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Welcome to PSR's Environmental Health Policy Institute, where we ask questions -- then we ask the experts to answer them. Join us as physicians, health professionals, and environmental health experts share their ideas, inspiration, and analysis about toxic chemicals and environmental health policy.

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Coughing and headaches at work - The cause may be sitting right next to you

By EvelynI. Bain MEd, RN, COHN-S. FAAOHN

This essay is in response to: What are the health hazards of exposure to fragrances in consumer products and cosmetics? How can our regulatory system effectively address such hazards?

Recognizing irritant chemicals in the air around you

Are you coughing at work? Do you have a headache every day or often at school?  Do others around you mention headaches? Do you hear coughing, but no one appears to be sick? The answer to coughing and headaches at work or in group settings may be sitting close by or walking through your work area. It could be a man or woman wearing personal fragrance, wearing clothing washed in a scented laundry detergent, who has bathed or swabbed in a scented soap or body lotion, or who has just used a cleaning chemical, air “freshener,” or hand sanitizer. These products contain chemicals which are recognized as respiratory and/or neurological irritants, known to cause coughing and headaches, and to trigger asthma attacks.

Personal fragrances (perfumes), scented body lotions, cosmetics, fragranced laundry products, hand sanitizers, and many cleaning products contain formaldehyde, phthalates, and a multitude of chemicals classified as volatile organic compounds (VOCs). Formaldehyde is recognized as a potent respiratory and neurological irritant, capable of causing asthma in susceptible people who are exposed. Phthalates, found in many cosmetics, are recognized as respiratory irritants and disrupt the endocrine system, making the unborn fetus, with its developing reproductive system, particularly vulnerable to exposure through maternal use. VOCs are derived from petroleum products. Acetone, benzyl alcohol, methylene chloride, and ethyl acetate are just a few of the VOCs found in fragrances and perfumed products. VOCs vaporize at room temperature, are inhaled, and quickly pass through the blood-brain barrier, causing headaches. VOCs also settle along the respiratory track and in the lungs, causing coughing and precipitating asthma attacks. These facts explain why when fragrances permeate the air, susceptible people experience health effects.

While walking through a shopping mall, watch and listen to people walking by the stores that sell scented candles and body products. How many cough? Do they know that they are being exposed to respiratory irritants? In the grocery store, listen for coughing in the detergent and cleaning product aisle.

Moving toward fragrance free workplace and community

A few simple steps can help you begin the process of improving air quality and health at work or in the community.

1. When you hear coughing around you or a headache suddenly appears, STOP, SNIFF, AND LOOK AROUND! Try to locate a fragrance source.

2. Think about how often you may be exposed to these respiratory or neurological irritants or notice symptoms of coughing and headaches. Keep a written record.

3. Talk with others to learn how extensive the problem is and begin an awareness campaign.

4. Do a “cough count.” In some facilities, nurses learned about doing a cough count in the presence of environmental cleaning products and other respiratory irritants, such as powdered latex gloves. They wondered who was coughing more: the staff continuously exposed to these products, or the patients with severe respiratory illnesses (patients often cough and have headaches from the scented products and cleaning agents)? They learned that the staff members were often coughing more than the patients, which initiated the campaign to remove powdered latex gloves and other respiratory and neurological irritants from healthcare settings. Latex gloves have gradually disappeared from most facilities. . 

These steps help you to develop awareness for moving to fragrance free environments.

Some employers have recognized the adverse health effects posed by personal fragrance and scented cleaning chemicals. They have developed Fragrance Free Workplace Policies and work to educate their employees on this issue, post signage to reinforce the policies, and include this topic in employee orientation programs and company handbooks.

Here’s an example of such signage, this one used by the Massachusetts Nurses Association: “Men and women are asked to refrain from wearing scented personal products when working or visiting in this workplace.”

In truth, enforcement of these policies is a difficult task, but awareness and education go a long way toward reducing or eliminating the use of these products and in turn improve the health of all. At work and in community and educational settings, networking and coalition building can move the issue of a Fragrance Free Environment forward and reduce adverse health events in those affected.

There are many useful resources in a quest to improve air quality where you work, learn, or gather with your neighbors:         

Health Care Without Harm, Risks to Asthma Posed by IndoorHealth Care Environments, Autumn 2006, University of Massachusetts, Lowell, MA, accessed 10/08/2011

Houlihan, Jane, Brody, Charlotte, Schwan, Bryony, Environmental Working Group,  Not Too Pretty, Beauty Products and the FDA   Copyright,  July 2002 by. All rights reserved. Accessed 10/08/2011

New York State, Department of Health. Volatile Organic Compounds (VOD’s) in Commonly Used Products, Revised, February, 2011, accessed 10/07/2011

Environmental Working Group, Girl, Disrupted: HormoneDisruptors and Women’s Reproductive Health, accessed 10/08/2011

Massachusetts Nurses Association, Work Related Asthma in Nurses and Their Co-Workers: available at www.massnurses.org, click on On-Line CE, accessed 10/07/2011

Massachusetts Nurses Association, Model Language for aFragrance Free Policy, accessed 10/08/2011

Comments

Amy Cochran said ..

I am so grateful that the public is becoming aware of this. I'm fighting the complacency of people who don't care because it doesn't affect THEM personally, and they like the smell. Little do they know the dangers in the nice smells that mask the formaldehyde and other carcinogens that may one day affect their health or those of their loved ones.

November 20, 2011
Joy Jaber said ..

I think fragrances should be banned in public places, the same way smoking is in most places. Particularly places like airlines and theaters, where you are confined close to other people and can't escape their toxic smells. Air "fresheners" also need to go in public bathrooms to make them more accessible to people with fragrance sensitivities (a growing percentage of the population).

November 14, 2011
Richard Weiskopf said ..

This is very informative. The public needs a lot more education on this, and this is a good start. Thank you

November 7, 2011
Liberty G said ..

Thanks, Evie, for pointing this out. I was actually forced to leave a job some years back because a new co-worker made me so ill with her per-fumes!

November 5, 2011
Claudia Crane RN said ..

Glad to hear the MNA is in the forefront on this. (I grew up in Framingham, now live in Philly). I have very reactive airway, and have succeeded in getting my church to stop using incense. Fragrances are just part of the spectrum of VOC's/aromatic hydrocarbons/particulates we humans inflict on our fellow creatures' lungs every day.

November 4, 2011

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