Date Published: March 17, 2018
Publisher: Springer Netherlands
Author(s): Anne Steinemann, Amanda J. Wheeler, Alexander Larcombe.
Exposure to fragranced consumer products, such as air fresheners and cleaning supplies, is associated with adverse health effects such as asthma attacks, breathing difficulties, and migraine headaches. This study investigated the prevalence and types of health problems associated with exposure to fragranced products among asthmatic Australians. Nationally representative cross-sectional data were obtained in June 2016 with an online survey of adult Australians (n = 1098), of which 28.5% were medically diagnosed with asthma or an asthma-like condition. Nationally, 55.6% of asthmatics, and 23.9% of non-asthmatics, report adverse health effects after exposure to fragranced products. Specifically, 24.0% of asthmatics report an asthma attack. Moreover, 18.2% of asthmatics lost workdays or a job in the past year due to fragranced products in the workplace. Over 20% of asthmatics are unable to access public places and restrooms that use air fresheners. Exposure to fragranced products is associated with health problems, some potentially serious, in an estimated 2.2 million asthmatic adult Australians. Asthmatics were proportionately more affected than non-asthmatics (prevalence odds ratio 3.98; 95% confidence interval 3.01–5.24). Most asthmatics would prefer workplaces, healthcare facilities, and environments that are fragrance-free, which could help reduce adverse effects.
Exposure to fragranced consumer products, such as air fresheners, cleaning supplies, laundry detergents, perfumes, household items, and personal care products, has been associated with adverse human health effects (Steinemann 2009). Effects include headaches and migraines (Andress-Rothrock et al. 2010; Silva-Néto et al. 2013), contact dermatitis (Johansen 2003; Rastogi et al. 2007), infant diarrhea and earache (Farrow et al. 2003), reductions in lung and pulmonary function (Dales et al. 2013; Shim and Williams 1986), irritation of the airway mucosa (Elberling et al. 2005), and exacerbation of asthma symptoms (Kumar et al. 1995; Millqvist and Löwhagen 1996; Shim and Williams 1986; Weinberg et al. 2017).
Using an online national population survey, cross-sectional data were obtained on types of exposures to fragranced consumer products, associated effects on health, effects on work and quality of life, awareness of fragranced product ingredients and labeling, and preferences for fragrance-free environments. The survey contained 35 questions (outlined in the Supplementary Material), each on its own page, with multiple choice and open format response categories. Categories of fragranced products evaluated in the survey included air fresheners and deodorizers, personal care products, cleaning supplies, laundry products, household products, and fragrances.
Key findings of this study are that exposure to fragranced products is ubiquitous in Australian society, that it is associated with a range of adverse health effects in 33% of the general population, and that these adverse health outcomes affect asthmatics (55.6%) more than non-asthmatics (23.9%) (POR 3.98; 95% CI 3.01–5.24). Further, in each category of adverse health effect investigated in this study, asthmatics are proportionately more affected than non-asthmatics (Table 2).Table 2Prevalence and types of health problems reported by individuals who experienced adverse health effects associated with exposure to fragranced productsAsthmaticNon-asthmaticPOR (95% CI)Prevalence (n)PercentPrevalence (n)PercentRespiratory problems10633.9779.84.71 (3.38–6.56)Mucosal symptoms8326.5719.03.63 (2.56–5.15)Skin problems5216.6526.62.81 (1.86–4.23)Migraine headaches5316.9577.32.60 (1.74–3.88)Asthma attacks7524.081.030.61 (14.55–64.36)Neurological problems288.9212.73.57 (1.98–6.40)Cognitive problems278.6182.34.02 (2.18–7.42)Gastrointestinal problems216.7151.93.69 (1.88–7.26)Cardiovascular problems216.7121.54.63 (2.25–9.54)Immune system problems247.7121.55.35 (2.64–10.84)Musculoskeletal problems185.8111.44.29 (2.00–9.20)Other51.6162.00.78 (0.28–2.15)Total17455.618823.93.98 (3.01–5.24)
Results revealed that nearly all asthmatics used a fragranced product (99.0%) or were involuntarily exposed to others’ use of fragranced products (92.3%), or both (99.7%), at least once a week. Thus, the potential for exposure is widespread, especially from involuntary exposure. These results are similar to a nationally representative US population study (Steinemann 2016) showing widespread exposure to fragranced products from own use (98.3%), others’ use (92.1%), or both (99.1%) (χ2 = (1, N = 618) = 0.003, p = 0.955).
Results from this study show that voluntary and involuntary exposure to fragranced products is widespread in Australian society, that exposure is associated with a range of potentially serious and adverse health effects, and that these effects are more common in people with asthma or an asthma-like condition. In addition to the adverse health consequences, exposure to fragranced products imposes significant adverse impacts on workplace productivity and quality of life, including the ability to access public places such as restrooms. A straightforward approach to reduce undesirable effects would be to reduce or avoid use of fragranced products, especially in public places that would impose involuntary risks, and to implement fragrance-free policies in workplaces, healthcare facilities, and other environments.