Sensitive to fragrance? You’re not alone – but the science is still out – Science

Jacqueline Wilkes can’t stand the smell of air fresheners, perfume, aftershave and scented laundry powder.

“I find these fragrances highly offensive,” she says.

“They make me feel headachy, sick in the stomach and breathless.”

Unfortunately Jacqueline is not the only person in her family with a sensitivity to fragrance.

Her mum Nancy has a lung disease and is on oxygen therapy. Her reactions to scented products are even worse than Jacqueline’s.

“If she comes in contact with people wearing these fragrances, or products with fragrance in them she can be severely ill,” says Jacqueline.

Nancy chokes up, becomes weak and dizzy and gets headaches and sore muscles.

Anxiety about encountering smells keeps Nancy at home a lot, Jacqueline says.

“She’s really cut down on her socialising. It’s quite isolating for her.”

Even the health professionals Nancy sees wear cologne, or use air fresheners and toilet deodorisers.

And because fragrances are naturally volatile, they get around. At home Nancy can be affected not just by scents on visitors, but by wafts of deodorant or laundry powder used by the neighbours.

One in three affected by fragrance?

A survey of people in the US, Australia, UK and Sweden last year reported that as many as 1 in 3 people have ‘fragrance sensitivity’.

The study, by Anne Steinemann from the University of Melbourne, found adverse effects were most often caused by fragrance in products worn by others, in cleaning products, and in air fresheners or deodorisers.

Top of the list of adverse effects were respiratory problems (difficulty breathing, coughing, shortness of breath), mucosal symptoms (e.g. watery or red eyes, nasal congestion, sneezing), migraine headaches, skin problems (e.g. rashes, hives, red skin, tingling skin, dermatitis), and asthma attacks.

And Dr Steinemann found that 9 per cent of people found the effects of fragrance ‘disabling’, causing them to lose workdays or even jobs.

Products like air fresheners and cleaning materials have also been linked to a more serious condition called Multiple Chemical Sensitivity.

What does the science say?

The science is not in yet, says molecular pharmacologist and toxicologist Ian Musgrave of the University of Adelaide.

We know that components of fragrances can, in some people, cause contact dermatitis — a condition that makes skin red or inflamed.

And there have also been a number of studies that have found that perfume triggers migraines and asthma attacks.

But differences in methodologies make it hard to compare findings on the proportion of people affected, says Professor Musgrave.

“Steinemann’s results are plausible, although they may be overestimated.”

And the difficulty is not just in comparing research, but also attributing causality.

That’s because most studies are — like Dr Steinemann’s — based on self-reports by people, who may be mistaken about the cause of their symptoms.

Dr Musgrave says two other studies that have deliberately exposed people to fragrance under controlled experimental conditions suggest there is no link between fragrance and respiratory problems, although these were small studies.

Could something else be involved?

Other experts have suggested there are neurological and even psychological factors playing a role.

Perhaps people come to associate fragrances used to mask other environmental agents that trigger adverse effects, like mould or cigarette smoke, with the reaction, says Dr Musgrave.

“They could then become anxious or triggered by the fragrance even when the mould or cigarette smoke is not present.”

Dr Musgrave says it’s not clear whether the conditions reported in the study by Dr Steinemann were caused by fragrance itself or other possible triggers in the environment.

“Nonetheless, this issue is important to community groups and even if it is not fragrance itself, but other factors (such as triggers concealed by fragrance) more research is needed to ensure that health issues are not being missed,” he says

It’s also a controversial one, with the idea that perfumes poses health hazards listed among the 2011 Top Ten Unfounded Health Scares by a website supported by the hygiene and cosmetics industry.

So, what can you do if you’re affected by fragrances?

Although the science is not yet conclusive, Jacqueline and her mum are not taking any chances.

“There’s no doubt in our minds that fragrance is the culprit,” says Jacqueline.

She’s not convinced we know the full impact of fragrances on health, so she tries to avoid them altogether.

One way to do this is to use unscented products only, which means avoiding those labelled as containing ‘parfum’ or ‘fragrance’

Another way is to use simple products like bicarb soda and vinegar.

If fragrance use by others is the issue, having a conversation with them is a good starting point.

However this can be tricky, as Jacqueline and Nancy found when they complained about fragrant oil sticks used in a physiotherapist’s practice. They were told to go elsewhere!

If you are in the workplace and you can’t solve your problem by talking to colleagues, you could ask your boss to deal with it as an occupational health and safety issue.

This could mean putting some distance between you and someone who is wearing a strong scent, or changing the chemicals used in places like bathrooms.

Some countries even advise workplaces on how to have a “scent-free policy” — although Dr Musgrave says this may not solve the problem if the scent is covering up some other environmental trigger.

Natural versus synthetic scents?

Jacqueline says she focuses on avoiding products containing synthetic fragrance and petrochemicals.

But since the exact ingredients of individual fragrances are not required to be on the label, consumers are a bit in the dark.

So Jacqueline avoids anything labelled ‘parfum’ or ‘fragrance’ and opts instead for essential oils like eucalyptus, lavender and peppermint, which she and her mum find aren’t a problem for them.

But, it is worth noting essential oils can have their own risks.

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