Ruminations

Making Sense of Scents

"There is little justification for continuing to tolerate artificial scents in our hospitals."
"[I]t was thought that they [asthma triggers like second-hand smoke, cleaning agents and scents] were not disease-causing, but rather disease exacerbating."
Drs. Ken Flegel and James G. Martin, Editorial, Canadian Medical Association Journal

"[There] really isn't any strong scientific justification [in support of scent bans]."
"And in those populations [of people who find scents intolerable], we don't really understand what are the drivers of those effects"
"What we found was that people's reactions were completely dependent on how we characterized it [study questions, leading to responses]."
Pamela Dalton, scientist, Monell Chemical Senses Centre, Philadelphia

Concerned doctors, writing in an Oct. 5 editorial in the Canadian Medical Association Journal, called for a perfume and aftershave ban in hospitals. They argued that these artificial scents may lead to “unintended harm” to vulnerable populations, particularly those with asthma or skin sensitivities.
(Photo : Lindsay Wilson | Flickr)

It is a controversial issue. But because so many people claim to suffer the effects of exposure to artificial scents, anyone who is sensitive to the issue is aware of it, and they usually make an effort not to give offence. Some medical centres urge people not to use artificial scents in their premises on the premise that exposure to them causes distress to many people; asthma sufferers, for example.

Roughly a third of people suffering from asthma claim exposure to scents worn by other people has the effect of making their condition much worse. And according to Statistics Canada, in 2014, 2.4 percent of Canadians twelve years of age and up, representing 800,562 individuals, have reported being diagnosed by a health professional with "multiple chemical sensitivities."

If that isn't recognized as conclusive enough, then there is the Canadian Lung Association's assertion that between 15% to 20% of the population suffers from asthma, bronchitis, emphysema or some other breathing problem that compromises their health and their comfort. People sensitive to scent report headaches, dizziness, wheezing, nausea, fatigue, confusion and anxiety.

Patients undergoing chemotherapy as a result of cancer can be extraordinarily sensitive to specific scents, according to the University Health Network in Toronto, which explains their scent-free policy. So it makes sense that the Canadian Medical Association Journal's editorial in their latest edition argues that artificially fragranced personal products be banned in hospitals.

Hospitals, after all, are where people are admitted when their health fails, when they require treatment, and when they are obviously physically and mentally stressed. To be subjected to the fallout from their reactions to artificial scents simply represents another stressor on people whose vulnerability is at a high volume.

It makes good policy to ban scents for that reason alone. Bearing in mind that at one time there were no restrictions in hospitals on people smoking on the premises, anywhere, including in patients' rooms. From a well-proven health standpoint, exposure to carcinogenic nicotine in hospitals represented a fundamental neglect of best health practises; scents now enter that arena albeit with less urgency.

The two Montreal doctors who between them authored the editorial point to scents' potential to cause "unintended harm" to patients with asthma or other upper airway or skin sensitivities. Dr. Dalton, on the other hand, feels that the evidence pointing to the harm that scents represent is based on "fuzzy and inconclusive" science.

She points to a minor study her own team had conducted with asthma suffers. They exposed the study subjects to a pure rose compound held to be innocuous at any concentration. Half of the study subjects were informed that the scent had the potential to make some people feel better while the other half were told it made asthma worse.

The responses from the study subjects aligned perfectly with what they had been told. Those informed the odour was harmful reported more problems with breathing, but more than that, the researchers were able to identify an actual alteration in their inflamed airways, an alteration that clearly resulted from the suggestion; the subjects' apprehension led to a very real physical reaction.

On the other hand, aromatherapy, the use of pleasant scents to bring comfort to people, represents an alternate area of therapy, used in some hospitals as a relaxant. Perhaps in part the issue of avoidance and reaction is one in some instances of auto-suggestion. Which is not to say that such reactions are self-induced and not to be respected.

When someone is ill, or must cope with health conditions that impose restrictions and discomfort and fear in their lives they are due consideration. Banning scents from hospital environments on the basis of that consideration represents no hardship to the wearers of scents, and augers benefits to those who suffer from unwanted exposure to scents.