Environmental Sensitivities Coalition of Canada

Who is affected by fragrances, quats and VOCs?

32.2% of the population has self-identified as having negative health reactions to fragranced products. Anyone who has a condition on our list of affected disorders could be affected. Additionally, in 2010 the Women’s College Hospital stated 3% of the population – 1.1 million Canadians have been diagnosed with multiple chemical sensitivity. A later study in America in 2018 listed 12.8% of their population had been diagnosed with MCS, which was a jump of 300% since the last report. 3.8 million people have asthma, 2 million have chronic obstructive pulmonary disease, 4.7 million people have migraines, 1.5% of the population have chronic fatigue and 1.4% have fibromyalgia, all of whom can be affected by fragrances.

What are fragrances, quats and VOCs?

Fragrances, scents, quaternary ammonium compounds (quats) and volatile organic compounds (VOCs) sensitivities are types of environmental sensitivities and can occur across many disabilities, chronic illnesses, neurological conditions and episodic health issues. Fragrance chemicals can be inherent or added in products and can be masked by use of other substances. Chemicals in fragrances can be compounded from petrochemicals or include phthalates, which are endocrine disruptors, and benzene derivatives, aldehydes, and toluene. These are known to cause cancer. Volatile organic compounds can be found in chemicals, building materials, essential oils, plants and foods and emit aerosols into the air similar to fragrances. Health Canada warns about the dangers of indoor VOCs. Quats are are cationic surfactants (surface active agents) that combine anti-bacterial and virucidal activity, they are not airborne. In a recent study they were found to disrupt cellular pathways in mice, and scientists are now calling for a review of their safety for humans.

How people respond to these substances

These substances can range from minor irritants, to triggers/precipitants and even cause some conditions depending on type of substance and duration of exposure. People with illnesses such as multiple chemical sensitivity can be affected by low level substances, which might be listed as non-toxic and imperceptible by the general population.

Negative physical responses to fragrances/scents, quats and VOCs include:

How do I avoid these substances and make my space accessible?

Create signage, send emails and post on websites and community announcement areas that your space has a fragrance free, low VOC policy. Request that people entering the space at minimum wear no perfumes, colognes or essential oils and then educate them on the various personal products they use that can contain these substances so they can begin researching alternatives that fit with their lifestyle for use in accessible areas.

If a sensitive person indicates someone is wearing fragrances that are harming them, ask that person to leave if possible and explain the policy. If it is not possible for the person to leave, keep them in an area away from the sensitive individual. Ensure they understand the policy so that future infractions are avoided. Unenforced fragrance free policies are not accessible. 

While Canada advises against using ozone generators in homes, ozone and vaporized hydrogen peroxide sterilization may be helpful in reducing VOCs and fragrances. These must be done by a professional and the space must be aired out and properly vented for a minimum of 48 hours after treatment before people can return. We do not recommend buying ozone machines to treat spaces yourself. The EPA warns against the use of personal ozone based air purifiers for the home. The EPA writes that the level of ozone that home ozone units emit, is not sufficient to remove odours and VOCs. While ozone is effective at treating VOCs in high doses, the level required is harmful to humans. At these doses it can also damage plants, paint, electric wire casings and rubber. If possible, only ozone treat an empty space before you move in. The Washington Post (paraphrasing an ozone treatment specialist) writes, “To prevent damage to the plastic coating on electrical wires, trained technicians run an ozone generator for only two to four hours at a setting that is safe for wiring. Then they leave the house closed for two full days, allowing the ozone molecules to do their work. The technicians air out the space before people and pets move back in.” Should you choose to use professional ozone treatment, be sure to ask potential providers about their methods to ensure your property is not damaged. In addition, as surface off-gassing can create more contaminants, all surfaces should be washed after any treatments.

High humidity causes some household items to off-gas infinitely. One study shows this is especially true of architectural coatings, cleaning agents and moth balls. Use of a dehumidifier lowers the aerosols created by various products that can off-gas. 

Proper air flow and ventilation is necessary to remove offending air and gases and is also helpful in pandemic safety. Running your HVAC system constantly may cost a bit more, but it will keep the air fresh and help people with ES safely access your space. Having a charcoal filter on your HVAC to absorb fragrances and VOCs and changing your filter as indicated by the manufacturer will also help. Use of an UV-C HVAC may break down VOCs, but it is still advisable to add charcoal filtration to all air purification systems for maximum benefit. People who are very sensitive may require an additional air purifier with charcoal filter in the room to help with air quality. Weather permitting, open windows will help ventilation and air flow.

Location of problematic items

Offices and schools

Keep printers, print inks, high VOC art materials and other off-gassing items in a separate closed-off room with proper ventilation. If someone with ES has to use these items as a part of their job or project, run an air purifier in the space.

Stores

If you sell scented products, ensure all scented items are in air tight packages. Open soaps in grocery stores are among the worst offenders for accessibility. 

Locate your scented cleaning products on the opposite side of the building far from the entrance. Create a section for your unscented personal care and cleaning products that is far from your scented items. Do not locate food items near scented products as they can absorb the fragrances. Place an air purifier at the entrance of your scented product section. 

Do not burn candles or incense. These smells permeate all products and often cannot be removed from fabrics. You not only create an inaccessible space, you limit the amount of customers who can purchase items at your store curbside and online.

Safe Products

Baking soda and natural vinegars are the base level of cleaning product most highly sensitive people with ES use in their homes. Some people cannot tolerate vinegar. During the pandemic, unscented soaps and detergents are recommended to clean. Many of our working group members do best with Seventh Generation unscented and Nature Clean unscented products. Nature Clean has the added benefit of being a Canadian company, should you be trying to shop local. We are not affiliated with these companies or any companies that sell these products. 

As twenty seconds of hand washing has been shown to effectively disrupt the protein that envelopes the Covid-19 virus, thoroughly cleaning spaces with unscented soaps is a safe alternative to disinfectants. The CDC even lists cleaning with soap to be sufficient unless someone with Covid-19 has been in the house in the last 24 hours. Health Canada states that there is no proof that hand sanitizers kill the virus, but they can lower transmissions. As all hand sanitizers are not safe for people with ES, we recommend frequent hand washing with unscented hand soaps.

This list of non-toxic products is recommended by CASLE and the Women’s College Hospital Environmental Sensitivities clinic in Toronto, but it has not be updated since 2011.

The Environmental Working Group is a tool to look up ingredients in products to see if they are considered fragrances, but they list an overall letter grade rating of products that does not weigh fragrances, quats and VOCs as a fail for the product. As such, we do not recommend them for product selection. They are funded in part by Beautycounter, Beauty Juice and Dr. Bronner, all of whom make products that contain fragrances and VOCs, so they are not a reliable source of product safety for people with ES. They are also funded by Brown Advisory Group, which is an investment firm which could sway their product recommendations towards products they have invested in. They often are out of date on ingredient listings so be sure to check the label of products to see if they match the database.

Treating fabrics

Use of a wet vacuum system with hot water and unscented soaps can remove offending substances from many fabrics such as carpets and furniture. A mix of natural white vinegar and water using similar methods can also help should the unscented soap not be sufficient. As with rubbers and plastics, heat and UV are very effective methods of off-gassing fabrics. However, some fabrics will retain the offending substance and cannot be treated and must be replaced. This is most common with fabrics that contain synthetic fibres, PVC and other plastics. For clothing and pliable fabrics, many have had success in soaking the item in a mix of water and vinegar, for up to a weeks time then rinsing. Some items take multiple treatments before they are able to be used. 

Healthcare

Dentist offices

A 2008 study in Athen Greece found twenty times the recommended level of VOCs in the air, largely from surface and tool disinfectants being used. They  tried different types of natural ventilation in order to examine their effect on the air quality, and found that  double cross-ventilation was the most effective. A high quality air purifier in each room and an open window is recommended. In rooms without windows, two air purification systems should be used to create cross ventilation. 

Dental staff should wear fitted carbon filtered masks while performing all disinfecting, mixing of substances and vapour inducing processes. Patients should not be in the room while any disinfectants are being used and there should be a significant wait after cleaning the area to allow for VOCs to be cleared by air purification systems. 

Product choices should be rethought. In California, they have a 1% VOC maximum limit on products allowed to be used in medical facilities. Unscented soaps should be used in place of surface disinfectants. UV and heat sterilization of tools should be used in place of quat and alcohol disinfectants. Office floors should be cleaned using unscented soaps and detergents. 

Medical facilities and hospitals

VOC hazards to patients and staff in medical facilities are very high. In this 2012 study, they found: “The patient/personal cleaning task using products containing chlorine was associated with elevated levels of personal chloroform and α-pinene exposures. Tasks associated with instrument sterilizing and disinfecting were significantly associated with personal d-limonene and 2-propanol exposures. Surface and floor cleaning and stripping tasks were predominated by housekeepers and floor strippers/waxers, and use of chlorine-, alcohol-, ethanolamine-, and quaternary ammonium compounds-based products was associated with exposures to chloroform, α-pinene, acetone, 2-propanol, or d-limonene.”

All healthcare providers should have high quality carbon filter air purification devices in offices and rooms without proper HVAC systems, especially in rooms without windows. They should use unscented hand soaps before exams, rather than hand sanitizers, which have not been shown to kill the Covid 19 virus.

For tool sterilization, steam, dry heat, plasma gas sterilization, vaporized hydrogen peroxide, ultrasonic and UV-C methods all currently exist. These are all safer choices for staff and patients. We should be moving away from using inaccessible products and investing in these human and environmentally safe options.

UV-C disinfectant systems have been found to be effective at killing ebola, K pneumonia, C diff, MRSA and VRE and have been used with great success at various hospitals internationally. They also are used in the nighttime cleaning of laboratories and meat packing facilities. UV-C HVAC systems exist. These systems should be used in all healthcare facilities to enable the use of less harmful products such as unscented soaps and detergents for a healthy safe full sanitization process that eradicates microbes and is accessible to staff and patients. This 2019 study found that the combination of UV-C and surface cleaning yielded the best results. The ESCC would like to see local testing within Canada of this process beginning with MCS/ES safe patient rooms in every hospital that only use these two methods. 

Currently hospitals are not accessible to patients with ES who react to fragrance, quats and VOCs. If the disinfectants which cause the bulk of the issues were no longer used, no additional protocols would be needed. As is, hospitals should have a process in place and ‘safe’ rooms where no offending products are used and proper air purification exists. Otherwise, they are not providing equal access to healthcare and failing to live up to the Accessible Canada Act.