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By Mary Carpenter
ARTIFICIAL SCENTS are popping up everywhere—in taxis and Ubers, in hotel rooms and lobbies, in new cars, and even at the gym. In humid workout rooms and indoor pools, one person’s fragrant spritz can be overpowering. Scents often drive DC resident B.N. to switch hotel rooms. Most hotels save a few odor-free rooms, B.N. says—though she once had to try four rooms before finding one that was okay. For B.N., a sore throat and headache can be set off by scented environments, by highly perfumed dinner guests and Amtrak riders—and recently by the glove compartment scent-disperser in her 2017 car.
Starting with perfumed clothing, the company ScentAir makes Bloomingdales smell like Baby Powder, Lilac and Coconut—except at Christmas when the scent switches to Sugar Cookie, Chocolate and Evergreen. These are a few of ScentAir’s “over four billion ‘enduring impressions’… Other stinkers include the Westin Hotel and Resorts, Anytime Fitness, Jimmy Choo Shoes, Saks…” according to the blogger Multiple Chemical Survivor.
Many people are not so happy about all these scents. In surveys by University of Melbourne environmental pollutant expert Anne Steinemann, 50% of American respondents preferred workplaces, healthcare facilities and professionals to be fragrance-free; more than one-third were irritated by perfumed products worn by others; and about 20% reported ill-health effects including headaches and breathing difficulties. “Lawsuits under the Americans with Disabilities Act concern involuntary and disabling exposure to fragranced products,” according to Science Daily.
Among all those with chronic health issues, 22% suffer from some degree of chemical intolerance—and more than 6% are “greatly affected,” Claudia Miller, an environmental health doctor at the University of Texas, San Antonio, told Jill Neimark of Discover Magazine.
People who object to being forcibly immersed in strong artificial odors—as well as flowers in especially aromatic arrangements —may be afflicted with “hyperosmia,” increased olfactory acuity or heightened sense of smell.
Steinemann receives hundreds of letters, phone calls and emails from people who report respiratory, dermatological and neurological problems that they attribute to scented products. “Adults pass out around air fresheners,” she says. “Children have seizures after exposure to dryer sheets.”
About 2.5 million Americans have “fragrance allergies,” according to the American Academy of Dermatology—although doctors disagree about whether the reaction is truly allergic or rather sensitivity to an irritant, which causes headaches, sore throats, etc. Scented skincare products are the main cause of “cosmetic contact dermatitis,” with symptoms that range from skin itching and redness to blisters and swelling.
Sufferers of Multi-Chemical Sensitivity (MCS; also called Environmental Illness, and IEI for Idiopathic Environmental Intolerance) can have devastating reactions to environmental toxins—although the American Medical Association, many medical professionals and others don’t recognize MCS as a true medical condition. Not until B.N.’s sister broke out in large red welts over her whole body after visiting a scented ladies room were friends and colleagues convinced she had a serious problem. (Some experts trace chemical sensitivity to a genetic component.)
“Odor cues,” i.e. telltale odors, make chemical sensitivity difficult to document. In “studies where the chemical odor was masked or suppressed by menthol,” according to British allergist Adrian Morris, both study and control groups had similar symptoms.
MCS skeptics charge that the impact on health maybe due more to perception than to actual toxic effects–in which case smell alone would influence the perceived IAQ (indoor air quality) strongly enough to spur physiological responses. Even when four commonly studied “abundant indoor fragrances”—pinene (pine), limonene (citrus), linalool (floral, sometimes spicy) and eugenol (clove)—are present at two- to three-fold below their thresholds for sensory irritation in the eyes and airways, they might be close to or above thresholds for odor detection. In that case, smell alone could influence the perceived IAQ (indoor air quality) enough to spur physiological responses, according to Danish researchers Peder Wolkoff and Gunnar Nielsen.
Skeptics also point out that the pinene blamed for negative health effects is the same odor inhaled from pine trees during “forest walking”—a pleasant experience for almost everyone.
Also affecting the perception of toxicity are psychological conditions, like anxiety, which are capable of inciting physical reactions. On the other hand, the mind is increasingly acknowledged by the medical community to play a valid role in chronic health complaints, such as pain. (In studies where placebos are clearly labeled as such, if doctors explain the important role of the mind in causing symptoms, patients often improve—sometimes even more than they do with mainstream medical treatments.
A single fragrance can contain hundreds of chemicals, some of which react with ozone in ambient air to form dangerous secondary pollutants, including formaldehyde. Testing 25 top-selling products including air fresheners, laundry detergents and lotions, Steinemann and colleagues detected 133 VOCs (volatile organic compounds) including ethanol and acetone, which are often used as carriers for fragrance chemicals.
An initial extreme exposure can cause the “neurological setpoint for sensitivity” to fall —an actual change in brain processing which has become evident only with the latest imagining techniques, according to Claudia Miller. The change sets off what she calls TILT—toxicant-induced loss of tolerance, with toxicant referring to manmade poisons versus toxins, which are naturally occurring poisons such as spider venom. TILT is a “genuinely new class of diseases unique to our toxic, modern times,” according to Miller.
A man whose office had been sprayed with a potent pesticide (an organophosphate now banned for indoor use) first developed what felt like a bad flu and afterwards each encounter with fresh paint, gasoline odors and other chemicals provoked symptoms. Following many moves, he finally settled in a renovated travel trailer with porcelain (inert and non-reactive) tile floors but still often needs to sleep outdoors. Chemical-free housing exists in various forms around the country—such as a settlement near Dallas —but can be impractically remote and expensive.
Dallas’s Environmental Health Center, founded by controversial cardiovascular surgeon and “clinical ecologist” William Rea, attracts patients from around the world with complaints Rea traces to environmental sensitivities. Although charged in 2007 by the Texas Medical Board for using pseudoscientific test methods, failing to make accurate diagnoses and providing “nonsensical” treatments,” Rea continues to be a popular lecturer and was keynote speaker at last year’s Environmental Health Symposium in San Diego.
Ann Lloyd, a 70-something socialite, was sleeping on the beach to avoid toxins until Rea diagnosed her as a “universal reactor” (to almost everything) and suggested she move to Seagoville. She lived there for 10 years, afterwards moving to a secluded island in the Bahamas, and credited MCS for causing her to lead a simpler life—one that kept her young.
—Mary Carpenter regularly reports on topical subjects in health and medicine.