All Hospitals Should Ban Perfumes and Other Scented Products, says Canada’s leading medical journal

Evidence suggests as many as half of all asthma cases are mostly aggravated by artificial scents, and not classic allergens such as dust mites and pollens

Sharon Kirkby, October 5, 2015 

Every hospital in Canada should be required to enact “scent-free policies” discouraging staff, visitors and patients from applying artificially fragranced products to their bodies, Canada’s top medical journal says.

While perfumes, scented deodorant, lotions or creams may help people feel more attractive, “they may result in unintended harm to those who are vulnerable,” particularly people with asthma, or other upper airway or skin sensitivities, the Canadian Medical Association Journal says in an editorial published Monday. “There is little justification for continuing to tolerate artificial scents in our hospitals,” the journal says.

While a growing number of workplaces — including some hospitals — discourage people from wearing perfumed products, it is not de rigueur in all Canadian healthcare institutions, the authors say.

“Hospital environments free from artificial scents should become a uniform policy,” argues the CMAJ — the same journal that, four years ago, published a news article stating scent-free policies were “generally unjustified” and based on “fuzzy and inclusive” science.

It is becoming obvious that some people can be made to feel ill, or even seriously harmed. It’s time to call a stop Dr. Ken Flegel, co-author of the new editorial, says more has been learned in the intervening years about fragrance sensitivity to justify taking precautions in hospitals.

Like second-hand cigarette, smoke, perfume and other strong odours can irritate, and trigger inflammation in, the airways of people with asthma.

According to the Canadian Lung Association, 15 to 20 per cent of the population suffers from asthma, bronchitis, emphysema or other breathing problems, and a third of people with asthma say their disease is made worse by exposure to perfumed products. In addition, Statistics Canada states that, in 2104, 2.4 per cent of Canadians 12 and older — 800,562 people — reported having been diagnosed by a health professional with “multiple chemical sensitivities.” Chemicals in perfumes and other fragranced products can cause health problems such as headaches, dizziness, wheezing, nausea, fatigue, confusion and anxiety. Cancer patients undergoing chemotherapy can also become extremely sensitive to certain scents, according to the University Health Network in Toronto, which has a scent-free policy, posted at the entrances to all four of its hospitals.

Flegel says evidence is emerging that as many as half of all asthma cases are mostly aggravated by artificial scents, and not classic allergens such as dust mites, pollens and pet dander.

“Asthma specialists are becoming aware that they don’t understand the underlying cause of at least half of their asthma cases — they don’t appear to be the classic allergic mechanism,” said Flegel, an internal medicine doctor in Montreal and an associate editor at the CMAJ.

Instead, many may be due to so-called irritant, or toxic asthma, he said. Researchers have identified receptors in the airways that appear to react to “noxious stimuli” such as the chemicals in perfumes and colognes.

The end result, Flegel said, is the same: “You get a big inflammation in your lungs, and it can be much more rapid and instant than it is with the allergic kind” of asthma.

“From a hospital or healthcare perspective, there is no benefit to wearing personal scents — they’re to make one person more attractive to other people, and maybe a specific person, who knows,” Flegel said.

But, “It is becoming obvious that some people can be made to feel ill, or even seriously harmed. It’s time to call a stop.”

He said scent-free or scent-reduction policies should become part of the Canadian hospital accreditation standards. “Like many other things in hospitals, like washing your hands, word gets around and the policy gets adopted with a lot of effort,” Flegel said.

Federal and provincial human rights acts require employers to accommodate workers with scent sensitivities, but not patients in hospitals, Flegel said. “If you walk into a hospital and you meet any old doctor who’s got lots of stuff in his spiky hair and it really smells, there’s nothing you can do about that, and you may need that doctor’s help,” Flegel said.

“Nurses and doctors have to get into patient’s intimate space. We’re the first ones who should be setting the example. You shouldn’t expect a patient with scent asthma who is lying in bed to be nursed by someone who radiates perfume as soon as he or she walks into the room.”

In response to a request from the Post, the Canadian Cosmetic, Toiletry and Fragrance Association referred to its website, which states that several U.S. medical groups “have all rejected MCS (multiple chemical sensitivity) as a legitimate organic disease.”

“It is important to ask whether the majority of Canadians who enjoy scented products should be required to stop using them without credible, medical evidence demonstrating that they post a significant, physical health hazard,” the association says.

All hospitals should ban perfumes and other scented products, says Canada’s leading medical journal