repeated low-level exposures, such as in a “sick building,” or a one-time, high-level exposure such as a chemical spill or pesticide application. TILT can cause chemical intolerances that impair a person’s health, ability to work or go to school, and other everyday activities. There’s a widely accepted screening instrument to help identify TILT, called the QEESI, or Quick Environmental Exposure and Sensitivity Inventory. It’s free to download.

Hospital staff members need to avoid wearing fragrances. This is important because patients may be unable to speak for themselves. Even worse, fragrances may precipitate vomiting in chemotherapy patients whose treatments cause nausea. And there’s certainly a need for a no-fragrance rule around newborns, babies or children, and in the intensive-care or critical-care units.

Fragrance policies for the health-care industry are emerging. Some examples:

  • The Centers for Disease Control has issued a policy governing its installations.
  • A Canadian organization, Bryant Community Healthcare System, for example, applies a policy for both employees and patients.
  • And the Massachusetts Nursing Association published an excellent article as far back as 2006 explaining the value and way of setting up such a policy.

I don’t recall fragrances being such a problem when I was a medical student in the 1980s. Then it was tobacco smoke — first hand, second hand and third hand — and smoke retained in patients’ clothing and on their breath. We medical students would stand as far away as possible from these patients when we told them to take a deep breath and exhale. Now people come in the hospital and leave “vapor trails” of fragrances behind them — in elevators, corridors and stairwells.

Fortunately for my mother, I’m a professor and assistant dean for the dual degree MD/MPH program at the UT School of Medicine, which is directly across the street from the hospital. I’ve published many papers, books, and a screening questionnaire for assessing chemical intolerance, but not everyone knows this.

Before I left her bedside last night, she asked for a stack of my business cards so she could pass them around.

How to Say ‘It’s OK to Not Wear Cologne’

How can people convey to others that it’s OK to not wear cologne? A friend of mine does this very well.

Depending on the setting, she will say something like, “This is going to sound strange, but I want to compliment you on not wearing a lot of cologne or fragrance. I have a terrible allergy to fragrances and sometimes it is really hard for me to find people who I can sit next to without developing a headache.”

The chemicals in fragrances are designed to be perceived by our noses and cause emotional responses — hopefully positive but not for everyone. Some chemically intolerant individuals get angry, irritable, sleepy, or even confused.

The blog Now Smell This published a list of names for new perfumes and colognes. Some are spot on such as Heidi Klum’s “Surprise” and Gucci’s “Guilty.” This is not to mention “Japanese Cherry Blossom,” the perfume involved in a pending disability lawsuit.

The New Fear of Flying: Cabin Air

Flight delays, missed connections, stuffy cabins, narrow seats, screaming children. As if commercial air travel isn’t hard enough, now comes evidence that it could be harmful to your health.

In recent lawsuits and public complaints, dozens of passengers and airline personnel report inflight chemical exposures that triggered serious illnesses. The illnesses are similar to those associated with “Toxicant-induced Lack of Tolerance,” or TILT, a clinical condition that breaks down a person’s natural resistance to chemical compounds.

The Boeing Co. recently settled a suit out of court in Seattle with a former American Airlines flight attendant. She alleged that contaminated cabin air in an MD-82 jetliner caused her to have tremors, memory loss and severe headaches. US Airways pilots and flight attendants have filed a similar suit involving a Boeing 767. They reported headaches, sore throats, eye irritations, dizziness and nausea.

A similar incident in 2011 involving a Lufthansa Airlines jumbo jet came to light in December 2013. The trade publication Aviation Herald said the crew aboard the Airbus A380 detected a “chemical odor of dirty socks” when the plane took off from Frankfurt en route to San Francisco.

One flight attendant reported feeling ill after the incident and has been unable to return to work due to headaches, fatigue, poor concentration and eye irritation, the publication said. Subsequent lab tests on the flight attendant identified exposure to the neurotoxin tricresyl phosphate, an organophosphate used in aviation lubricants, the publication said.

At issue are so-called “fume events” where petroleum smells enter the aircraft cabin. Commercial airliners routinely pump, or “bleed,” compressed air to the cabin from outside. Nearly all airliners use this “bleed-air” ventilation system. The airline industry and government regulators say the system is safe, and has been in use since the 1950s. The industry says the number of reports of illness is minuscule compared to the thousands of people who fly each day.

Critics say bleed-air systems draw a substantial amount of air past the engine, thus raising the risk that petroleum fumes can enter the cabin. Loose engine seals and poor aircraft maintenance raise the chances that air can become contaminated on its way to the cabin.

Air travel is difficult for people with chemical intolerances, but until recently no one suspected that taking a flight might trigger illnesses in otherwise healthy people. Finding solutions is urgent because the sheer volume of passenger traffic may leave hundreds of thousands of people exposed and vulnerable to a new sickness.

On any plane, the people most affected by a lack of fresh air usually have asthma, suffer migraines, or are already chemically intolerant. It’s fortunate that the largest amount of fresh air is sent to the flight deck, where the pilot and co-pilot fly the plane. But even pilots and co-pilots have reported illnesses and, in a few cases, even impaired cognitive function.

Even under normal conditions, an air traveler’s “breathing zone” is frequently violated on flights. Some examples:

  • Boarding the plane, passengers sometimes enter a hot plane with little fresh air. Some of them get headaches or have difficulty breathing. Crews often turn off the PAC, or air-conditioning system, to save fuel. My advice: Ask the crew to turn it on.
  • Once seated, passengers encounter unpleasant odors — from perhaps from a cigar smoker seated nearby, those wearing fragrances, or others using nail polish. Again, as a passenger, your breathing zone is violated, and you’re stuck for the duration of the flight.
  • Waiting for takeoff, passengers sometimes breathe exhaust from other planes lined up ahead of them.
  • Also, the fragrance from restroom deodorizers can cause problems. I was on a recent flight and the odor was intense. Putting potent deodorizers in tiny spaces can cause a very high concentration of fragrance. Passengers also carry the fragrance back to their seat. Recommendation: Sit in the middle of the plane. That way fewer passengers will drag their restroom fragrance vapor trails past your aisle.

Facts and narratives about airplane illnesses are becoming more widely known. MSNBC.com reporter Jim Gold has written an excellent article about the situation.

Passengers may have few defenses, but scientists are working to minimize exposures aboard airplanes. In his article, Gold describes efforts to develop a biomarker for TCPs, or tricresyl phosphates, one of the suspected contaminants in fume events. One key researcher, Dr. Clement Furlong of the University of Washington, said the goal is to better understand the chemistry of the incidents so refiners can develop less-toxic engine fluids. This might improve the bleed-air system, or at least minimize its potential risks to health.

TCP is the cause of numerous poisonings and is a neurotoxin, in part via organophosphate-induced delayed neuropathy. It has been responsible for many deaths. The most serious incidents occurred in the 1920s when TCP was used to adulterate Jamaica Ginger, and in Morocco in 1959 when cooking oil was adulterated with jet-engine lubricant containing TCP.

TCP’s mechanism of action is similar to other organophosphates in that it can inhibit the enzyme acetylcholinesterase, leading to a buildup of acetylcholine in the synaptic space. This can lead to hyperactivity in cholinergic neurons in the brain, and at neuromuscular junctions in the peripheral nervous system resulting in apoptosis of those cell types. This is the reason for paralysis and other irreversible neurological problems seen in the “Gingerjake” syndromes during Prohibition, when TCP was added to gingerjake moonshine.

Dr. Furlong is working to develop a blood test to prove with a biomarker that someone aboard an aircraft during a fume event was exposed to TCPs. A reliable test would dispel the uncertainty now in the air for air travelers.

TCP is one of many substances capable of initiating TILT. However chlorpyrifos, or Dursban, is one of the most common causes. Why has chlorpyrifos initiated so many illnesses? You may want to review a paper I co-authored in the Archives of Environmental Health about initiators. Note mention of TCP on page 121.

Symptoms and health effects of TILT often accumulate over time. People can gauge their sensitivities using the free QEESI questionnaire. It is a clinical tool to evaluate whether someone has TILT or is acquiring intolerances.

Chemical structure of TCP      Chemical structure of chlorpyrifos, or Dursban
Illustrations depict chemical structures of TCP, left, and chlorpyrifos, or Dursban, which is one of the most commonly reported initiators of TILT.

The Best Smell is No Smell

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!