Symptoms of exposure to the chemicals in fragrances vary greatly. Minor problems include eye, nose, and throat irritation; dry, cracking skin; rashes; and mild headaches. Some of the more serious health concerns are migraine headaches, allergies, vertigo, fatigue, nausea, vomiting, blood pressure changes, central and peripheral nervous system changes, and difficulty breathing.

Fragrances in personal care, laundry, and cleaning products are volatile synthetic compounds made from petroleum products and may contain hazardous waste–disposal chemicals such as toluene and ethanol. Other chemicals employed in fragrance manufacturing, such as phthalates (a family of industrial chemicals used to make plastics, like PVC, and solvents), are suspected hormone disrupters. In an article in the Massachusetts Association for the Chemically Injured, Susan Wilburn, a specialist for occupational safety and health for the ANA, wrote that the ANA’s research found that many perfumes contain preservatives as well as pesticides, which are added to fragrances to repel insects.

Even though fragrances in cosmetics come under the jurisdiction of the Food and Drug Administration, they are one of the least regulated substances. Most fragrance chemicals have never been tested for toxicity because the fragrance industry has successfully claimed that ingredients are trade secrets.

The Centers for Disease Control and Prevention recently published the National Report on Human Exposure to Environmental Chemicals, a two-year study reporting on exposure to 116 environmental chemicals—compounds or elements in air, water, food, soil, dust, or other environmental media—that are present in blood and urine. The report found that children and women of childbearing age whose children could be exposed to chemicals in utero have the highest levels of phthalates, pesticides, and other harmful chemicals.

Among health care workers, nurses with allergies, asthma, chemical sensitivity, and fragrance intolerance are a growing subpopulation in need of a fragrance-free work environment. It is important to note that eliminating fragrances in the health care workplace is not only a key step in creating a healthy environment, it may sometimes be a matter of law. Under the Americans with Disabilities Act, a nurse may be able to request accommodation if a major life function is affected. Unfortunately, although a nurse may have a claim under the act, the law is not clear and may not always provide protection. Since no legal ruling exists, nurses must become advocates for a fragrance-free health care workplace on behalf of coworkers, patients, and themselves, following in the footsteps of Brigham & Women's Hospital in Boston, which is one of the few hospitals with a fragrance-free policy.

Follow these tips to achieve a fragrance-free workplace:

• Be informed. Take time to learn the scientific evidence about fragrances and their potential adverse health effects.

• Recognize the challenge. Many people may consider requests to change their preferences in soap, shampoo, cologne or perfume, or laundry detergent a personal affront.

• Expect resistance. People are not going to change just because you want them to, especially if they don't understand why.

• Create a situation focused on productivity. Make it easier for your nursing colleagues and supervisor to appreciate that your job performance and theirs will be enhanced if fragrance chemicals are not in the air.

• Offer product substitutes. Give your colleagues a short list of inexpensive, easily obtainable, and effective fragrance-free personal care, laundry, and cleaning products.

• Be appreciative. When your colleagues carry out your request, take time to thank them. Then work toward a fragrance-free institutional policy.

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