Air Quality and Accessibility in Health Care; Why Aren’t All Health Care Providers Fragrance-Free?

Can you smoke in a hospital or doctor’s office? No. Why not? Because smoke adversely impacts air quality and our health (despite what the tobacco industry has tried to claim).

So why then are fragrance chemicals still allowed in these environments?

One would think that with so much information about how harmful most fragranced items are, and how easy it is to find fragrance free substitutes, that the health care profession would be the first to embrace fragrance-free, low to no VOC indoor environments for both themselves and all the sick and vulnerable people they serve. This includes children, people with asthma, autism, heart and respiratory diseases, migraines, chemical and environmental “sensitivities”, and others who are prone to having symptoms greatly exacerbated by fragrance chemicals and poor indoor air quality.

We know some fragrance ingredients cause cancer. We know some are endocrine disruptors. Some are even neuro-toxic.  Fragrance chemicals trigger asthma, allergies, migraines, and mild to life threatening symptoms in people. Some of the chemicals have been linked to early puberty in girls, reduced sperm counts in men, reproductive defects in the developing male fetus (when the mother is exposed during pregnancy),  and hormone disruption which leads to some cancers, thyroid disease, obesity, and diabetes. There is also evidence suggesting that exposure to one of the ingredients that make fragrances last longer and stick to everything may cause liver and kidney failure in young children. What more are we waiting for?

Graphics by Roslyn Rodgers, health effects text by Linda Sepp.

Smoking is banned in most public indoor environments due to the harmful effects of breathing in smoke. Fragrances (and many of the products they are added to) are linked to some of the same harmful effects, as well as others mentioned.  Pesticides, cleaning products, air “fresheners”, scented hand sanitizers,  laundry products, and other perfumed and cologne products worn and used by staff not only affect their own mental clarity and job performance, but can leave staff vulnerable to long term health problems, as well as being barriers to access for those who are more sensitive and vulnerable to poor air quality and toxic incitants than others.
According to Statistics Canada’s 2003 National Population Health Survey, the prevalence of doctor-diagnosed multiple chemical sensitivities was 2.4% in people aged twelve or older, and 2.9% in people thirty years of age or older. The 2005 National Survey of the Work and Health of Nurses revealed that 3.6% of all Canadian nurses experienced chemical sensitivities.

In 2010, 8.5% of Canadians aged 12 and older reported that they had been diagnosed with asthma and 6.4% reported that they had diabetes.

In 2009, 4.2% of Canadians aged 35 and older reported that they had been diagnosed with COPD. Smoking is the leading cause of COPD (chronic obstructive pulmonary disease), although exposure to lung irritants such as second-hand smoke, air pollution and chemical fumes can also contribute.

An estimated 186,400 new cases of cancer will be diagnosed in Canada this year and an estimated 75,700 people will die from the malignancy. Thyroid cancer is the most rapidly increasing cancer.

Some places, like the US CDC (Center for Disease Control and Prevention), have instituted good indoor environmental quality policies, banning the use of all fragranced products in their buildings, in order to protect the health of their employees, recognizing the fact that a healthy indoor environment makes a better work environment.

One would hope that hospitals and other health care providers could also recognize this and act accordingly, without each and every individual person who requires a safer indoor environment  having to make a special (and expensive all around) appeal for accommodations via the courts.

This reluctance to change, and the way some health care institutions and “professionals” seem addicted to using harmful fragranced products, makes me think of the ads where doctors were used to sell cigarettes.

Until all health care environments are safe to breathe in,  we need signs that let us know and warn people if entering the premises might cause health problems due to poor indoor air quality. We also need the enforced right to safe health care brought to our homes when it’s not safe for us to go there.

The wheel has already been invented, providing safe health care environments CAN be done. The following are just a few of the resources I found that any health care provider could use to make their environment safer for themselves and everyone who uses their services.

Health Care Without Harm

Health care institutions, like institutions outside the health care sector, regularly use a surprising number of highly toxic materials. These toxins affect patients, hospital staff, and hospital visitors.

Fragrance Free Implementation Kit for Health Care Facilities

National Institute of Building Sciences IEQ Indoor Environmental Quality Project


Practice Greenhealth

Environmental solutions for the healthcare sector and support to create better, safer, greener workplaces and communities.

Canadian Lung Association: Pollution & air quality > Indoor air quality > Scents

Creating Access to Health Care

Not So Sexy: Hidden Chemicals in Perfume and Cologne


Fragranced Consumer Products: Chemicals Emitted, Ingredients Unlisted

  • These 25 products emitted 133 different volatile organic compounds (VOCs), for a collective total of 421 VOCs, and an average of 17 VOCs per product.
  • Nearly one-fourth of these VOCs are classified as toxic or hazardous under federal laws. Each product emitted at least one of these chemicals.
  • Some of these VOCs are classified as probable carcinogens with no safe exposure level, according to the U.S. Environmental Protection Agency.


INDOOR AIR QUALITY: Scented Products Emit a Bouquet of VOCs including some that are classified as toxic or hazardous by federal laws. /

EWG Cleaners Database Hall of Shame

Consumer Products Contain Potentially Harmful Chemicals Not Listed on Labels

Fragrance in the workplace: what managers need to know by C De Vader (2009)

Journal of Management and Marketing Research

” It took decades for the workplace to acknowledge the dangers of smoking and to recognize the deadly effects of exposure to second-hand smoke. Once acknowledged, it was a few more years before the workplace became safe for workers from the dangers of second hand smoke. This paper suggests that fragrance is following the same trajectory”…

14 responses to “Air Quality and Accessibility in Health Care; Why Aren’t All Health Care Providers Fragrance-Free?

  1. Wow! What a fantastic resource.

  2. Here’s an article I just ran across that discusses these issues from a design perspective:

    Healthy Interiors: If These Walls Could Talk

    …”We can’t always see, smell, or hear the presence of chemicals in building materials, furniture, and finishes. One may associate chemicals with cleaning solutions, disinfectants, mercury, and laboratory chemicals, but carcinogens, reproductive toxins, and asthmagens are frequently found in furniture, casework, fabrics, beds, and medical equipment.”…

    “The potential implications can be subtle but significant, including effects ranging from longer patient recovery times to more sick days for staff. The health effects from building materials reach farther than the occupants of the building, stretching into the broader community.4″…

    “In healthcare, building projects typically need to meet many requirements. Even though there is no perfect environmentally preferred solution overall, the four experts agree that the products chosen need to meet a project’s desired aesthetic, provide ergonomic comfort, have acoustic qualities, be durable and stain resistant, support infection control, have inherent antimicrobial properties, and support good indoor air quality—with an approved green maintenance protocol.”

    Janet Brown, EDAC, can be reached at

  3. The Healthier Hospitals Initiative

    Safer Chemicals

    “Every day, patients and workers are exposed to a wide array of chemicals in hospitals and health care facilities. More chemicals are used in health care than in any other sector. Many of these chemicals have been shown to have a lasting negative effect on individual health, public health and the environment.”

  4. Excellent post! I hope you do not mind if I repost. In the U.S., we are so far behind Canada when it comes to dealing with all of this. We need better laws to protect us. Thank you for writing such a wonderful article about how dangerous hospitals and doctors’ offices can be for people who are and can be injured by fragrances!

  5. Perfect timing for the post. My dad goes fragrance free for me, and yet, I just had to tell him to leave my house. He had taken my mom to dialysis. While he waited — a lady a seat over had perfume on — although he had left there 2 1/2 hours ago before coming to my house — I broke out in hives amongst other reactions. That one person not only contaminated their car but my house 30 miles away. If you can’t even safely go to a medical facility where can you go.

  6. Emily Ploegman

    Great info can I use your graphic, I will take it down if you want me to.!about-us/g2ww4

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